After almost 20 years in the hospital as a PACU/PCU/Stepdown nurse, I finally made the jump into Home Health. It's something I thought I always wanted to do, but after just two weeks I'm honestly ready to pack it in and head back to the hospital.
The patient care itself is basically the same as the hospital except you're doing it all alone, in the patient's environment, without the support you'd normally have on a unit. Add in the hours of driving between visits and the endless charting, and it feels overwhelming.
I like the idea of home health, but the reality has been rough. Are there any seasoned Home Health nurses here who can give me a reason to stick it out?
Specializes in Emergency Department, Pediatrics, Wound Care, PACU.
The only perk to home health is the schedule being super flexible. Charting is daunting at times but atleast you get to do it at home? When I did it I felt like I was working constantly. I severely dislike the point system, if that's what you use. Also, if they require you to be case manager and on the point system - way too much work for the pay.
I worked home health pre and post OASIS. Before OASIS documentation was rarely difficult/time consuming but once OASIS/HCHB/Pointcare - whatever name is attached came into being, it was a deal breaker for me. I didn't mind charting some from home but the recerts/IDG notes (when I worked hospice), case management notes - all became a huge no.
The documentation is repetative & very slow on a tablet even for the most seasoned home health nurse.
Agencies that pay per point screw nurses out of income because documentation is part of the pay for whatever point is assigned, nurses who are salaried also get screwed over because they are also spending non compensated time documenting.
As others have said, no patient wants a nurse sitting in their house for hours documenting & it is NOT possible, even for the fastest nurse, to complete ALL documentation in a 45 min visit.
Time will help you get faster but home health nursing is time consuming & often what you are experiencing is exactly why nurses leave & return to the hospital or drop to PRN/part time.
I enjoyed the freedom of home health in not having to be at an office right at 8 or stuck in IMCU for 12+ hrs but with OASIS as it is & the home health companies a dime a dozen how so patients who really don't need services are being kept on for profit, no way I would work it again or recommend it.
That being said, there is no shame if you know, even this short time in, that it is not for you. That is not a failure - its a lesson. So, decide what is best FOR YOU & go from there. I assure you, whatever company you are working for is going to do whats best for them, even at the expense of a good nurse.
As a nurse who has done home health for approximately 30 years, I concur with ALL of the nurse's above written statements regarding home health. Once upon a time, nurses working in home health really brought home a good and excellent income, but with OASIS, that really choked the income making capacities for many of us still in home health. I have looked at 2007 which was the last year that I EVER made decent money in home health. Of course, the cost of living was not then, like it is now. In 18 years, there has been ZERO INCREASE in the wages and compensation on home health visits. I work Tuesday through Saturday, but my two "off" days, Saturday and Sunday, are spent completing paperwork. I figured that even with all of my years of nursing experience, I come in to under $30.00 per hour. It really sucks. I would LOVE to do something else, but like everyone else says, the flexibility of the job, the autonomy and independence, you will NOT find anywhere else.
I truly appreciate all of your comments, advice, and support.
I'm heading into my second month in home health, and I've come to the realization that this just isn't for me.I love the impact, the one-on-one time with patients, seeing their progress, and knowing that my work truly matters. But as many of you warned me, the work never ends. Between the nonstop calls, OASIS charting, and constant coordination, it's been almost impossible to maintain any sense of work-life balance.I'm a huge believer in protecting your peace and your purpose, and right now, that means choosing stability. There has to be a better way for nurses to deliver great care without burning out and maybe one day, I'll help build it. For now, I'm grateful for the experience, the lessons, and the reminder that sometimes "not the right fit" is still part of the right journey. Thank you all so much for all you do!
I truly appreciate all of your comments, advice, and support.
I'm heading into my second month in home health, and I've come to the realization that this just isn't for me.I love the impact, the one-on-one time with patients, seeing their progress, and knowing that my work truly matters. But as many of you warned me, the work never ends. Between the nonstop calls, OASIS charting, and constant coordination, it's been almost impossible to maintain any sense of work-life balance.I'm a huge believer in protecting your peace and your purpose, and right now, that means choosing stability. There has to be a better way for nurses to deliver great care without burning out and maybe one day, I'll help build it. For now, I'm grateful for the experience, the lessons, and the reminder that sometimes "not the right fit" is still part of the right journey. Thank you all so much for all you do!
You lasted one month longer than I did! I was sent into a filthy, smoked-filled home that triggered a major asthma attack. Avoiding the triggers, I hadn't had an attack in nearly 40 years. I quit in the spot!
As an RN I have done home health for nearly 30 years. At first, doing home health was not a job, it was a hobby. HOWEVER, in 1998 came the OASIS Documentation. That certainly changed the direction of home health FOREVER. OASIS is how Medicare and insurances decide whether to reimburse or not, or taketh away funding. Over the past 20 years, the OASIS paperwork burden has quintupled and there has been absolutely ZERO increase in the pay per visit, salary pay nor hourly pay to do home health. It is IMPOSSIBLE to complete your documentation in the patient's home. Patients and families simply don't want the nurses sitting there for 2-3 hours on the computer!! This is something management refuses to pay attention to. Finally, for me at least, I am sick and tired of needing to do all of my documentation on my 2 days off. I can't even clean my house, make other plans because of all the *** paperwork that is due. Yes, we use tablets but still it is overwhelming. In the next year even though I am turning 65, I will be transitioning out of home health in order to try to have a life. Yes, there is flexibility, HOWEVER, it comes at a price.
"Home health" means driving from patient to patient to quickly assess, do a lab draw, or wound care. Then HOURS of OASIS charting! I quit!
I prefer "Private duty," providing direct patient care instead of walking out after 10 minutes. There ARE agencies that hire private duty nurses and require NO OASIS charting, just an electronic or paper checkoff of care and meds given.
LubbDubb77, BSN, RN
123 Posts
The only perk to home health is the schedule being super flexible. Charting is daunting at times but atleast you get to do it at home? When I did it I felt like I was working constantly. I severely dislike the point system, if that's what you use. Also, if they require you to be case manager and on the point system - way too much work for the pay.