LPN's...how's HH working for you?

RN1263 · Jan 18, 2011

I'm an hourly paid RN in home care and have to do everything you mentioned. I don't mind because at least I get compensated for my actual time. If I work 10 hours I get paid for 10 hours. Sometimes I don't get 40 hours, but I don't mind.

peacetou · Jan 18, 2011

Sorry, I thought it was just a lpn thing. I agree with your thinking (i don't care if I get 40 hrs either). Do you have a certain number of pts you have to see every day? sounds like you don't have to do 40 hours but are you full-time?

thanks:redbeathe

RubyRN,CHPN · Jan 18, 2011

I am an RN and I get paid hourly. All visiting staff LPN's included have a productivity requirement for a given shift based how many visits. RN's who work a 8 hour shift it is equivelent weighted 5 (because of case management responsibilities) and LPN's is 6 visits for 8 hours. We have supplies drop shipped and the CM usually orders those. LPNs generally do repeat visits for wound care, labs, etc. Everybody keeps track of miles, care coordination time, and travel time as well as actually time per visit. I work 10 hour shifts and sometimes I get done before 10 hours and sometimes it's over 10 hours; either way we are compensated for all our hours worked regardless.

peacetou · Jan 18, 2011

I enjoy my job very much but honestly, I have a history of herniated disk. Right now, after about 100 miles of driving today, I am in pain and too exhausted to chart.I was doing ok in the beginning but now the pain has reared its ugly head and I believe that the smartest and most honest thing to do would be to quit. My manager doesn't need me to come crying to her about how much pain I am in. I accepted a job that I can't physically handle (all the time) She has been really great and I hate to leave this fine company. I have so many emotions right now...anger (at myself for being old and sick, embarrassed and disappointed to let her down after all her hard work training me and grief.) But it just wouldn't be fair to them, if I end up calling in sick all the time or to myself, if I force myself to try to work in pain and maybe injure myself even more.

I'm just got this job 20 years too late. I'm sure you agree that I am doing the right thing.

Thanks for listening, PTU

RN1263 · Jan 18, 2011

Sorry, I thought it was just a lpn thing. I agree with your thinking (i don't care if I get 40 hrs either). Do you have a certain number of pts you have to see every day? sounds like you don't have to do 40 hours but are you full-time?
thanks:redbeathe

hi there!

Yes, I'm full time RN, but don't have a case load. Our productivity is based on how fast we got done with our patients for that day depending on how many points you had for each visit (SNV= 1 point, SOC=3 points, etc.) divided by how many hours you worked that day. They continue to do that daily, then average out your productivity for 3 months. We have 2 CM's in the office that handle all the patients (scheduling, recert dates, etc) and the nurses in the field case manage for our visit, then hand it back over to CM's in office with updates if needed. I love it this way, but it's the only agency that I've heard of that does it w/ this model. I have recently become their admissions nurse also. That's been giving me more hours, sometimes it's good, because they don't want me to go into over-time (if they can help it), so I had an extra day off last week to prevent it (I didn't mind!).

In response to your other post:

********* now the pain has reared its ugly head and I believe that the smartest and most honest thing to do would be to quit. My manager doesn't need me to come crying to her about how much pain I am in. I accepted a job that I can't physically handle (all the time) She has been really great and I hate to leave this fine company. I have so many emotions right now...anger (at myself for being old and sick, embarrassed and disappointed to let her down after all her hard work training me and grief.) But it just wouldn't be fair to them, if I end up calling in sick all the time or to myself, if I force myself to try to work in pain and maybe injure myself even more.****************

Have you discussed any of this with your DON? I have multiple sclerosis and although I do pretty well most of the time, my company is fully aware of my condition. There are companies that don't give a rats ass and I worked for one of those before and had to leave when I got very ill, because I didn't have a year in and couldn't apply for FLMA for leave time. I suggest discussing it with the DON and ask for accommodations before quiting. An accommodation you could ask for while feeling ill would be to decrease your work load (to part time) and decrease drive time (local visits only) for a period of time while you are in severe pain. I would suggest that you state that you will be seeing a pain specialist and that the accommodation can be dropped when the severe pain subsides. Of course, if you don't feel this would help or make a difference in your pain level and you would suffer, then perhaps ask the DON for time off, until you feel well. I would just hate to see you leave a job you stated you love.

As I stated, I have MS and when I relapse (I say "when", because I've had relapsing/remitting MS for 19 yrs and it "always", eventually, rears it's ugly head) my company will have to provide either an accommodation or leave time, depending how severe and what symptoms I have. I think they value my work enough at this point where it wouldn't be a problem, they may not like it, but it is what it is! I advocate for myself in those situations, because no one else is going to do it for me and just because I have this illness doesn't mean I'm not a damn good employee.

good luck

peacetou · Jan 18, 2011

I've never heard of your model, myself. It sounds intriguing...no case load. It may be something others should look into. Maybe less stressful? My job is like RubyRN's description of her job.

Thank you so much for your advice. No, I haven't talked to my DON. She told me the "expectations" when we interviewed. I drafted a letter last night but don't want to send it. Now I am thinking that I will write a different letter. I think it's a great idea and if it can work for you, maybe it can for me too. What's the worst that can happen, right? she says no, I was going to quit anyway. she says yes, and I get to stay in a great job!

Thank you again for taking the time to write me. I like what you said about being your own advocate. :redbeathe

PTU

RN1263 · Jan 18, 2011

No problem! And yes, the worst that can happen is she says no, but I'd first give her the opportunity to work with you, before quitting. If I were a manager I'd much rather work something out with someone that was having a legitimate health issue, then have to hire and train someone else that won't be up to speed for months.

good luck, I'm glad I was able to help.

Melina · Jan 19, 2011

No caseload? How many nurses will see a single pt? I've never heard of this either. Is there any issue with continuity of care?

Mel

RubyRN,CHPN · Jan 19, 2011

We have some exceptional LPNs working in the office triaging phone calls from pt's., following up on orders, doing intake, and authorization. Have you considered moving to an office position. Some of these nurses have conditions which make it difficult for them to work out in the field. Have you considered working in the office?

RN1263 · Jan 19, 2011

No caseload? How many nurses will see a single pt? I've never heard of this either. Is there any issue with continuity of care?
Mel

Yep, No caseload. They try to keep 2 nurses w/ the same patient, but it doesn't always work out. So, many times I may see someone that I never have seen before. I will read a past visit note, review POC and speak briefly with CM re: current issues with that patient. Plus, we have case conference once a week. Some patients complain if they've seen too many nurses, but as I said they are trying harder to keep it to 2 maybe 3 nurses for a patient. The mornings can get crazy because they can throw a patient on your schedule last minute that you've never seen before, but I adapt pretty well and I'd rather have that happen then to have to carry a caseload.