I love home health but I miss my life

Specialties Home Health

Published

I am posting this in the hopes of getting some feedback from seasoned home health nurses.

6 months ago I took a job as a home health nurse. My career previously had been all hospital based. I decided to make the switch because I wanted autonomy, challenge, and a chance to be able to spend more time with patients providing better quality care. I love teaching and that is a big part of home health nursing. I do love the freedom to make my own schedule. I love being able to be totally present while in a visit and not having to answer calls from other patients or the tele room while trying to provide care.

What is not going well is everything else. I have had to give up all hobbies, interests, friendships, and family time in order to complete the work assigned on any given day. We work on a 27 points a week system. I am salaried for 40 hours but I consistently find myself working 12-16 hours 5-7 days a week to complete the documentation. I am determined to find a way to create an efficient work flow that generates quality work in 40 hours a week. Has anyone been able to achieve this in home health? I have not found any other coworkers at the company I am currently at who have any sort of work/life balance. It appears that the work culture thrives on its employees boasting about how many hours they spend working per week. Since this is my first home health position I am unsure whether this is a company problem or a problem unique to home health in general. Any feedback would be greatly appreciated!

I would stick with you current pay system. It honestly take a year to become proficient working in home care but it is possible! I run a busy home care agency and this is the biggest issue with nurses new to home care and I always tell my nurses it takes time! I walked into an agency with a mass nursing turn over and currently have nurses starting to hit their year mark with the company and they have finally got it down!

some tips:

Always call your patients the day before to schedule

Plan your patient education the day before as well!

Complete as much charting in the home as possible!! At least 80%.

Make your physicians phones calls in the home, or in the drive way before you leave the patients house

And get as much Oasis education as possible!!! These tricky questions can take a lot more time if you don't u don't stand them!

Having a salaried position is so much less stressful that having a per visit rate where you ha e no guarantee!

Also make sure that your company pays you for any additional visit you do over your expected productivity! No sense in working overtime if you don't get paid for it

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Wait, you see 7 patients a day and you're only 6 mos in? Is that every day or a fluke?

Our new nurses aren't seeing that many at the 6 month mark. With us, that's a senior nurse average and if PPV, can be very lucrative.

I am 7 months in and see 5-7 a day. 28-30 a week average. That is my choice I could see 36 a week if I wanted. I give a couple pts a day to the LPNS. I have been 6 a day since 2 months in. It's not hard. Takes me from like 830-2. I live in my territory and we have very little traffic in our area. I spend about 45 min a pt (some wound care is more intensive and takes more time) today I saw 5 and did a soc all by 245. That included about 45 min at the office dinking around and sitting in the Starbucks drive thru :) now I am charting my soc and watching dr. Phil while kiddos swim. Wish I didn't have to chart the start I will say that! And yes ppv is very good money if you can get the visits you can't beat it

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Wait, you see 7 patients a day and you're only 6 mos in? Is that every day or a fluke?

Our new nurses aren't seeing that many at the 6 month mark. With us, that's a senior nurse average and if PPV, can be very lucrative.

I responded to this but it's gone so I am sorry if you see it twice. Not sure if you were talking to me or not. I am 7 months in and I see 5-7 a day. By choice. I could see 8-9 a day if I want and some do as we are all PPV. I am not looking to make a million I left icu to spend more time with my kids and for the amazing flexibility! We have no shortage of pts, actually the opposite. We do tho have. Amazing lpns to take the overflow. I would cry without them! If you can average 5-6 a day I would try ppv I am making much more than the high level icu nurse I was.

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I responded to this but it's gone so I am sorry if you see it twice. Not sure if you were talking to me or not. I am 7 months in and I see 5-7 a day. By choice. I could see 8-9 a day if I want and some do as we are all PPV. I am not looking to make a million I left icu to spend more time with my kids and for the amazing flexibility! We have no shortage of pts, actually the opposite. We do tho have. Amazing lpns to take the overflow. I would cry without them! If you can average 5-6 a day I would try ppv I am making much more than the high level icu nurse I was.

That was my set up and it was very good to me. Great job, 100K+ income, 8-9 hrs/day including my commute, connected to my community, working close to where my kids attended school, flex schedule so I never missed anything.

However so many don't go about home health like they should to make it as successful as you and I have had it. People will move heaven and earth to work at a prestigious campus but not for a long term home health job. Home health tends to be plan B, or C,D,E.. and by that time they don't have to flexibility to move and build up their home health career.

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Ya I can't understand why it's plan C or D. It is by far the best job I have ever had. I worked ICU in the big name facility in our area. I was so proud to say what I did and yet hated what I did. But I had made it. Finally couldn't take another day and went to home health. Something I had never even considered. Now I want to beat myself over the head and scream from the roof tops, you don't have to work in the trenches! You can work a job that is so so flexible, you are so appreciated and make amazing money! The only advice I can give is find an agency that works for you and really sit and figure hour how to make home health work. Once you find your routine and get it down you will be amazed at how wonderful it is!

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I have an interview with HH on Monday... Trying to get out of a hospital job that I no longer enjoy... How do I find an agency that works for me???

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Specializes in Pediatrics Retired.
I have an interview with HH on Monday... Trying to get out of a hospital job that I no longer enjoy... How do I find an agency that works for me???

The agency that facilitates your escape is the one that works. You never really know how they are until you're on the inside. If it's the wrong one then you can use it as a stepping stone to move on.

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Hi,

I work home health. I have a routine that I perform: I talk with my patient perform all nursing tasks. I pull out my computer and chart in the home. My only problem is admissions. I am still trying to find that balance of completing all the work in the home or in my car before going to the next patient's house. My co workers have taught me some tricks as well. If you have papers to turn in you write on one copy then make lots of photocopies.

I hope this helps.

Karen Palardy, MSN, RN

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I am a new nurse who's started out in home care 6 months ago as my first RN job. I see up to 8 pts per day and sometimes more depending on how busy the oncall shift is (we get scheduled to be on call once or twice a week on top of our day shift) for a regular shift its PPV and with on call we get a premium. I do feel that it gets too much to handle at times being a new nurse

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I am a new nurse who's started out in home care 6 months ago as my first RN job. I see up to 8 pts per day and sometimes more depending on how busy the oncall shift is (we get scheduled to be on call once or twice a week on top of our day shift) for a regular shift its PPV and with on call we get a premium. I do feel that it gets too much to handle at times being a new nurse

Holy smokes, that is a lot! Do you not work in a state that has strict requirements re new grad orientation?

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Specializes in Med/Surge, Psych, LTC, Home Health.
It appears that the work culture thrives on its employees boasting about how many hours they spend working per week.

I used to work with an occupational therapist in Home Health, who loved to boast about how many hours he worked. It irritated the crap out of me, but looking back that wasn't the only thing that irritated me about this person. :)

Anyway... I worked home health for about 2.5 years and the only time I had any sort of life was when I worked PRN. Full time... I had no life. You really can't work full time for most HH agencies and expect to have much of one.

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Specializes in Home Health,ID/DD, Pediatrics.

I don't have a life and I'm tired of it. I work all day, do as much charting as I can in the home and if I'm able I'll finish in my care right after the visit but unfortunately those days of having the time aren't frequent enough. If you have a bigger territory or are in a high traffic area then that can put a kink in your day, then if you have a territory where the pt's are non-compliant then you will run into more snags which prolong visits and eats into your time. I plan my day in advance, call and confirm my pt's the day before and try to do as much as I can in the home BUT, when you have a wound care pt like a wound vac you really can't do much documentation in the home. Then if your management isn't supportive or they only care about getting visits done i.e. SOC/ROC/picking up extra then your having to constantly try to avoid having extra work piled on which then prolongs your day. I see 6 to 7 pt's per day, anything more then that is too much. It also depends on the pt mix on a day to day basis, there have been days where 5 pt's took me the full day b/c complications etc...

I am where you are, I want a life. I love my job (the pt's, hate the ridiculous amount of charting and the constant additional crap being thrown at us) but the money isn't worth the fact that I have zero family time and no hobbies. I can't even take care of myself. I'm not willing to work so much for very much longer so I'll be thinking about what I want to do. I really believe that very few HH agencies make it to where the nurses aren't worked into the ground. If you find one stay!!! Unfortunately I don't know of many nursing jobs in any area where you can make a good living and have a life and it's getting worse and worse.

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