I just started in home health about 4 months ago. I absolutely LOVED it the first couple of months and couldn't imagine doing anything different, felt I hit the jackpot with an amazing company. The patients are amazing and actually appreciate every little thing you do for them which is the complete opposite of how you are treated in the hospital setting. So, our weekly productivity goal is 25 points. (Regular/wound care 1.25pt and SOC/ROC 2.25pts) Last week I saw 32.25 points and this week I already have 34.25 points assigned to me, which will change as I get more admissions. The constant emails/phone calls questioning every little thing are making my anxiety almost debilitating as I am trying my best to give the best care, which lets face it the patients are not getting at this load. If I send back a patient, for whatever reason, I get a phone call asking why I wasn't able to see the patient and I am getting to the point where I want to say "HELLOOOO look at my load, how on Earth can I see this many patients?" One day I saw 2 SOC, 2 Recerts, 2 discharges and 2 wound cares. I am kind of on my own out here and don't really have coworkers to ask if this is normal. I did my research before trying out home health so I knew the charting would be awful, but I was okay with it since I would be able to do it in the comfort of my home. I know a stress-free nursing job doesn't exist, but my God I wasn't expecting it to be this bad! We are required to be on call about 8 days a month and have to call patients on Sundays to schedule for Monday so I really only have 1 day where I don't have to think about work. I am really missing those 4 days off every week.
Thanks for reading if you got through all that. Advice/words of encouragement appreciated!
It will get easier once you are more comfortable with the job. Hopefully you just aren't assigned what ever patients someone else can't see and have your own patient list. That and using a laptop helps tremendously. Are they using a good software for charting, it makes a huge difference. I used Kinnser and had no issues getting charting done while I visited the patient unless there was some pressing matter.
I don't think they should dictate to you when to call your patients, that is just telling everyone a blanket statement so that the ones that don't call like they should aren't held accountable. As long as the patients are satisfied that is the goal. Some of my patients knew I would be there every Tuesday morning or whatever, so I just reminded them about it the week before, etc. I always gave patients a range, such as in the afternoon, etc. Some patients I had to call right before I got there because they would forget if I called them the day before, so what was the point of telling them then, right?
AS far as saying you can't add another, just say, you can't you already have a full day and will be lucky to get the ones done you already have. What other plausible reason is there? That you want to go home early or something? Which is not a good reason as far as I know.
If the agency doesn't have a system set up where you can be successful then adios.
I have heard of people doing 10 to 12 visits per day, but im not sure thats even possible.
I have done up to 9 visits a day if all were follow ups and relatively simple, and not too far apart. However that would be one long day in a week with other days being 4-6 visits. There’s no way I could sustain that. And of course the documentation would be done later at home, no time for that in a day with 8-9 visits.
I have known nurses and PT who do 10+ visits a day routinely. There’s no way those patients are getting adequate care. But the agencies sure turn a blind eye.
Caliotter, whats the difference between home health and extended care? Can you tell more? Thanks.
In essence home health nursing encompasses nursing care that takes place in the home setting. There are two major kinds: intermittent visits and extended care. Extended care is also called shift care, continuous care, and if paid for by the client, private duty. Intermittent visits are typically what many mean when they use the term "home health". These are 45 minute to one hour visits with specific goals that usually occur after a period of hospitalization and are of limited duration. The nurse makes several of these visits during their work day. Extended care is routine care usually provided in eight or 12 hour shifts that can last for years or the rest of the patient's life. Many of these extended care patients would have been placed in institutions in years past. Some refer to extended care as "private duty" and intermittent visits as "home health".
I have witnessed this and have seen such a thing . I worked for an agency once where LVNs would see 10-15 patients a day. I at one point would get 2 SOCs, 2 Non billable D/Cs, 3 Oasis Transfers, 2 Aide Supervisory Visits, and a Oasis D/C. RNs would see an excessive amount of patients, the mom and pops can really scam nurses. The agency had about 1000 patients in a region, I was there briefly.
I have nurses that do up to 20 per day. 10 AM and 10 PM usually. 2 SOCs in one day is ridiculous for a CM. D/Cs and transfers are simple though, at least in my company. I can complete one in 5 minutes.
Forest2
625 Posts
It will get easier once you are more comfortable with the job. Hopefully you just aren't assigned what ever patients someone else can't see and have your own patient list. That and using a laptop helps tremendously. Are they using a good software for charting, it makes a huge difference. I used Kinnser and had no issues getting charting done while I visited the patient unless there was some pressing matter.
I don't think they should dictate to you when to call your patients, that is just telling everyone a blanket statement so that the ones that don't call like they should aren't held accountable. As long as the patients are satisfied that is the goal. Some of my patients knew I would be there every Tuesday morning or whatever, so I just reminded them about it the week before, etc. I always gave patients a range, such as in the afternoon, etc. Some patients I had to call right before I got there because they would forget if I called them the day before, so what was the point of telling them then, right?
AS far as saying you can't add another, just say, you can't you already have a full day and will be lucky to get the ones done you already have. What other plausible reason is there? That you want to go home early or something? Which is not a good reason as far as I know.
If the agency doesn't have a system set up where you can be successful then adios.