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
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!
The $100 per hour sounds average for some areas.... i am not sure which region of the country you are in but i am in North Carolina and just took a HHA position here.... this agency pays $35 for revisits $60 for Start of cares...
the company i worked for in Connecticut payed $45 for revisits and $100 for start of cares/recerts
i checked an agent in florida and interviewed with them.... they were the same as Connecticut ....
The $100 per hour sounds average for some areas.... i am not sure which region of the country you are in but i am in North Carolina and just took a HHA position here.... this agency pays $35 for revisits $60 for Start of cares...
the company i worked for in Connecticut payed $45 for revisits and $100 for start of cares/recerts
i checked an agent in florida and interviewed with them.... they were the same as Connecticut ....
hope this helps....
Thanks... I live in CA.....Can I ask you a question? What exactly do you do when you start a case? Any tips besides doing complete/comprehensive assessment?
Thanks... I live in CA.....Can I ask you a question? What exactly do you do when you start a case? Any tips besides doing complete/comprehensive assessment?
Usually the admitting nurse is the first to nurse to get to know the patient unless the patient was with the agency in the past....
You will go to the patients home with paperwork from the hospital/md that will act as your orders.
You will perform a thourough head to toe assessment.
You will interview patient re: primary diagnosis and any secondary diagnoses.
You will fill out a form if your agency is medicare certified for medicare called and Oasis. It is a long form and will be the bulk of your time spent on each case.
You will write the patients care plan based on nursing diagnoses and pt needs that you identify during the visit. In my experience, start of care visits average around 2 hours inclunding paperwork/pt assessment.
Of course these steps/procedures may vary from agency to agency.... from state to state.....
I am finding out now that you dont have to do as much paperwork for private pay/private insurance patients, if the agency is not medicare certified. In my previous position we did the OASIS for ALL patients.
feel free to ask any questions you like..... if i cant help, i am sure someone else here can!
Usually the admitting nurse is the first to nurse to get to know the patient unless the patient was with the agency in the past....
You will go to the patients home with paperwork from the hospital/md that will act as your orders.
You will perform a thourough head to toe assessment.
You will interview patient re: primary diagnosis and any secondary diagnoses.
You will fill out a form if your agency is medicare certified for medicare called and Oasis. It is a long form and will be the bulk of your time spent on each case.
You will write the patients care plan based on nursing diagnoses and pt needs that you identify during the visit. In my experience, start of care visits average around 2 hours inclunding paperwork/pt assessment.
Of course these steps/procedures may vary from agency to agency.... from state to state.....
I am finding out now that you dont have to do as much paperwork for private pay/private insurance patients, if the agency is not medicare certified. In my previous position we did the OASIS for ALL patients.
feel free to ask any questions you like..... if i cant help, i am sure someone else here can!
Hi, thank you for replying.......I actally was able to see the OASIS form and the way I see it, it maybe time consuming to fill out the the whole form but some of the questions are questions that I normally see when I get direct admit patient in the hospital where I work and I also open the care plan for each patient I admit at the hospital...Do you think this is something similar in the HH world? What about the billing part of the OASIS form, am I also repsonsible for completing and filling it out? I am actually a bit excited about it as I like one on one care with patients and the fact that I will do this when I want to not being stuck with a time clock. I am just hoping that I will like. What do you think are the major disadvantage of doing HH? I ask so much question for the reason that I want to be prepared when I start. Thank you again!
Hi, thank you for replying.......I actally was able to see the OASIS form and the way I see it, it maybe time consuming to fill out the the whole form but some of the questions are questions that I normally see when I get direct admit patient in the hospital where I work and I also open the care plan for each patient I admit at the hospital...Do you think this is something similar in the HH world? What about the billing part of the OASIS form, am I also repsonsible for completing and filling it out? I am actually a bit excited about it as I like one on one care with patients and the fact that I will do this when I want to not being stuck with a time clock. I am just hoping that I will like. What do you think are the major disadvantage of doing HH? I ask so much question for the reason that I want to be prepared when I start. Thank you again!
The major disadvantage, as i am sure anyone will tell you, is the paperwork.
That said, if you are organized and stay on top of it (complete as you go pt to pt is best) then it wont seem so bad...
Paperwork is the complaint i hear about most often, but i seem to have been able to avoid any nightmares with it.
The advantages though, far outweigh the disadvantages. There is no comparison. You get that one on one with your patients... you are pretty much on your own during the day.... not on your feet for 12 hrs straight .... most of the time it is a really nice, enjoyable and relaxed atmosphere....
As with anything, it will be what you make of it. You will hear from some that dont like it but as you can see here from all of the posts most home care nurses LOVE what they do.... you feel like you can really make a difference afterall.
The major disadvantage, as i am sure anyone will tell you, is the paperwork.
That said, if you are organized and stay on top of it (complete as you go pt to pt is best) then it wont seem so bad...
Paperwork is the complaint i hear about most often, but i seem to have been able to avoid any nightmares with it.
The advantages though, far outweigh the disadvantages. There is no comparison. You get that one on one with your patients... you are pretty much on your own during the day.... not on your feet for 12 hrs straight .... most of the time it is a really nice, enjoyable and relaxed atmosphere....
As with anything, it will be what you make of it. You will hear from some that dont like it but as you can see here from all of the posts most home care nurses LOVE what they do.... you feel like you can really make a difference afterall.
wow...i'm getting more and more excited as I get answers to my questions.....Organizational wise, I think it will not be a problem for I like things to be organized especially paper works....I just seem to notice though that in the hospital world getting organize is a bit of a challenge for you are always on the go...but I think when I start HH and the fact that I can take my work with me at home will be much of an advantage for me.....Now one more question (sorry) as far as getting orders from the doctor...how do you get it? do you call the doctor infront of the patient or do you take care of that once you're home? Does patients call you in the wee hours? or once you left their doors, you're done until the next visit (if you are to follow up on them)?
wow...i'm getting more and more excited as I get answers to my questions.....Organizational wise, I think it will not be a problem for I like things to be organized especially paper works....I just seem to notice though that in the hospital world getting organize is a bit of a challenge for you are always on the go...but I think when I start HH and the fact that I can take my work with me at home will be much of an advantage for me.....Now one more question (sorry) as far as getting orders from the doctor...how do you get it? do you call the doctor infront of the patient or do you take care of that once you're home? Does patients call you in the wee hours? or once you left their doors, you're done until the next visit (if you are to follow up on them)?
Please don't feel sorry to ask so many questions....ASK AWAY.... i wish i had someone to ask that would be honest with me about my career options.
As for you orders... your agency will send you out to the pt with the discharge paperwork from the hospital/nursing home or the orders directly from md...usuall it is discharge paperwork though....regardless, this paperwork will be given to you by the agency....
if you find something else that you feel your pt needs, you can always call the doc to get new orders then you document everything
as for pts calling you.... if you have an agency cell and they encourage you to give pts that #.... then you would turn that phone off when you are not working ..... most agencies i know of have pts call the main office # only and if a pt needs his nurse, she is paged by the agency staff....
agencies usually have afterhours calls go to an answering service who in turn calls the on call nurse.... the on call nurse will decide if the patient really needs to be seen or if she can talk them through the problem/procedure over the phone.... if it is an emergency she advised pt to call 911 then hangs up and follows up with pt to determine the status....
if something like a foley comes out or an iv... you might have to make the visit if you are "on call" .... you should ask the agency if you will be required to take call.... some agencies only require their full time nurse to take call others require everyone to rotate weeks.... you are always paid additional money for the on call rotation....
if you are a dedicated admission nurse, you probably wont have too much follow up with pts after they are set up and have had their first visit with the nurse managing their case....
where in california are you.... are you in southern cali? my son wants to go to USC... next year and i am planning to move to LA area May 2007
you can PM me if you are not comfortable discussing that here
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!
The agency I work for seems to handle mostly geriatric patients as well, all on Medicare/Medicaid. The agency gave me a suitcase on wheels, full of good stuff like a scale, BP cuff and stethescope, themometer, alcohol hand cleanser, blood spill clean up kit, gloves, gait belt, glucometer, paper towels, tape measure, plastic wound measurement thingy (LOL -can't think what it is called), small med book, bandaids, and some lab draw stuff.
Plus I carry a over-the-shoulder bag, holding the charts and paperwork needed for all the folks to be seen that day. May be a good idea to carry a small book you can turn to if you find yourself with questions.
I think doing 3 openings a day sounds like a good load. Would not want to do anymore, personally. The OASIS forms are long and, while not difficult, are time consuming, and some of their terms I find strange. Like one question about 'is the patient confused?' - I put 'yes', as she is pleasantly confused. Then was told they really mean 'is the patient climbing up the walls confused' Well, how was I supposed to know that??
We get paid by the hour ($25.) and are given 4 hours to do the initial assessment and all the paperwork, so $100. sounds fair to me. How far will you be driving? And do you get paid for milage as well?
That's pretty funny ($100 per visit, really?????). And, 25/hr!!! I get paid 17.87/hr as a new grad plus .45 cents per mile, 60miles per day average. We are expected to do 5 visits per day and I am in a rural state. Granted, we don't do OASIS because it's new moms and babes but a new admission takes 1.5-2 hours. Most days I see 6 or 7 babies and kids ( I would make a lot more with the per visit pay!)
1. GET A ROAD ATLAS!!!
2. If you use an appointment book, pay for one that's easy for you to use.
3. Did I mention, get a road atlas?
4. Carry med/surg or assessment type texts with you in the car.
5. Carry dog bones too. It keeps the dogs happy and the clients LOVE that you thought of their pet!
After awhile you'll figure out what to carry with you. Definitely soap and paper towels for hand washing. Gloves. Purell for when you leave your soap at people's houses. Chux for having a clean surface to set down your stuff (in some houses you need it. I go to one house that I refer to as "the sticky house!") If you have clients you see regularly, carry thier phone numbers with you for those days you wake up sick or need to reschedule.
I hope you love your job! The freedom and autonomy are hard to beat, that explains my willingness to accept my payscale!!
Another publication you will need to become familiar with is the HIM-11, Medicare's "Bible" on Home Health. Your agency office will more than likely have a copy available. You can also download a copy in a zip file to your home computer for your own use:
powernurse
87 Posts
The $100 per hour sounds average for some areas.... i am not sure which region of the country you are in but i am in North Carolina and just took a HHA position here.... this agency pays $35 for revisits $60 for Start of cares...
the company i worked for in Connecticut payed $45 for revisits and $100 for start of cares/recerts
i checked an agent in florida and interviewed with them.... they were the same as Connecticut ....
hope this helps....