Input Wanted! - Efficiency and Time Management in Home Health Nursing

[RN'n'AZ]

Hello fellow nurses! I am a home health RN in Scottsdale, AZ. I have been practicing in this field for about five years now, mostly in management but now have returned to the field. I am a VERY thorough person and do quite a bit of teaching with my patients. We are medicare and therefore have tons of paperwork. I am trying to find ways to be more time efficient as I do about 25-30 visits per week and find myself spending most of the evenings and weekends doing paperwork and care coordination after an 8-10 hour day. My biggest gripe is that I feel like I make most of the effort in care coordination with other disciplines when I feel is should be their responsibility to report to me as a case manager as well when I referred them to the patient. I feel like I am on the phone all of the time. Anyways . . . What ideas have you as a home health nurse found to be helpful in being efficient while still delivering quality of care? Anything is appreciated. Thanks!

[RNRutRO]

One thing that I noticed, for me was do as much of the charting in the home as possible. I find that when I don't do that, I am sitting at the kitchen table do charting on my day off. Sometimes it's impossible, you have a sweet old lady that talks and talks, and you want to devote 100% of attention to her. So, I find that if I sit in the car and "finish" up the note, then I don't have that crabby day of doing notes.

Also, do you hav case conference? THat's a great time to get feedback from the other disciplines on where they are at with your patients. Plus it's a good way for you to know what needs are to be met.

Just a couple of ideas. Let me know what you think.

[RN'n'AZ]

Thank you dearly for your input. That is actually a great idea. Sometimes I find myself stuck with 8-10 visits in a day so it is harder to do that. But I have made it my rule to NOT have that many in a day. When you are casemanaging a load of 40 visits per week the amount of time put in becomes outrageous. So, in answer to your response, yes that helps. :) Since we are all so autonomous in what we do, it would be great to see a thread develop where nurses share their little tricks of the trade. Anything from time management, a valuable piece of knowledge from "that wound that just would not heal!", scheduling visits, helpful ways of managing frequent orders that can become complicated . . . and the list goes on! I love home health but find my head spinning in circles sometimes, feeling like I need to become the patient. Lol!

Also, we do have weekly case conference with our supervisor one-on-one. This is where I do seek clarification on my train wrecks, develop a new plan. This is where I get my head together, at least for a moment. :) Homecare never slows down and is full of fast balls that come from any and every direction. I have learned to just be flexible, resourceful, creative, and enjoy the ride! Woo-hoo! :)