LPN in homecare

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I have been an LPN for over 2 years now. I started in LTC and now for 2 years have been a visiting nurse. Medicare rules are that LPN can't supervise HHA in homecare. Does anyone know the rationale of this? I just don't get it, I can manage PICC lines, wound vac's, change cath's, etc but cant supervise a HHA? Sam

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Specializes in Pediatric Private Duty; Camp Nursing.

I'm an LPN in home health too, and the notion for me to manage HHA never came up. Believe me, you aren't missing anything. I supervised CNAs in a SNF and although many were wonderful caregivers, a few were not. So this particular responsibility became the biggest thorn in my side. Medicare and other institutions can pop up any sort of responsibility roadblocks for LPNs that they feel like. I assume that not all PN programs teach leadership. My program did and I believe myself to be qualified, but, oh, well. I got enough to concern myself with without worrying about what OTHERS are doing, so I'm happy this way.

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I don't understand the rationale either, but thank your lucky stars you don't have to be "charge" over anyone. In my current job (in a SNF) the LPN on the floor is referred to as the "med nurse" and the RN is the "charge nurse". I love it.

What's that? CNA1 called off third night in a row? Not my problem. CNA2 and CNA3 are arguing over who has to take the "hard" hall? Couldn't care less. The aides are raising holy hell over changes in the shower schedule? I can just sit back and watch. :)

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The home health agency I am currently working for has LPNs in supervisory positions such as scheduling, interviewing, disiplinary and all that. Two in fact that I can think of right off. One does the scheduling and the other is over the Private Duty division of the agency and does all the hiring and firing.

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I work LTC. Don't EVER want to be charge there (or anywhere like it). There are too many personalities to juggle and we're not just talking about patients. I'm making a hcange in the not too distant future and leaving the LTC field (hopefully-as long as its not the only job option). I love nursing but the slant I've gotten on it here has left a sour taste in my mouth. Not having to be "in charge" of everything doesn't upset me a bit

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Specializes in Homecare, Public Health.

I never understood the rationale and still don't. It's slightly insulting I was taught in school to supervise CNAs -I supervised my CNAs in LTC but I can't in someone's home?

I'm also not allowed to do admissions, ROCs or discharges which I did do in LTC. Otherwise I love homecare.

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Specializes in wound care, sub-acute, community nursing.

I am also a VNA nurse, have been for 3 years. Not sure why an RN has to do that, but I don't want any more documentation than I have right now that's for sure. I am about 6 months away from completing an LPN to RN program now and will have those duties soon after, but I will also be looking into acute care after I graduate....just for something different.

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