Is home health that bad?

Specialties Home Health

Updated:   Published

I have been interested in home health nurse since starting nursing school. I liked the idea of the freedom of the job and the flexibility that goes with it. You can also travel doing home health. From what I have read, charting takes forever and you are usually not paid to do it?!? You have to put a lot of miles on your car. There is usually not much orientation. Pay rates are pretty low. etc.

Are there any good companies out there? Does anyone love their job? I don't want to make a big mistake by leaving a hard to come by hospital job and end up hating home health.

I agree with SallyCV, I would definitely go with a PRN position. I am looking into home health right now, and slowing leaving LTACH PRN. I work in the hospital setting, long term care, and I am tired of the 12 hour shifts. I would like more freedom and feel like I actually did something good for my patients. I am not sure if I want to go into Home Health through agency or what. However, I went into nursing knowing I could work as much or as little as I wanted. So, I had to go PRN due to the department rotating schedule which I hate! It is so constricting. I want the flexibility to work as much or as little as I want. Who knows, I may want to do Home Health full time. We shall see.

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I love home health but it has changed a lot !!! I am currently working home health and my last pay period (2 weeks) I worked over 106 hours and drove over 700 miles. This sets you up for failure before you even walk out the door to see your first patient. Charting is over the top and I am salaried. Management makes you feel as if there is something wrong with you that you can't keep up on the charting. It's not just me. Not one RN I work with can keep up with the charting. On call is not on call, it's working. I drove 131 miles Saturday to see 4 patients. I have been a nurse for 30 plus years. I have a ton of experience from ER, cardiac, ICU, Infusion RN, chemo certification, OCN etc... and traveled for 5 years. Home Health used to be the "cush" job and had a very low turn over rate. Not true today. The flexibility is all but gone and the push for more is never ending. :-(

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Home Health can be very rewarding. It can be a little intimidating at first getting used to being in someone else's home, but you get to know your clients on a much deeper level. There are challenges as in any other setting but nothing you can't get through.

Good luck!

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All true I'm afraid. I love it but I can't do it full time and I'm done doing it per diem. I can take 4-6 visits of any kind a day but I can get a break when I need it. Can you try per diem so you can see for yourself? A company may be good in terms of culture and financial reward but home care is home care wherever you go. I've watched four very good nurses come and go in the last year alone as well as two supervisors. I hate that the job is presented as eight hours a day. Maybe eight hours minus drive time, phone calls/emails/ order writing/reports to coordinate care. 8 hours if you have six basic, uncomplicated visits within a 0-5 mile radius. Never happened for me. You're told to document as much as you can in the home but you can't document easily or completely because of the environment and/or time factor. How can you document while you assess the patient, change dressings, educate and collect blood specimens?

You finish it for six patients when you get home. Visit pay may be good but that covers chart review, travel time to the lab, wound vacs, PICC line dressing changes, IV drug administration and anyone you have to send to the ED. My low ball hourly was all of the above. Little documentation happened during the visit I think it came out to less than $10/hr when all was said and done.

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My agency just rolled out the new COP - medicare conditions of participation- documentation. It is a nightmare. Plan on spending 2 hours just charting on a new admit after hours. We already met with another software vendor but it was no better. Even a revisit note is tedious- half of note will no longer preload as medicare will not accept cookie cutter notes any longer. Charting in the home is going to be a thing of the past. I used to be able to do the visit and have documentation done before I left. Anyone else having same experience?

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I just saw that you make 1000-1800 a month! Is that correct?

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I am in the same boat. Many years of LTC/Rehab as LPN, now an RN and want to move into HH, very excited! Good Luck!

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Specializes in Infusion.

How is it for an

LPN? What are you doing for patients?

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I see that the last comment was posted July 2018, but I'd like to keep this thread alive, for any nurses out there considering home health. I just started a home health job, and my company is excellent. I love everything about the job... minus the charting. I've done private duty home health before, and I thought that the multiple pages of narrative we were required to do was a lot, but visiting nursing is above and beyond all that. If it weren't for OASIS charting, I would absolutely love this job. OASIS is my nemesis, but I am determined to master it, because, as I said, I love everything else about my job. I love being able to make my own schedule, I love that my company is growing, I love that no matter what time of day or night I can text a question to someone else on the team, and they will answer. I love meeting new people in their homes, on their turf, and I love visiting people who know me because I'm "the visiting nurse." I get to sit down with them, ask them questions, play with their dog or cat, and figure out what's really going on with them. My last job was in a hospital, and while I got to know many "frequent flyers," this is so different. My main job as a visiting nurse is education, with some skilled care here and there, like wound care or infusions, but mainly education so people can manage on their own. Some people desire that education, and other people expect the skilled nurse to act as a home health aide and housekeeper. You can see their faces fall when it's explained what skilled nursing really is. Most people, though, are happy just to have a nurse come to see them 2 times a week and take their vitals, monitor their weight and blood sugar, and give them advice on diets, medications, how to avoid ER visits, etc. I do really love my job. I'm just trying to get along with OASIS - it's like that one coworker you know you need to get along with, but just can't find it within yourself to like.

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Addressing the charting part of home health. I try to do most of my charting in the home as I am speaking to the patients. I do my medicine reconciliation, check for med interactions, document my vitals and assessment questions while I talk to the patients. Then I do the narrative at home or in the car where I can think. Sometimes it is better to finish up in the car at a local drive up restaurant so you are not taking work home. It's not so bad. I find the documentation so much easier than trying to juggle 6 patients at the hospital.

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On 1/31/2020 at 11:29 PM, Krispy Kritter said:

Addressing the charting part of home health. I try to do most of my charting in the home as I am speaking to the patients. I do my medicine reconciliation, check for med interactions, document my vitals and assessment questions while I talk to the patients. Then I do the narrative at home or in the car where I can think. Sometimes it is better to finish up in the car at a local drive up restaurant so you are not taking work home. It's not so bad. I find the documentation so much easier than trying to juggle 6 patients at the hospital.

I totally agree with you about the charting in the home, I find I get a lot more accomplished if I chart while I'm there. But I'm still learning how to do SOC's and I've never been very good at multitasking. I need to learn to listen with one ear and chart at the same time. I tend to get lonely older people who are so happy to have someone to sit and listen to them (which I do love to do) that every time I ask them a medical question, it turns into a long rambling story, and my computer always logs me out because I'm trying not to be rude while they're talking to me, lol. And then I leave and at best I have contact info, vitals, PMH, and other pertinent assessment info scribbled onto my notepad in pen and ink (because at the time it's faster just to write it down), and I go home and transcribe for hours. I know I'll get faster at charting the more I do it, but it's hard to see the light at the end of the OASIS tunnel right now.

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On 5/14/2016 at 3:30 PM, Haddoa said:

I have been in HH 7 short months. I left 6 years of bedside nursing with my last 2 in ICU. I hated the bedside. I knew I was unhappy but didn't realize how unhappy until I left. I love love loove home health. I work under the Amedisys umbrella and have found them wonderful to work for. I feel so lucky to work in the office I do. My bosses are literally the best ladies EVER!! If I had to a complaint it would be call. We do take it two week nights a month and one weekend (with another RN) every 4-8 weeks, so that can suck but with that said I have gotten 0 calls my last 4 weeknights. Weekends are usually busy but as a paid per visit employee I feel we are so well compensated. I make 1000-1800 A MONTH more than I made at the bedside. Best of luck in your choice!

Haddoa..do you still work for Amedisys?

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