New to HH visits, organization help

[Nurse_67]

I am a LPN that will be starting a new job in home health doing visits. I have experience doing home health shift work (12 hour shifts) with both hospice and pediatrics. The company I will be working for pays by the hour. I will go to the office in the morning, clock in, pick up a company car, do my visits then clock out at the end of the day. I was told they want me to "work up" to doing 6 patients a day.

I'm a bit nervous as this is a relatively new company that is expanding. They have one full time RN, one prn RN and one other LPN. After I was offered the job and accepted, the DON kept saying how happy the RN was going to be to have help because she was never able to get all her paperwork done. I have been reading the HH forums on here and it seems like the paperwork is much more involved than when I was doing HH shift work. The company uses EMR and I was told it is a "really easy system" to learn. I am wondering what is the best way for me to get/stay organized, how to plan my day to best use my time and any other tips you can offer someone new to doing visits?

I love working one on one with clients in their home and having flexibility. I'm just nervous about getting myself organized and into a good routine so as not to be wasting time/energy unnecessarily.

[JustMeRN]

As an LPN you should be getting pretty basic stuff, daily wound care, follow up visits for Chf, copd etc. the most difficult paperwork is oasis, which you will not be doing.

6 revisits a day is very reasonable, as long as you don't have crazy drive times. Get in the habit right away of doing your paperwork at the visit, or just after the visit in the car. The biggest issue with paperwork is that people put it off and Rush off to the next visit, then need to play catch up for 6 visits of charting once they get home. If you do all / most of the paperwork at the visit (or in the car just after the visit) it is much, much, much more efficient.

Also, don't get sucked in. That's not to say don't interact with your patients, but set your boundaries early. Don't be the nurse who spends half an hour listening to the clients jabbering about holidays, or families etc etc etc before you even do your assessment. Go in with an air of "I mean business". And understand if you have a client with true social issues the best course of action is to involve social work, or ask the pcp office to intervene if you don't have social work. Trying to fix everything is another time management pitfall. You can't do it alone!

Good luck!

[Libby1987]

Everything said above plus..

Have teaching plans on hand, whether that's handouts or just general guidelines to follow. There are common conditions that we see that would be helpful for you to be very familiar. Same for medications.

Keep your car well stocked for cath changes, wound care, labs (always have specimen cups, you'll run into s/s UTI pretty frequently). The agency will probably given you the basics to start but it will be up to you to keep replenished.

Lint roller, Ziplock bags, disposal bags, micro kill wipes (or equivalent).

See lab patients before noon and on route to a convenient lab.

If you have a fingerstick protime, make sure you have back up lab draw supplies (blue top have a short shelf life so check exp dates frequently).

Save every phone number into your phone. Collect as many contacts as you can.

Schedule paperwork and and phone calls into your visit. For your routine simple visits that will be 45 min plus drive time. An hour for complex visits.

Make your phone calls from patients' homes, let them see you communicate on their behalf, even with your team members.

You are going to be very dependent on the organization of others, be flexible and tolerant at first as you're learning and become part of the solution and assist in organization and planning.