Need Advice of different jobs PLEASE!

Daytonite, BSN, RN · Dec 30, 2005

Hi, Karen! It's good to see that you have been job shopping and I wish you all the luck in the world! I don't think it would be fair of me to say one way or another which job you should take. I wanted, however, to tell you some of the things I discussed with my mother's home health nurse. I will PM you the name of the company she worked for, but do not want to print it here publicly. I can tell you that Heartland is a national company in case you did not know that. They also own a slew of nursing homes around the country. They are also connected to the Manor Care group of nursing homes.

We saw probably 4 different RN's while my mom was on home care, but her primary nurse was a very cool person. Mom's primary nurse would come at least once a week and she took the time to sit and talk with mom. She made things so comfortable. I was a bit worried because my mom is a pack rat and tends to collect junk around her that she really should be throwing out. Marilyn didn't even let it phase her. She wasn't pushy about introducing equipment my mom needed, she would discuss it with mom and suggest what she would be able to do. No uniforms (I saw that as a plus). She did tell me that she had a pretty extensive area to service. She was paid per client visit. I asked her plenty of questions when I could because I really didn't know a lot about home health care. She told me she pretty much set her own appointments throughout the day. A cell phone is a must. She would call in the morning to let us know she would be dropping by that day and about what time. She always called again to let us know she was on her way over and would be here in 30 minutes or so. She did draw my mother's blood a number of times (my mother is on Coumadin). She also is the one who got the other people of healthcare to see her.

She had also been a hospital staff nurse, but liked this much better. In the home she only had to deal with one patient and sometimes the family. This, I think, would be something that would attract you to this kind of position. She was able to work her patient visits around her family (she had school age children). She said she made better money than she did in the hospital. However, she did say there was a lot of paperwork she had to do. I never saw her doing it in front of us except when she was doing the initial evaluation.

She also told me that there was a big turn over of RNs within the agency she was working for. She said she oriented a lot of new RN employees, many of whom left within 3 months. She didn't understand why, but felt that a lot of it had to do with the paperwork because the actual physical work of it was not that hard. The other thing she mentioned was that new RN employees had some problems with learning all the resources that were available to suggest to the patients. However, the longer a person stays at this job, the more you learn about the resources available if you make that a goal. My impression was that home health nursing involves a great deal of patient management of resources. As the home health RN, you would decide (if it hasn't been ordered by the doctor) if the patient needs oxygen, physical therapy or a visit from a social service person and get a doctor's order to get those things. I do remember her saying one time that her company preferred that their nurses take care of all patient problems, but that she wasn't going to put her license in jeopardy and if she felt it necessary the patient be seen in the ER, she would call 911 herself for them. She had to have some knowledge of the Medicare and insurance rules for reimbursement because most of the clients using home health services have them paid by a third party insurer.