I love home health but I miss my life

[bfit262]

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!

[starmickey03, MSN, RN]

I honestly don't understand how you can't have a life while doing HH, unless of course it's agency specific. I worked in HH from late 2014 to 2015 and will be getting back into it next week because I miss the work/life balance I had with it.

I usually saw between five and seven pts a day. I would start around 9am and be done most days by 3pm. No weekends or holidays and was only on call once every eight weeks. The agency had weekend nurses and swat nurses that would go out after hours so us full time nurses didn't have to worry about that.

I was able to put my children in dance classes and sports. That's not something I could do while working in the hospital because of working every other weekend and during the week I wouldn't be home until 8pm or later. And I loved being able to carve time out of my day to make it to the kids awards assemblies and any other appointments.

Like some others have said, I would do my visit and chart that visit before leaving the home. Sometimes, I'd also do as much of the SOC in the home as I could. And to top it off, HH never stressed me out, not even a little bit.

Oh, and the fact that I could easily make $2,500/week in HH made it that much better.

[Ebart]

If your agency has a program that allows you to take a small tablet into home, you can usually complete at least 50% of your OASIS documentation there, you are probably writing a cheat sheet to document from when you get home, go ahead and check off the answers in the system, depending on your program you may be able to complete even more, this is a Hugh time saver, and will give you a better outlook once you get home , even if only 50% completed.

[Dlowe]

I am going to sound like a total Debbie Downer here but.............I can personal identify with your struggle! I was a HH case manager for 7 years. I hate to tell you that I am currently suffering from burnout related to nearly the exact work load you describe above. Unfortunately I have no tips or helpful hints for you, if I did I would still be working the job I loved! At my agency were not allowed to say NO to an assignment given by management. I have not encountered a case management position that was PPV only salary. We considered them visit nurses at my agency. They could complete the majority of assessments, documentation as case managers with the exception of admits, resumption of cares and discharges. I hope you are able to find a way to make it work for you, I wish I could have. I miss my patients, autonomy and burnout is simply not a place anyone wants to find themselves. 7years was far too long to struggle but I can't say I didn't give it my all.

[Dlowe]

I mean absolutely no disrespect but have you actually worked in the field? or only management? Do you hire nurses with home care experience? The pay was so poor at our agency we had a very difficult time recruiting seasoned nurses. This a tough job for new nurses that need to improve or learn new skills plus critical thinking on your feet in some very difficult situations. All of your suggestions mentioned above are great, I have effectively implemented them myself, however I guess after 7years I just couldn't hack it. At 7years I had the most seniority by 3years..................