In Home Nursing

[London Turtle]

In Missouri, we have In Home nursing: Nurse visits that are authorized by Senior Services, funded by Medicaid. The visits are supposed to be maintence type nursing ie: Med set ups, Insulin set ups, VS, Nail care, Labs, Monitor skin condition. We are authorized to go into home 1xW, or 1xM. It is actually a very good program, but many downsides. If we are authorized say, 1xW, and this patient has a med change, and needs help to adjust med tray w/ new RX, were not authorized to go and make that change, but we can do it on our own time or the Agency's time, -if they decide to pay the nurse for the visit. Or, say the Doc suddenly decides he wants labs done, and Wow! you were just in the home yesterday. Now Senior Services has come up with a new plan which sounded so good, but now that we are doing it, we find out we are doing a whole lot of freebie work. They want us to do semi-annnual visits on all our In Home clients. The form we fill out is 5 pages and a med list. Very time consuming, repeating some info 3 times. If we are already in the home for nursing then we fill out this extensive form along with our regular visit report, copy and send to SS, orders to Doc, and original to Agency without any extra compensation. They form may take 30 min to an hour or more to fill out, not to mention just directing all the paperwork to where it's supposed to go. If there's not already nurse visits, and we have only a caregiver in the home, then we actually do get paid for the visit...wonder of wonders. One of the reasons to do these visits is to ensure that the services we offer that client is adequate and reasonable. So when I find the client needs more help, this form goes to SS with request to caseworker for whatever change the client needs. One time I had made a request for a service change, and 3 weeks later when I hadn't heard from the caseworker, I called him to see what was up. And he said "Oh I didn't read the paperwork"

So I'm assuming these mounds of forms will be stockpiling in these client's charts and rarely if ever read. I think Medicaid dreamed up this program to get alot of work done for free. I am not happy. Does any one else do In Home nursing? Is this throughout the US, or just Missouri? Does anyone else have any opinions on this subject. I used to LOVE home health, but it's hard to love your work when you don't get paid for what you do.

[Traveler]

That's not something we have done in Tennessee. We do have Medicaid only patients that need HHA's. The nurse has to go out q14 days for a supervisory only. If we see at that time that there has been a change in condition, we call the pt's MD to see if they will order hh.

[renerian, BSN, RN]

Very sad to say but that is common. Do more with less, do more get paid less as the nurse.............

renerian

[London Turtle]

Very sad to say but that is common. Do more with less, do more get paid less as the nurse.............

renerian

Thanks for your reply, Renerian. It goes on and on....... Would still like to hear from any other nurses who do In Home HH.