New to Home Health....any tips or advice?

powernurse · Mar 21, 2006

Hey all!
I was just offered a job full time at a home health agency. Previously, I have worked LTC and acute rehab. I am excited about starting this new chapter in my career, and it seems that home health is a field that you either love or hate. I'm hoping that I love it.
Any tips or advice for newbies in Home health? It just seems like so much....scheduling my visits, making the quota (it's 27 "points" for full time employees per week), not getting lost driving, my safety. (I'm new to this state anyway....how will I ever find my way around, especially in these rural areas??!!??) I don't want to be out on the field all day, and then come home and spend hours on paperwork. I will have at least a full month or oreintation, and more if I think I need it.
Thanks in advance for any tips you can give me. :kiss
Jennifer

the fact that you said "27 points" makes me ask.... who is the agency?

i am interviewing thurs for a new company and it sounds like they use a "points" system which i never heard of before

as far as tips/advice.... i hate to say it but home care DOES have way too much paperwork.... now that said it is the most rewarding area of nursing i can imagine....you really feel like you make the difference acting as patient advocate....

as far as getting to know your way around....during orientaion you'll prob get a feel for the layout of your territory if your preceptor is covering your territory....

what i found invaluable is go to one of the major bookstores and get a STREET ATLAS..... it is an entire book with detailed street maps.... and unless you live in an area where they are constantly adding new roads, it will become your best friend.... if you find that you get lost easily or that the map book is too cumbersome, then get clear and concise directions from your patients/patient's families before going out the first time.... let them know to bear with you.... and call them back if you have trouble...

9.5 times out of 10 your patients will be very understanding...

while it is true you will learn to HATE the paperwork.... I know you will LOVE the freedom, patients, and every other aspect of home care....

good luck

and i hope to hear from you about which agency that is.... pm me if you like

weetziebat · Mar 22, 2006

I've been working in Home Health now for eight weeks - an ole timer! But will give you my perspective.

I love my patients! You really do get a feeling of being a 'real' nurse. The opportunity to stop and chat with them, in their own setting can't be beat. You learn so much, and have a great opportunity to be their advocate.

The independence is nice - being able to schedule your own appointments, and having the freedom to stop if you want a cup of coffee, or need to run an errand. Or deciding you want a particular day off etc.

My agency sends us out with detailed driving directions, which is lovely. I also live in a small city, which makes it lots easier. I am also fortunate to live in what is considered a safe area - don't think I'd want to do HH in a big city, like L.A.

We cover an area of 30 miles in each direction, but very few of our patients live more than 15 miles.

I get paid by the hour, which I prefer - but that is just a personal preference. And we don't work on a point system. Do you know yet how many 'points' are assigned for what? We get paid for the hours we put in, which may or may not be what you are supposed to get. In our case, it is often a lot less.

There is a lot of paperwork. Somes places more so than others, but it is a lot in any case. Especially the loooong Oasis forms, which get filled out on admission, re-cert, discharge - waaaay too much, IMHO.

But what it all comes down to is the agency, and its policies. I find a huge difference in how they all seem to operate. Which, in turn, can make a huge difference is how happy you will be with your job. Ask a lot of questions.

Good luck, and let us know how it turns out, O.K?

powernurse · Mar 22, 2006

the independence is nice - being able to schedule your own appointments, and having the freedom to stop if you want a cup of coffee, or need to run an errand. or deciding you want a particular day off etc.

or the freedom and luxury to stop and go to the bathroom! :lol2:

NurseyTee · Mar 22, 2006

I just recently left HHC after 7 yrs. I wish you the very best, I'm sure you will love it, I know it had it's ups and downs, but doesn't everything? You will love the flexibility and the ability to give one on one care.

Jo Dirt · Mar 22, 2006

I'm waiting to get my RN license (hopefully in the next couple of weeks) so I can get started in home health. I think my favorite thing will be the FREEDOM. I hate spending 8-12 hours cooped up in one place.

jenrninmi, MSN, RN · Mar 22, 2006

I'm a HH nurse for 1 1/2 weeks now. LOL! I had my first independent visit today and absolutely loved it! I got lost though - which is not unusual for me. lol! My agency covers 6 counties, so I know there is a high likelyhood of having to do a lot of driving. Bummer. I hope most of my patients will live closer to me. We'll see. So far I really like it!

akvarmit · Mar 22, 2006

I've been doing HH for about 3 months (hardly an expert, more like just driving with a permit) but I absolutely love it! I do well if I can focus on one thing at a time, get very engrossed in it and move on. I did the ER for 2 years, and I learned alot, but my skills of being detailed weren't really valued there. (I am a med/surg nurse at heart)

We get paid on a "unit" system, so many for open, recert, resumptions, etc. We also get extra units for lots of miles...that kind of covers the time I'm stuck in the car. I average 60-80 miles a day, my territory is more rural. I like to listen to AM radio or lectures on tape, etc. And I definitely have known "potty" stops already in my routine depending on where I'm going.

That "thinking a few days ahead" mentality is a little tough, but I'm getting used to it. The dang insurances that only precert 2 or 4 visits at a time make my brain hurt, but I have all the precert forms hanging right in front of me at my desk.

Just my 2 cents

Dawn in Pa

homehealth43130 · Mar 24, 2006

To help find your way, especially in a rurual county - stop at the county courthouse and pick up a county map - they are usually free - and become your best friend. Good luck with your job -

FreshRN05 · Mar 31, 2006

any suggestions on home health books such as nursing care plan books??? gladly appreciate the help!

weetziebat · Mar 31, 2006

As far as suggestions for Home Health books, I've not seen any care plan books that impressed me. But I do have a couple of books that I would highly recommend for HH nurses.

The first is 'Manual of Home Health Nursing Procedures' by Robyn Rice, published by Mosby. It is a large, 3-ring binder book with great info. Only downside is the cost. I ordered it from Amazon for $130.

The second book I like is called 'Home Health Nursing Pocket Consultant', also published by Mosby. It is ~8x5", spiral, and full of good info. Can't remember the cost, but certain it was less than $35. and you may be able to find a used copy.

No doubt lots of other good books out there, but these are my personal favorites. Good luck

FreshRN05 · Mar 31, 2006

thanks for the book suggestions..I have another question???? when you go out on the field to do HH...what things do you normally bring with you? (equipments, books etc) The HH agency that hired me only takes Geriatric patients and mostly under Medical/Medicare programs? What are the most important things I ned to bring with me everytime I go and see patients (besides my skills and compassion)..By the way, I'm only gonna be doing admission assessment (opening cases)...I'll be starting next week and I'm only doing this 1-2 x a week with max of 3 patients a day...What do you think? and what do you think of $100.00 per case? does this sound fair pay? Sorry one question turned out quite a few

Thanks again!