Is this for me?

wonderbee, BSN, RN · Sep 17, 2007

I've been in home care for less than a year with the same company, most of the time with hospice and now with the HH division. The idea of flexible scheduling for me has been mostly that, an idea. Yes, I make my schedules but then my supervisor gets a hold of it and it's not so flexible any more and it bears little resemblence to the one I submitted. I don't know if it's industry wide or more of a company thing. Probably more of a company thing but I'm sure it happens elsewhere too.

When that schedule is being changed, what gets changed out of it is scheduled time for paper work. I work for a company that is struggling for its dollars with a lot of pressure from corporate. I am personally opening one new admission a day on top of my regular visit schedule wit its phone calls and discharges. That paperwork is a pretty big pile and it doesn't just do itself. So weekends and nights have been devoted to getting it done.

Like I said, this is the way MY company is run. There are those that have nurses that do strictly admissions and others do visits and case management. I'm sure it's better somewhere.

My point is, don't assume that you won't have to work nights or weekends just because you work home health on dayligiht. Make sure you check it out. Good luck.

RNsRWe, ASN, RN · Sep 18, 2007

Thanks for the reply :)

I know I'm going to have to work some nights, some weekends, just to get that blasted paperwork done from what I'm seeing here! However, I guess I'm trying to figure out if, overall, I'll be able to spend more time with the family if I'm working home health than if I'm working 12 hour hospital night shifts.

While it's true I'm working during most of their sleeping time, I'm also sleeping during more of their "fun" times or "need mom" times than I'd like. I play with my sleep schedule ALOT, and yet I am still feeling the pinch of missed time with the kids.

Is anyone who is reading this also familiar with this kind of thing? Did any of you leave a hospital job for home healthcare for more family time...and did it work out? What do you now like about your HHC job that you didn't have in the hospital?

I'd really appreciate any feedback!

angshallad · Sep 19, 2007

Hi,

I moved from hospital work to home health about a year ago for pretty

much the same reasons you are thinking about. For me it has really worked out well. Our agency does all charting on laptop, I do most of my charting after I get home and transfer it to the office when I am done each night. I do have an advantage in that I am a per-diem case manager which means I follow the same patients, but can decide on the number of patients I want to follow. I usually see 5 a day which has me getting home at the same time the children are getting home from school.

hope this helps, let me know if you have any questions

Angela

RNsRWe, ASN, RN · Sep 21, 2007

Angela: thanks! Yes, I was wondering about this kind of thing. Per diem in my world means you come in for each shift on a per-day basis (duh); you get the exact same assignment that every other nurse gets. It isn't easier or harder, the per-diem benefit is that you choose how frequently you work.

So there's such a thing as a per-diem case manager, where you can limit the number of cases you'll take? Does this also mean you're killing your earning ability? Did you see a big change from hospital wages to what you're doing now?

Sorry for the pile of questions, but the more I know, the more I know.... :)

angshallad · Sep 21, 2007

Hi again,

our agency has two types of per-diem staff, one in which the per diem nurse fills in for case managers on an as needed basis and then the per diem case manager. I choose to case manage simply because I wanted the certainty of knowing I would have work each day.

of course no benefits, our agency pays $45 per revisit and $54 for an opening or recert. i moved from the south (where i worked in a hospital) to the north (where i am doing homecare) - pay is definitely better up here.

anything else just let me know. the transition in nursing has been easy, the laptop charting was more difficult to learn than i expected, but now that i am familar w/ it, i wouldn't trade it for anything, no papers, all the information right where you need it - great.

best of luck

angela

RNsRWe, ASN, RN · Sep 22, 2007

angela, wow that does sound good! Of course I realize that income varies considerably but I'm in the Northeast and I imagine the pay would be pretty decent. Doing the quick math, figuring that four of your five daily visits are re-visits, and one is a new one (playing the averages game), multiplying those times five days a week and figuring on 48 weeks a year (hey, everyone's gotta take time off!) I'm seeing over $56K a year. Nice. Even without benefits or paid time off, it still looks good (that's where hubby comes in!).

If I could get a gig like that, it definitely sounds like it fits in with the Hearth & Home plan I'd like to have. :)

I appreciate the feedback; I still have alot of thinking to do. Sometimes I just really love what I do, and other times I would be thrilled to swipe out and never go back. I DO like the patient interactions, and would want that in home care, so I know just "supervising" with tons of paperwork isn't my style. I like to go in and DO, too :)

I'll let you know if and when I make a move!

caliotter3 · Sep 22, 2007

From what I gather from your description of your needs, you won't be able to get the hours you would like unless you arrange a part time position or some unique schedule or duties. You would then be limiting your income. Most of the money made in hh is because people in all kinds of positions, work steady hours which closely mimic regular shifts in a hospital setting. Another option that I have seen discussed is to become qualified in coding or transcription and get work that can be done in the home. I believe you would really have to put a lot of effort into this to get it to be worthwhile income wise. There is a lot of competition for home based work. Why don't you make some informational calls to agencies and discuss your questions with the Directors? That way, you could get a better picture if there are any employers in your area that might be able to offer you what you need. Good luck, and I hope you go into hh and find it to be satisfying.

Bugaloo · Sep 22, 2007

Hi, I was reading your post and thought I would throw in my 2 cents worth. I worked 12 hour nights at a hospital and then went to home health, because I thought I would have more time with my 4 year old son. I soon realized that working 8-5 every day and doing TONS of paperwork at home after work, plus on call weekends was actually taking more time away from him. Some nurses say that doing paperwork at home is a plus, because at least you are home with your kids, but I really wanted to leave "work" at work. I am now doing 12 hour nights at another hospital and feel almost sane again. Think about it long and hard. Good luck with whatever you decide to do!

pedinurse05 · Sep 23, 2007

Hi, I was reading your post and thought I would throw in my 2 cents worth. I worked 12 hour nights at a hospital and then went to home health, because I thought I would have more time with my 4 year old son. I soon realized that working 8-5 every day and doing TONS of paperwork at home after work, plus on call weekends was actually taking more time away from him. Some nurses say that doing paperwork at home is a plus, because at least you are home with your kids, but I really wanted to leave "work" at work. I am now doing 12 hour nights at another hospital and feel almost sane again. Think about it long and hard. Good luck with whatever you decide to do!

I totally agree with this poster. I left the hospital for HH and found it more time consuming with the HH! I am now going back to the hospital!

RNsRWe, ASN, RN · Sep 26, 2007

Thanks, everyone, for your input...it's invaluable. Which of course is why I posted here!

I'm still on the fence on alot of decisions. I really REALLY like that when I leave work, I truly LEAVE. Yeah, it's frequently on my mind, scheduling problems or a bad night or whatever, but it's inconsequential really. My time away from the hospital is my own.

I do like the idea of setting a schedule myself with home visits and paperwork being more flexible than what I have now, but I definitely see the downside you all are talking about. Especially about "being home" with the kids but only physically, not really "being" there. This was totally true when I was in nursing school: I was home more than a "working" mom, but I was also studying alot and therefore not really as available as I would have liked. So, I know what you mean about that.

I think I'm just frustrated with the balancing act, as probably any working mom is! I've never had this struggle, as I was fortunate enough to NOT have this juggling until this last year. And now that I'm expected to be in two places at once, I'm trying to figure out the best way to meet everyone's needs.

Thank you all for your thoughts.... there's just no easy answer, is there??