I've had it!!! Need to vent again

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Do any of you have to deal with marketing people at your agencies that accept patients when you don't have the staff to care for the patient? Or one that "overlooks" homebound status. I am the only RN on the road at this time. The DON is on vacation, and our other RN is playing DON, which translates into...stay in the office behind the desk, since the DON does nothing but her hair/nails/cell phone calls to friend/family. Next week first off I start with 5 SOC and 7 reg visits in one day. This is also happening with the PTA's. They are doing as many as they can, and writing missed visits for the rest due to "scheduling". I told them it was poor business, not to mention unethical, to take on new pts when you can't provide services to the ones you already have. That didn't go over well. And yesterday, I caught crap for not admitting a patient who not only was not in need or interest of HH (she was looking for a caregiver), but clearly stated she was not homebound by any means. I referred her to our local Medicaid Waiver/Personal Care program. I was told I should have come up with "some reason" to admit her. So, once again the "gang" is ignoring me, not speaking unless they have to. Are all for-profit agencies like this?

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Do you work at my office? Same stuff here. Most clients just wants someone to come and and clean their homes!!!!

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5 soc's and 7 visits? are you pay per visit or hourly, and do they pay overtime?

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Specializes in LTC/hospital, home health (VNA).

I would quit if I had that patient load for a day. That is atleast 2 days work for me. I have never had more than 2 admissions a day and 1-2 visits if I have 2 admits. We ALWAYS have no more than the equivalent of 6-7...the admits counting as 2 and recerts/ROC more like 1.5. I would definitely be looking for something else - that type of day is not fair to the patient or to you. I work for a non-profit VNA....occasionally I feel that there is more being taken in than can be seen properly...but that is very rare. And if I don't admit b/c of non-homebound or other reasons there has never been any problems.

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I am salaried, and no OT unless sent out on the weekend, and even that is straight time. I am just so done with it. I don't know what day I'm giving notice, or if I'll just lose it and leave one day. I do have another job in the works, just will take a few weeks to start.

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You are doing the right thing for yourself by leaving. You described the situation that occurs in most for profits (and not for profits also). I really fail to understand how agencies think they can get a good market reputation by taking on business they can not handle. Make certain that your new postion is in place before you give notice and good luck.

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Mrssuzi it sounds as though you are being ran into the ground. Why is it that home health companies can get away with making nurses work overtime without being compensated? Nowhere anywhere do you see things like this happening in the workforce and employers getting away with it.

I don't see them doing this to the home health aides where I work. why? they don't put up with it thats why. But we as nurses have let them get away with this for so long it has become commonplace. Time for all of us to collectively put a foot down.

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I told them it was poor business, not to mention unethical, to take on new pts when you can't provide services to the ones you already have. That didn't go over well. And yesterday, I caught crap for not admitting a patient who not only was not in need or interest of HH (she was looking for a caregiver), but clearly stated she was not homebound by any means. I referred her to our local Medicaid Waiver/Personal Care program. I was told I should have come up with "some reason" to admit her.

Good for you. It is never wise to bend one's ethics or the law! I would leave, too. Plus, who wants to be a part of a poor service company?

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Every time your management gives you an assignment that is unfair or illegal, you can thank another nurse. Thank her because at one time she did it for them without saying a word and now they expect you to do it too.

We had a patient that needed BID dressing changes...and someone mentioned the fact that it is two separate visits and you get paid for them both whether its same nurse of two different nurses. My supervisor said to me "well the girls at soo and soo they used to just charge for one visit, and, you know, just run by and do the other one"

I just looked at her and said. There's only one house I'm going to today that I don't charge you for and thats my house.

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if someone just "runs by and does the visit" without charging for it, they best hope nothing happens to the patient, as it is their license!!!!! BID is BID and that means 2 full visits!!!! not one regular and one run by!!!! that supervisor needs to be counseled!!!! if you have orders for BID SN visits then that is what needs to happen--i am on a roll tonight, just one of those mondays!!!

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Specializes in oncology, trauma, home health.
if someone just "runs by and does the visit" without charging for it, they best hope nothing happens to the patient, as it is their license!!!!! BID is BID and that means 2 full visits!!!! not one regular and one run by!!!! that supervisor needs to be counseled!!!! if you have orders for BID SN visits then that is what needs to happen--i am on a roll tonight, just one of those mondays!!!

Ok you guys, I need some advice here..

I got to work today and had 3 admits in my box. With the "team meeting" going on about "productivity" I almost threw up. So then I have 1 recert, 1 post hospital, 1 regular, one admit and one oasis discharge. I was thinking "5 point a day" this is now 1)team meeting 1.5 recert, 2 post hospital, 2 admit, 1.5 discharge. When I complained they said, "Do a non-visit discharge" so the entire time I was really making it up to get the work done. What do I say? NO??? "There is no one else!" they tell me. Truly a rock and a hard place

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i have done a non-visit discharge also, but i had seen the patient in the past and did my d/c based on my last visit, that is different than a "run in and do the dsg"...the way i interperted it was they were asking that person not to get paid for the visit, but just run in and change the dressing (like doing a favor for someone) but doing a d/c without a visit happens alot, as for example, the patient calls and says they do not want HH anymore, we have to do that discharge.

it makes me mad when they say "your quota is 6", then when push comes to shove the quota goes out the window!!!!!

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