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 but I'm a newbie and would appreciate replies from those working in the hhc industry.
By the way, finally received copy of 485 BUT there is no physician's signature at the bottom. Shouldn't there ALWAYS be a signature??
Is there a website, book, or pamphlet that will answer my questions regarding legal/illegal home health care practices any of you can recommend? Thanks.
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.
Well, I've decided not to address the issue with agency boss. I just won't accept any cases w/o the 485 anymore and if they choose to never offer me another assignment, so be it. At minimum, I won't lose any sleep at night worrying about the potential consequences of bad choices.
It can take ages to get a signature on the 485 and most of the time, the agency does not bother to get a copy of the signed form to the house or to the nurses. The copy of the form that goes forward for the MD signature is sufficient until the signed one is obtained. Normally it will have the signature of the RN who is approving it to go forward, so you know that is the one that is going to be approved and signed. Ninety-nine out of 100 times the MD will sign the form without making changes.
My agency has a strict policy to have all work submitted, including the POC with in 24hrs of a SOC. However, I have been so busy that It has been physically impossible to do it and have taken two days before. I told my boss that in order for me to turn all my work in on time I would have to grow 5 hands, two pairs of wings, and learn how to fly to make that happen! LOL:lol2: I see your predicament though. I'm surprised other agencys dont have the same deadline. 2 weeks is a joke.
but I'm a newbie and would appreciate replies from those working in the hhc industry.
vintagestudent
101 Posts
By the way, finally received copy of 485 BUT there is no physician's signature at the bottom. Shouldn't there ALWAYS be a signature??
Is there a website, book, or pamphlet that will answer my questions regarding legal/illegal home health care practices any of you can recommend? Thanks.