Published Jul 25, 2009
i am in need of some serious advice. i am currently employed as a clinical manager in a medicare-certified agency. we have seen a great deal of sudden, steady, increased census over the last several months with no sign of "letting up." i consider myself well-versed in medicare cop's, oasis, pps, practice standards, etc., and understand the business end of things. i am being asked more and more, though, to compromise and implement what i believe to be "in the gray areas," ...at the very least. i am seeing our outcomes decline, our surveys suffer, and more complaining by once happy staff. i have been trying tirelessly to make my bosses (new & plural!) understand the clinical necessities in order to make an agency successful, compliant, and, most importantly, provide our patients with the best care we can deliver. they however, are not clinically trained, and it has become a constant battle to make them understand the rationale for what is needed. the shoestring has been stretched to its breaking point, as well as some of my staff! this is taking it's toll on my mental and physical well-being. i guess i am asking advice on whether it is all worth it. would i be chopping off my nose to spite my own face if i were to say "see ya" and move back to field nursing, or get out of home health altogether? from what i am hearing and reading, the nursing market is looking pretty dismal right now. i am so frustrated and disenchanted that i don't even know where else my skills could take me, and i have been a nurse for almost 16 years! any thoughts or advice would be greatly appreciated! thanks
In spite of the problems, I don't see where you are going to get a better situation than with home health. With the economy the way it is today, I would be very, very hesitant to leave a job to look for greener pastures, or for that matter, any reason, even an extreme one. But maybe a little change of scenery? How are your competitors doing for management positions? Might be worth some investigation. Maybe just a little change will help your overall outlook. Good luck.
In my experience, when non-medical people own home care companies its because they think they are going to make a lot of money. They need a strong manager to keep them ethical and "out of the gray areas". That manager is you. You could change agencies. I know in Michigan the Home health companies are still hiring. But you might run into the same problem, it is pretty rampant in Michigan where we have over 400 Home Care companies in Southeastern area alone. Thats a lot of competition. Most are mom and pop type companies that don't have a clue about how important the regs are. So if you do decide to leave, be cautious and ask a lot of questions. Even if they give you the "right answers" they may not live up to their word. I have left 3 agencies for unethical behavior even after they swore they would never act that way. Good luck!
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