LPN Home Care

postmortem_cowboy · Feb 21, 2007

Personally speaking, with the few home visits I had to make as an auditor (OASIS), due to RN's not being in the area for an IV problem and I was the only IV certed nurse that was available to do them. I'd much prefer the acute setting. Might be more sterile, but you don't have to worry about patients dogs, homes that aren't kept up, cleanliness issues etc etc etc.

Wayne.

zoeyzoe · Feb 21, 2007

I do home health for 2 different agencies. I work a 12 hour shift 1 day a week with a vent pt and that pays great. The other i work 6hr a day 3 days a wk with a pt with cerebral palsy, that pays ok. You are on a more personal level when you do home health. The only thing i don't like about some clients is when they get a little confused about the reasons your there, and think your some kind of maid, cook, or personal assistance. But lucky my current pts and i have a very good understanding of why i'm there

pagandeva2000, LPN · Feb 22, 2007

Personally speaking, with the few home visits I had to make as an auditor (OASIS), due to RN's not being in the area for an IV problem and I was the only IV certed nurse that was available to do them. I'd much prefer the acute setting. Might be more sterile, but you don't have to worry about patients dogs, homes that aren't kept up, cleanliness issues etc etc etc.
Wayne.

Please explain OASIS to me. I heard about it on some of the home health forums, but didn't comprehend what it actually is. I can understand about the cleanliness issues, though. I hate roaches and mice. So far, I have been lucky, though.

pagandeva2000, LPN · Feb 22, 2007

I do home health for 2 different agencies. I work a 12 hour shift 1 day a week with a vent pt and that pays great. The other i work 6hr a day 3 days a wk with a pt with cerebral palsy, that pays ok. You are on a more personal level when you do home health. The only thing i don't like about some clients is when they get a little confused about the reasons your there, and think your some kind of maid, cook, or personal assistance. But lucky my current pts and i have a very good understanding of why i'm there

Is vent care hard? I was offered a vent case, but I didn't learn about it in school, or work, so, I put it off. I was told that I can visit the home with a respiratory therapist, though and I am seriously considering it.

zoeyzoe · Feb 22, 2007

I wouldn't say vent work is hard, but if you haven't worked with one before, or have very little experience, it can be scary at first. Actually, before this case I only had vent experience during my clinical's. The agency I work for ask for vent experience, and I told them what I had, being a new nurse in all. They sent me out to orientate for a week, with the current nurses on the case. The respirator I work with is called the LP10. I took home a copy of the manual and read it from front to back. It helped me out a lot, but I was still nervous for the first 2 months. Now I'm pretty good with it and I'm not scared anymore. You just have to learn the common reasons the respirator alarm may beep ( most of the time its simple reasons), and what to do in case of an emergency, once I learned that, I was fine.

pagandeva2000, LPN · Feb 22, 2007

I wouldn't say vent work is hard, but if you haven't worked with one before, or have very little experience, it can be scary at first. Actually, before this case I only had vent experience during my clinical's. The agency I work for ask for vent experience, and I told them what I had, being a new nurse in all. They sent me out to orientate for a week, with the current nurses on the case. The respirator I work with is called the LP10. I took home a copy of the manual and read it from front to back. It helped me out a lot, but I was still nervous for the first 2 months. Now I'm pretty good with it and I'm not scared anymore. You just have to learn the common reasons the respirator alarm may beep ( most of the time its simple reasons), and what to do in case of an emergency, once I learned that, I was fine.

I just spoke to my agency today, and asked them to arrange time for me to visit a client with a vent while the nurse is there, or a respiratory therapist. We will see what happens in the meantime, but I really want to experience this so that I can start to get more cases and add to my nursing experience. The high alarms are obstructions and the low ones are usually leaks, am I correct? That was the only thing I remember hearing about in school and during NCLEX review...I am on my own, now. Thanks for the info.

auroranae · Feb 24, 2007

I have been working for a pediatric home agency doing private duty for chronically,terminally ill children since 1993. I have also spent the last 4 years working for a company doing home health visits 3 days a week. I love both positions for very different reasons, but also for the same reasons.

I love working with the kids even though they have some very unusual and often very rare syndromes. It keeps me on my toes and up to date with new meds and treatments. I do alot of trach and GT patients with these cases.

I also enjoy doing the home visits. On a really busy day I would put in 10 or 12 hours and see 7-9 patients. Not too bad, except that most of the time is spent in the car in traffic travelling from case to case. I would travel 100-150 miles a day most days. But the patients were varied and interesting. I would see new diabetics and cardiac patients to do diet and med teaching, new moms and babies for newborn checks and breast feeding teaching, wound care on just about every type of wound or surgery imaginable and alot of IV starts, maintenance and trouble shooting. I took care of patients with MS, cancer, chronic fatigue.... you name it. It is a great way to keep up on the latest techniques, meds and syndromes that are out there.

The down side is also my favorite part about both jobs- working on my own and being accountable for my work. It can be very stressful when you are in a home care situation and things are not going the way you want them to. You have to make decisions about the immediate care needed, contact the MD, arrange for supplies, therapies, and so much more. And you have to make sure you follow all state and company protocols, maintain the HIPPA privacy act, give quality care and be cost effective for the insurance companies so you do not use all the home care visits that they allow before the patient is well enough to not require the home visits.

With the private duty cases many of them are on public health programs and not of the highest educational level or in the nicest neighborhoods because so much of what they had was used to care for their child until they were eligible for assistance. I have had cases where the parents had to divorce and live separately with one of them quitting their job so they could qualify for assitance-- not because they wanted to divorce or live separately! It was the only way they could get the health care needed for their child.

It is a difficult type of nursing care to provide and not the kind of thing that everyone can handle. But you not know unless you try it, and the rewards in the people you meet and relationships you have with them is rewarding in itself.

Just my thoughts...

pagandeva2000, LPN · Feb 25, 2007

I would rather take a home case where I can remain with the client all day rather than travel. Mainly because I don't drive, but also, because I would rather remain stable. I have a pediatric client that has a trach (4 years old). She is very active, but also alot of fun. The family has been very supportive of keeping me, although I don't have much experience, and I am grateful for that. I hadn't been faced with having to arrange for supplies and therapies, (maybe because it is up to the RNs in my agency to do that, or it may be because the mother is extremely savy and communicates with the physician frequently), but I can understand having to initiate things in case of an emergency...simply because many of the supplies are not there.

It is interesting and disheartening to read that some parents seperate and divorce not out of disillusionment or irreconcilable differences, but to ensure that their children receive the medical care that they need! My Word...how can a government allow parents to seperate for this!!! I would simply fall apart if I had to leave my husband! I am glad you shared this. This is another consideration to ponder.