Is this normal?

[Cbunyar]

I've been working at my current HHA since April 2017

It's a rural area and our census runs between 65 to 90, I am the only RN in the field. The other RN is called a patient care manager and she doesn't see patients unless I beg for help. She does the oasis alerts which aren't many since I am oasis certified. We have one lpn, the other lpn is aN assistant to the patient care manager RN. We have trying to hire another field RN, but for the past year I am the only one. We are also trying to hire another lpn. A ton of turnover, been through 3 patient care managers, and 3 executive directors, the executive director is an RN and only does visits if he has to. I take call 7 days a week about every 3rd week. I do start of cares all weekend long. An lpn takes call with me only on Saturday and Sunday. LPN's do not take call during the week. They do not provide a cell phone, I use my own and sometimes get calls from MD offices with orders on patients that I have not seen that same day, and put the orders in and notify the LPN that saw the patient. On my schedule today, I was assigned 2 start of care visits, a recert visit, and 3 skilled nurse visits. I do all the starts, recerts, discharges, and RN follow up visits. We do not have a triage nurse in the office that can take orders, the patient care manager will direct them to call my personal cell phone. Every single day my schedule will change 3 to 4 times before I even start the day. If a patient needs a fall follow up they add it to me and sometimes remove a visit from me when I have already set up a time to see that patient. After every start of care I'm suppose to call the patient care manager with a start of care report. This includes immediate safety concerns, etc. But all she wants is for me to answer the questions and that's it. There is no support with getting these issues resolved, they say this is my job. Also when I'm on call I have to cover call for another office, sometimes those patients are 2 hour plus drive away. I started this job with no home health experience, I have worked many extra hours learning how to complete a chart. I had one week of training with another overloaded RN from another office. This job has overwhelmed me, burned me out, and has made me want to leave nursing altogether. I put in a three week notice. They act like I'm a "complainer" because I openly air my frustrations. I want to know if this is normal for hh, and if it's that "I just can't handle it" or if thee truly have unreasonable expectations.

[caliotter3]

Not only hh, but any other place of employment where management has found a door mat. Congratulations on seeing the light and giving notice.

[Libby1987]

I don't think that's the norm with the worst of agencies but it most certainly is not for any reputable agency concerned with quality of care and patient safety. Or retaining employees.

You have a year's experience, you're marketable to any agency now. Just be aware that you have probably developed practice habits out of survival that won't be acceptable by agencies who prioritize quality, satisfaction and patient outcomes.

[Smknd]

Hi my dear,

I've worked at two great Home Health agencies and what you've described is nowhere near to what I would call normal. Home health can be very stressful at times, ecspecially the charting... however what you described sounds awful. You have great patience and I would not give up on nursing because of this one encounter, maybe try different home health agencies if possible. And be encouraged not all places are like this!!!! Usually if we have an admit visit, we only have 1 other regular nurse visit scheduled for that day or nothing else scheduled- since admits can take a very long time ecspecially if you are a case manager and need to do some follow up phone calls.