Just hired by HHC agency--not feeling very good about it now

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Specializes in Just started in HH.

Recently hired by HH agency w/o ANY orientation. Discomfort #1. Twice I've been assigned a pt but not given the POC because the RN has not finished completing it. Discomfort #2. I've heard RNs hold on to them for 2 weeks. I've been VERY uncomfortable seeing my pt's without visually seeing the POC and have serious problems with this practice. I regret taking the cases like you have no idea. I will refuse to take cases if POC isn't ready for my viewing. Am I overreacting? Too paranoid maybe? (I don't think so.) This is my first LVN job since getting my license last year but I clearly remember being taught NEVER to do anything to a pt w/o seeing the care plan in hospital/LTC. Seems it also apply to HHC since we're directly caring for pts.

Question 1: Is sending an LVN for follow-up visits w/o a POC/485 the norm in home health care? Sure hope not :eek: but I'm a newbie and would appreciate replies from those working in the hhc industry.

Thank you for your input. :)

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Not cool that they should allow that. I ALWAYS get my admission charting in within 24 hours and 90% of the time it is completed the same day. It is not okay to send a nurse out (LPN or otherwise) without a POC, period. What that means to you is you are providing care to a patient without ORDERS, which goes against your license. If you happened to do something you shouldn't or not do something you should have, how would you know the difference? I don't think you're too paranoid. I would also refuse to take on a case that another nurse started but never finished.

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They will send you without letting you see the 485 if they can. You must insist because where else are you going to find the orders? When they see that you are serious about getting your copy of the 485 before going to the case, they will make the effort.

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Specializes in Just started in HH.

Thanks for the input. Yes, it was a bad choice on my part for which I am deeply regretful. Ugh! :(

Thanks again for your replies.

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When I see a pt for another nurse I get report from her before I see them. They tell me everything that I need to know and I can ask questions.

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Specializes in Just started in HH.
When I see a pt for another nurse I get report from her before I see them. They tell me everything that I need to know and I can ask questions.

That's very good, twokidsmom,rn. :) I hope the agency will be reasonable when I address the matter next week, but if not, well, then it's time to move on. Thanks for your input.

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Specializes in Just started in HH.
They will send you without letting you see the 485 if they can. You must insist because where else are you going to find the orders? When they see that you are serious about getting your copy of the 485 before going to the case, they will make the effort.

You're right, caliotter. I'll address the matter next week when I meet with the owner. Thanks. :)

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Specializes in Just started in HH.
Not cool that they should allow that. I ALWAYS get my admission charting in within 24 hours and 90% of the time it is completed the same day. It is not okay to send a nurse out (LPN or otherwise) without a POC, period. What that means to you is you are providing care to a patient without ORDERS, which goes against your license. If you happened to do something you shouldn't or not do something you should have, how would you know the difference? I don't think you're too paranoid. I would also refuse to take on a case that another nurse started but never finished.

I've learned my lesson and will refuse any case offered without the 485, paddler. Yeah, what a no-no that was.... :o

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Getting report is nice. But frankly, all I SHOULD need to know about the case ought to be on the POC. Taking "orders" in a hand-me-down way from another nurse is not orders at all and would never stand up in a court case. Good luck addressing your needs with management.

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I have been told the "orders" from the family. Wrong. I have also been told the "orders" from another nurse. Wrong. Both nurses and family members have told me the exact opposite or what they wanted me to hear, when relaying the "orders". The current 485 is the only source that one can trust for the doctor's signed, written orders.

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But the nurse who did the SOC which the 485 is taken from should know what is on that 485. Lately we have not received a copy of the 485 for weeks. We usually see our own cases but sometimes if going on vacation or might see a pt for someone if they are too busy.

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Specializes in Just started in HH.

Paddler and caliotter3, yep, you're right. Scary experience for this newbie and one she'll not forget. Thanks. :)

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