Is this normal? Or should I move on?

Posted
by donnydilaudid donnydilaudid (New) New Nurse

Specializes in LTC, med-surg, DD, agency. Has 5 years experience.

Hi y'all, new here, been a lurker for many years.  I'm new to home health; started in early December.  Have 5 years of prior experience in various settings (was staff in LTC, med-surg, and dev disabilities, and have done facility shifts through this particular agency.)  I had one day of ride-along for orientation, asked for more, but was told I'd "be fine, it's simple, you'll catch on."  Was given 5 patients with 12 visits total a week.  When I questioned it, I was told, "We'll have many more by New Years, just hang on until then."  The office schedules the visits and they can be as early as 5 AM or as late as 8 PM - no flexibility on times per the nurse manager.  Visits don't seem to be too technically difficult - lots of wound care and diabetics - and I do like the patients.  Financially, it's been rough.  I'm paid per visit and am not going to last much longer on the paychecks I've been making from them.  The way these visits are scheduled, I can't pick up a facility shift unless I want to end up working 6-7 days a week.  I am told weekly that, "we'll have a bunch of admissions soon and you'll have a full schedule."  That hasn't happened and I'm getting a sinking feeling from the lack of orientation and lack of patients.  Is this normal for home health?  I hate to jump ship on them, but I'm really considering just going back to LTC to have a livable paycheck...thanks for any and all advice/words of wisdom!

dusky1228

dusky1228

96 Posts

I’ve been in Home Health for over 20 years, after many years working in the hospital. This has most definitely not been my experience. We schedule our own patients once they are assigned to us, so they are flexible within the time range as long as you see them as many times as you’re supposed to. If you were part time, you would be paid regardless-but as a per visit nurse, you may be the last one in your agency who is given patients. That may not change. Why not look around for another Home Health position?

donnydilaudid

donnydilaudid

Specializes in LTC, med-surg, DD, agency. Has 5 years experience. 8 Posts

12 minutes ago, dusky1228 said:

I’ve been in Home Health for over 20 years, after many years working in the hospital. This has most definitely not been my experience. We schedule our own patients once they are assigned to us, so they are flexible within the time range as long as you see them as many times as you’re supposed to. If you were part time, you would be paid regardless-but as a per visit nurse, you may be the last one in your agency who is given patients. That may not change. Why not look around for another Home Health position?

Thank you!  You make a good point - there are lots of other home health agencies in my city, and I do enjoy the visits themselves.  Might just look into trying out another agency instead of throwing in the towel and going back to LTC.  I appreciate the feedback!

dusky1228

dusky1228

96 Posts

Good luck! 

spotangel, DNP, RN, NP

Specializes in ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds. Has 33 years experience. 45 Articles; 516 Posts

Agree with @dusky1228

Totally not normal. Once you have an assignment, you call the patients and schedule appointments and plan your day. The only hiccup would be an add on as someone called out and the pt needs an urgent visit today. This way you can work another job if you need too. I would start looking at other agencies or/ and for a more predictable schedule that fits your needs. All luck @donnydilaudid

I agree with other comments, there are better jobs in HH than that and you should get one.  In the meantime...reschedule those ridiculous visit times to make the schedule less toxic for your mental health. 

BBP42

BBP42

101 Posts

I have been a home health RN the last 5 years, currently working a salaried benefitted 24 hour position at a large hospital based agency and per diem for a smaller agency. At both agencies, I have always had so many patients that there was unlimited overtime available. I love home health but if I were in your shoes I would check out other agencies. I like to move employers by starting per diem for the new agency to make sure I like it while keeping my current job, and if it works to then apply full time for the new company. I am also open about this when I apply for per diem, that I want to see if the company is a good fit before jumping in full time, no one has ever had an issue with that. Is there another agency that you can try out per diem, that allows you to set your own visit times to work around your schedule? 

Simba&NalasMom

Simba&NalasMom, LPN

Specializes in Home health. Has 17 years experience. 616 Posts

Yuck! Totally not normal. The whole reason I love home health is I love my autonomy. I would never work for an outfit that didn't allow me and my patients to figure it out between ourselves. 

If you love the work itself there's definitely a better situation out there for you.

Vee D, ADN

Specializes in PDN, Group home,School nurse,SNF,Wellness clinic. Has 11 years experience. 47 Posts

I haven't had these issues. Then again I do pdn