New to home visits

KelRN215, BSN, RN · Jul 26, 2013

Salary depends on whether you are full time staff or per visit. For agencies in my area, I've seen anywhere from $27-$33/hr for salaried positions. Per visit in my agency is $40 for follow-up visits and $70 for admission visits. I have a laptop and smart phone provided by my agency as well as the majority of supplies that I need, including a baby scale. Mileage in my agency is $0.40 per mile. I claim the rest on my taxes.

More often than not, mom/baby visits are one time visits. You're there for an hour or two- not really enough time to get attached. Mom/baby visits are my easiest visits since the rest of my caseload is children with serious illnesses, mostly cancer. My usual duties involve splitting my time between the field and the office. It varies by the day. I can see anywhere from 1 to up to 8 patients in a day. 8 is a lot but can be do-able if they live close to one another and they are straight forward visits. Most of my patients have cancer and I might be visiting them to draw labs, administer chemotherapy, administer an injection or do central line care. My non-oncology patients typically have various congenital anomalies and I am visiting to do things like feeding assessments, weigh checks, cardiac assessments, respiratory assessments or to do teaching with the parents on their new G-tube or their insulin or whatever it may be.

I honestly don't have problems with needing to "separate my feelings" from situations or becoming attached. Children get cancer, that's reality. Some of my patients won't survive their illnesses. That's also a reality. I do what I can to help them and their parents today. I've had some very sad cases- child who was normal until his mentally ill sister tried to strange him and caused an anoxic brain injury, recently a baby with osteogenesis imperfecta who was taken from his parents by the state because abuse was suspected when they brought in their infant presenting with unexplained fractures. I do my job and move on. I am jaded from having been a pediatric nurse for 6 years- I expect bad outcomes and when a good one comes, I can celebrate with the families.

If clients avoid calls, don't call back or aren't home when I go for scheduled visits, I notify the MD or Case Manager and move on. People need to take some responsibility/accountability for their own situations.

LandD_RN_chica · Jul 26, 2013

Salary depends on whether you are full time staff or per visit. For agencies in my area, I've seen anywhere from $27-$33/hr for salaried positions. Per visit in my agency is $40 for follow-up visits and $70 for admission visits. I have a laptop and smart phone provided by my agency as well as the majority of supplies that I need, including a baby scale. Mileage in my agency is $0.40 per mile. I claim the rest on my taxes.
More often than not, mom/baby visits are one time visits. You're there for an hour or two- not really enough time to get attached. Mom/baby visits are my easiest visits since the rest of my caseload is children with serious illnesses, mostly cancer. My usual duties involve splitting my time between the field and the office. It varies by the day. I can see anywhere from 1 to up to 8 patients in a day. 8 is a lot but can be do-able if they live close to one another and they are straight forward visits. Most of my patients have cancer and I might be visiting them to draw labs, administer chemotherapy, administer an injection or do central line care. My non-oncology patients typically have various congenital anomalies and I am visiting to do things like feeding assessments, weigh checks, cardiac assessments, respiratory assessments or to do teaching with the parents on their new G-tube or their insulin or whatever it may be.
I honestly don't have problems with needing to "separate my feelings" from situations or becoming attached. Children get cancer, that's reality. Some of my patients won't survive their illnesses. That's also a reality. I do what I can to help them and their parents today. I've had some very sad cases- child who was normal until his mentally ill sister tried to strange him and caused an anoxic brain injury, recently a baby with osteogenesis imperfecta who was taken from his parents by the state because abuse was suspected when they brought in their infant presenting with unexplained fractures. I do my job and move on. I am jaded from having been a pediatric nurse for 6 years- I expect bad outcomes and when a good one comes, I can celebrate with the families.
If clients avoid calls, don't call back or aren't home when I go for scheduled visits, I notify the MD or Case Manager and move on. People need to take some responsibility/accountability for their own situations.

Thank you so much for all of your insight. I truly appreciate it. I'm thinking more and more this is for me. I'm actually really excited about it. I am setting up a shadow day to see if I like it. I'm sure I will. :) also, as far as attachment goes, I will have the same clients for up to 2 years. In your experience, have you had such long lasting clients?

KelRN215, BSN, RN · Jul 26, 2013

I've been at my job for 15 months and I've had some of my pedi patients since day 1. Treatment for leukemia, for example, is over 2 years long so I have those kids from diagnosis through the end of treatment. When they are discharged, we all recognize that this is a GOOD thing and there's nothing to get upset about. I cannot imagine a mother/baby case possibly lasting 2 years. Only a handful of times have I had a mother/baby case that was more than one visit and in those cases, there were other issues that warranted continued services- mother had cognitive delays, for example, or mental illness and even in those cases they never last more than one cert period (60 days).

anothergrumpyoldRN · Jul 26, 2013

Just remember that this is your JOB.

These people are not your friends, they are your patients.

Maintain impeccable professional boundaries.

Good luck!