Is this legal? Hospice RN required to do Home Health visits

Published

I work at a small home health and hospice company. I applied for and was hired as a RN casemanager for hospice and receive a salary. I have worked there over 5 years and have carried as many as 13 patients seeing them twice a week. I am also expected to take on- call every three weeks for seven days Monday to Monday. Over the last several months, our census has dwiddled downward and i now only have six patients. Our administrator has now informed me that i am expected to also work home health. I have no experience in med surg or home health, i do not want to work home health and feel it will put my license in jeopardy if they force me to agree. Please i need advice quickly

Up Vote Up Vote ×
Specializes in HH, Peds, Rehab, Clinical.

What nursing tasks would they be asking you to do that will put your license in jepordy? I'm confused. Is the REAL issue that they are asking/expecting you to do more and you are unwiling? You're seeing these patients anyway, right? But are unwilling to perform hands on care?

Up Vote Up Vote ×

You should not have problems doing intermittent visits, but if you do not want to do that, then it is time to find another employer. Based on the circumstances you presented, I don't see the employer as being out of line. They are trying to get their work done without having to cut your hours, as well as your pay. If this is unacceptable, they will just find someone who is eager to accommodate them.

Up Vote Up Vote ×
Specializes in Critical Care.

Nursing job descriptions typically leave the duties of the job open ended, including language such "and other duties as assigned", so usually yes, they can add whatever other duties they want to, and if you're salaried then there's not much incentive to add additional duties when other duties decrease.

Up Vote Up Vote ×
Specializes in Med/Surg, Ortho, ASC.

Others would be happy to have your position in today's economy/nurse over-supply. Sounds as if your employer is simply trying to,stay afloat in the face of dwindling patient census.

i do not understand how requiring home health visits would place your license in jeopardy? What are they expecting you to do that is out of the scope of an RN's practice?

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.

How would it not be legal and how would working in HH put your license in jeopardy? Is it because of the hands-on aspect of the job? Sounds to me like they're trying to help you out. I work in ambulatory care but something similar happened to me. The provider I was working with as her nurse left, therefore leaving me as an "extra." The manager went out on a limb and floated me to other clinics so that I could keep my job and I will always be grateful to him for that. I had no experience in pediatrics at all (that is where most of my float time was spent) but being grateful I still had a job, I accepted it and dug right in.

They could easily cut your hours or lay you off until the census goes up again. I would do the HH assignments and be grateful I still have a job.

Up Vote Up Vote ×
Specializes in Hospice / Psych / RNAC.

Home health is no different than treating hospice patients (which you say you've been doing for 5 years). I don't remember ever having 1 hospice patient that didn't require some kind of med-surg intervention; wounds, IVs, drains, catheters, pumps, monitoring, ect... You name it, it's been part of hospice care. Than being a case manager isn't the same as going out in the field. What I don't understand is how you case managed if you don't have knowledge of the procedures? It's often the case manger that gives advice of that type of thing and assigns cases according to each nurses skill level.

Just admit to them you don't know how and request to go out with another nurse and observe for 2 weeks or a month. Take the easy cases at first but your knowledge of wound care and any type of line that can go into a person has to be spot on before you take any cases on your own IMO; and so much more. Perhaps a refresher course.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
i do not want to work home health and feel it will put my license in jeopardy if they force me to agree.
I'll repeat this at the top of my lungs: the "my license is in jeopardy" mantra is outrageously overblown. Nurses generally do not lose their licensure in home health settings since they are managing stable patient populations.

Statistically, most nurses lose their licensure for issues such as intemperate use of alcohol or substances, impairment, drug diversion, theft, failure to comply with the terms of their state's impaired nurses program (IPN), and other problems revolving around addiction.

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.

It may be out of your comfort zone but it's not illegal.

The paperwork/charting should be quite similar. Many hospice patients I've had in the past were previous home health patients.

Up Vote Up Vote ×
Specializes in HH, Peds, Rehab, Clinical.

Chirp, chirp. OP?!

Up Vote Up Vote ×
I'll repeat this at the top of my lungs: the "my license is in jeopardy" mantra is outrageously overblown. Nurses generally do not lose their licensure in home health settings since they are managing stable patient populations.

Statistically, most nurses lose their licensure for issues such as intemperate use of alcohol or substances, impairment, drug diversion, theft, failure to comply with the terms of their state's impaired nurses program (IPN), and other problems revolving around addiction.

Preach it. Preach. It's irksome to say the least to read such histrionics on here so often.

Up Vote Up Vote ×
Specializes in retired LTC.

Asking for a little orientation time to 'brush up' on rusty skills is not too unreasonable. But don't expect them to OK some 6 weeks of training time when their business is having hard times.

Work (no pun intended) with them or look elsewhere if you don't wish to do the more clinical-ly type of nsg.

Up Vote Up Vote ×
+ Join the Discussion