Overworked

[KalipsoRed21, BSN, RN]

Sooooo, I really can’t tell anymore of it is me or my employers expectations. My agency expects me to see 6 points a day and drive no more than 75 miles. I often get assigned 6 patients (or two admits) a day. I drive around 50 miles. I manage 20-30 patients. I currently have 3 patients on vancomycin, one that has a wound vac, I have 1 additional IV patient who should have NEVER been admitted to homecare due to lack of caregivers and the social worker is working on getting him placed but it could take a week, the rest are a combination of wound patients who go to a wound clinic and I get weekly orders to keep up with, order supplies for and ensure all the orders are in, one psych patient that truly needs to be committed....

Now when I have my regular patients, I can MOSTLY get by and do it in the 8 hours I have to do it, but 3 times a month I am on call (like yesterday I saw 3 patients, did 1 SOC, and then saw 3 more patients after my call started and drove 95 miles) and I find that my employer does not give me time to catch up the day after in such instances. This also occurs every 3rd weekend I work because they will slam us with SOCs the whole weekend...like I’ll have 4 every weekend I work. And the following Monday I’ll have to see 6 patients AND try to get verification of orders and such for all the SOCs I did the weekend before.
I just can’t keep up with this and to try to meet their expectations of charting (regular visits turned in within 24 hours, SOCs within 48) unless I spend one of my days off catching up.
I find this unacceptable. I never get any rest because I’m working on my days off, and I work more than 8 hours every day I work. I never have a “lite” day. Like we do a quasi self scheduling thing where I manage my patient’s schedules but if I only have 3 patients scheduled one day they will add 3 other nurses’ patients to my schedule (like no choice, always have to have 6 patients).
I’ve been doing home health for 2 years. I do like it WAY better than working in the hospital BUT I find myself, even in the middle of a pandemic, considering going back to the hospital or just looking for some other job that truly only is 9-5 Monday to Friday and has no weekends or call. Because I need my life back.

How does everyone else handle this?

[caliotter3]

I left visit work for extended care. Extended care means my eight hour shift is my eight hour shift. Problem solved.

[Archerlpvn, LPN, LVN]

Depending on the EMR you use, if you self schedule, make sure to make the changes after 5:30pm, once the office closes LOL. So you can only see 3-4 patients on a given day, and they can’t add anymore to you after 5:30 that day. You have to be crafty/sneaky in this way so you can breathe.. have a discussion with them, let them know their full time demands are too high. If they don’t listen, drop down to part time or per diem or leave altogether. Home health has with reputation of working nurses to the bone, and if you don’t speak up, nothing will happen. Good luck to you 

[HonestRN11]

I am in the same exact boat as you. I can’t help but wonder if we work for the same company bc everything you’re saying is exactly the same as me. I have two young kids and I feel like I’m constantly working. I’m salary and I work well over my 8 hours a day. If I have a bunch of revisits I can get in all dome within 8 hours usually, that’s usually with no lunch or bathroom breaks though. But when I have a start of care I am required to do so much. Not to mention our company has a policy where a start of care is the same as one visit. Unless you see two in the same day then it count as three visits! Like what? How does that make sense. 

[KalipsoRed21, BSN, RN]

On 9/20/2020 at 9:23 AM, HonestRN11 said:

I am in the same exact boat as you. I can’t help but wonder if we work for the same company bc everything you’re saying is exactly the same as me. I have two young kids and I feel like I’m constantly working. I’m salary and I work well over my 8 hours a day. If I have a bunch of revisits I can get in all dome within 8 hours usually, that’s usually with no lunch or bathroom breaks though. But when I have a start of care I am required to do so much. Not to mention our company has a policy where a start of care is the same as one visit. Unless you see two in the same day then it count as three visits! Like what? How does that make sense. 

Nope, that sounds terrible. I get paid hourly and I sure as poo wouldn’t have stayed 2.5 years if I did this for a salary. I get paid 30.81/hour. I deserve more but what I want is to live my life. And there is no way a SOC should be the same weight as a visit.