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

[deblowe52]

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

[nurse4ever08]

It is not illegal. Home care visits are similar to hospice visits. Wound care, Cath changes, monitor med management. You do the same for hospice. At least I hope you would not ignore a wound in a hospice person

[roser13, ASN, RN]

I wish that OP would come back and respond. I'm thinking there must be more to the story.

[BuckyBadgerRN, ASN, RN]

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

Hey, at least OP is worried that she'll LOSE her license and not LOOSE it. Seriously, my spine gives a little rattle like canastas everytime I read that error on AN

[elkpark]

Hey, at least OP is worried that she'll LOSE her license and not LOOSE it. Seriously, my spine gives a little rattle like canastas everytime I read that error on AN

Be free, little license, be free!!

[tyvin, BSN, RN]

Hey, at least OP is worried that she'll LOSE her license and not LOOSE it. Seriously, my spine gives a little rattle like canastas everytime I read that error on AN

Amen! The lose, loose thing drives me crazy...

[Red Kryptonite]

Hey, at least OP is worried that she'll LOSE her license and not LOOSE it. Seriously, my spine gives a little rattle like canastas everytime I read that error on AN

Did you mean castañets?

[BuckyBadgerRN, ASN, RN]

Did you mean castañets?

Probably

[firstinfamily, RN]

You should have a copy of your job description and if you do not then ask for one. As stated above most nursing job descriptions include the "duties as assigned" clause. It does sound because of the census being low your boss is trying to keep you gainfully employed by putting you in the field while the census is low. If you have never done home health, you should ask for a slight orientation. You most likely had home health experience to get the case management job. The charting for home health is usually done in the OASIS format, you should have some orientation for this as well. If you had a copy of your job description and you signed it when you were hired, you most likely signed a form that said you could be re-assigned as needed. Tyvin: I do not know where you have gotten your information from but rarely do case managers assign patients to nurses, even in home health. Most case managers are usually social workers, occasionally they are RNs, but I have never known any of them to make assignments for Home Health Nurses. The Home Health Nurse is usually assigned a territory to cover and what patients are in that territory are who she follows up with. I would ask how long you are to follow these Home Health patients because usually the Home Health Nurse follows her own patients until discharged from services which could be anywhere from a month to three months or possibly longer.

[tyvin, BSN, RN]

... we seem to be getting away from the subject at hand, but why not since the OP has not responded since they posted.

What up deblowe ... holla back

[NRSKarenRN, BSN, RN]

Moved to our Hospice Nursing forum.

[westieluv]

Well, I work for the same kind of company that the OP works for (in fact, it sounds like she could very well work for my company). I wonder if anyone has considered that OASIS is not used in hospice nursing, at least to my knowledge. I am also a hospice CM, but from what the home health nurses say, OASIS is somewhat of a nightmare to learn and to use. I know that if my company were to suddenly make me start doing home care visits, I would not have a clue about OASIS and it would stress me out immeasurably.

Perhaps I am wrong and someone can clear this up for me, but it does seem that that would be one major difference between home health and hospice that would be very important to the practitioner.

[caliotter3]

Well, I work for the same kind of company that the OP works for (in fact, it sounds like she could very well work for my company). I wonder if anyone has considered that OASIS is not used in hospice nursing, at least to my knowledge. I am also a hospice CM, but from what the home health nurses say, OASIS is somewhat of a nightmare to learn and to use. I know that if my company were to suddenly make me start doing home care visits, I would not have a clue about OASIS and it would stress me out immeasurably.

Perhaps I am wrong and someone can clear this up for me, but it does seem that that would be one major difference between home health and hospice that would be very important to the practitioner.

I suspect she may be reading more into the situation than is required. When I first started doing visits, I was somewhat concerned too. But it was easy to figure out and I was somewhat briefed. You makes plans for the visit based on the goals of the service, and cover that on your visit, and then document accordingly. There have been numerous "how to" posts. Wound care is wound care, patient education is patient education, etc. If she is being sent to the home to do a hands on care visit, rather than a "care manager" type visit, it should be easier. So I can not see what the problem is, or even what she is making it out to be. Perhaps this person just does not want to do any more work than what the limited census calls for in her current job parameters. In that case, she should resign and get a job elsewhere.