Pay sucks - Venting

[rnbrit]

Left my job in the hospital two months ago to work for a home health agency full time. On paper the job sounded great. I was promised 30 visits a week and when I factored in the pay per visit rate it was more money than I made in the hospital.

Well that hasn't been the case.

In the two months I have been here I have had one week with a full patient load. The rest have been between 15-20.

They promised me I would stay within my home area but they have me driving 20+ miles out each visit each day. My days would be manageable if my patients were all close in proximity but they are spread out all over.

Instead now I am working 8-9 hour days and essentially making $17/hr. I made $27/hr in the hospital.

I am very much so regretting my decision to leave the hospital but at the same time feel guilty for not sticking it out here in home care.

I enjoy my patients and the management that I work for are incredibly sweet and helpful if I have questions. I just don't think financially I can swing this position much longer. The pay is just too unstable with cancelled services, cancelled visits, and patients who won't answer their phones to even allow us to schedule. Just this week alone I have lost 4 visits which may not sound like much but it is close to $200 that I am losing out on.

The only way I could see my income increasing would be to take weekend call but gosh I don't want to work 7 days a week. Yuck!

I've applied to several different positions and at this point I am ready to jump on the first one that gives me an offer.

Home Health is just not for me!

[AnOldsterRN]

I did Home Health for about 25 years as an RN. It's not what it used to be. There are hundreds of agencies opening up shop and fighting over contracts. Most small agencies do not survive. Visits are further and further apart. There is also a lot of fraud in Home Health as I saw with the last agency I worked for who was the last straw for me. Owners pressure to make more visits, do recerts, add PT (they get more money per episode by upcoming and adding PT). It's gotten so bad that the Feds have opened task forces across the country just to combat home health agencies.

i left to work at a SNF while also applying elsewhere. I miss the "flexibility" and not being stuck in one place for 8-12 hours. However, I do my work, I clock out, and I am done. No homework, no calls to go and open a case or other visit. No feeling like I am working 7 days, pressure to take what the agency wants me to take in order to make ends meet because you don't know if another case will come along, etc. You are are correct about the job instability.

The paperwork has has gotten so extensive over the years too. The pay is a rip off at "per visit." Last one 1099'd me on top of it and I was hit with self employment tax, no unemployment, no workers comp., no overtime, no basic employee rights (which I'm disputing with the IRS as I believe we were misclassified).

Flat per-visit rate. No accounting for drive time, gas, phone time, paperwork time. Count all of that time and money plus the visit time and you're often making minimum wage or a bit more.

My my biggest regret was staying so long in Home Health. I don't think I'll ever go back.

[Libby1987]

I've had an amazing career in home health, over 20 yrs from the old FFS days to the challenges in 2017. I've worked all of the aspects of it and made a good living doing something worthwhile and that I enjoy. No fraud. No abuse. But a very well developed skill set and continuing education in an ever changing field. I didn't get here in 2 months, I had to develop my skills but well worth while.

Quitting home one health in 2 mos is like quitting anything else in 2 months. Agencies and companies vary with some being much better employers than others. But 2 months is nothing when entering a completely new field. It may not be for you no matter how well paid and organized, and like any other nursing field it is hard work but it is also very fulfilling for others.

[caliotter3]

Oldster said it. For the vast majority of agencies there is that set of problems or the set of problems encountered when doing extended care, primarily agency management that won't back up their field nurses because there is a steady stream of replacement nurses available. Misrepresentation of one sort or another is the common denominator. There comes a point where you have to draw the line if you are doing this to try to earn a living. I noticed that when one's car breaks down for the last time and they can not get alternate transportation, all of a sudden, all calls from the agency cease, if they haven't for some other reason. One enjoys what they can from this area of nursing while it can be enjoyed, because that won't last for long.