please outline for me, a "good" home health agency

[NurseCard]

... because I'm so new to home health.... I'm not sure if the home health agency that I want really exists.

I have discovered that I truly love love LOVE home health. I love being a field nurse and have no desire whatsoever, at this time, to sit behind a desk.

Having said that, I really need to find a better agency to work for, I believe. My agency pays RNS per visit. We are required to take call one full weekend, at least, per month, and we generally WORK that entire weekend; we don't sit by the phone and hope we don't get called. We WORK. Then we are expected to work all of the following week. That results in exhaustion, at least for me.

We have horrible turnover, meaning of course overload for the remaining nurses.

It appears to be near impossible for field nurses to get any benefits. None of the field nurses seem to have them. We supposedly have to get so many visits per week to qualify.

The case managers apparently get screamed at for every little thing, another reason why I do not want to be behind the desk.

Our agency seems to hold on to patients, especially Medicare patients, for dear life, refusing to discharge anyone; meanwhile continuing to add more patients than there are nurses to care for them.

Can someone who has been doing this longer than me offer some insight? I work for a fairly small local company, not a huge national agency. I don't feel overall like the nurses at this company are treated well at all.

[Libby1987]

Sometimes I will agree to see a lot of patients out of necessity as well as the boost in pay but I'm working late and the care is the same.

I wonder how much working in a small community affects patient care and nurse satisfaction*. I live in my territory. My kids went to school with some of the grandkids. Some are friends with my in laws. They have family members that have been on service. I've had 2 family members at the same time. Same for my coworkers who have been here for years. Local providers know me by name. Not only could you not get away with shoddy care but who would want to?

So when someone is having a problem or we're getting a referral on someone I've known one way or another that's going to throw me into OT, it doesn't feel like I'm only working for the agency but for *my* community, my patient population. It's a sense of ownership. Some would call it a boundary issue but it works well for me, I'm invested in my work and I'm paid well for it.

*not that nurses working in high density patient populations don't also have good work ethics.

[BabaLouRN]

I have begun to believe that possibly the ONLY method for a Home Health RN is to work on prn basis for 2-3 different agencies rather than become a puppet to make quota. I don't have this option because I need to have the group benefits. It seems this "salary thing" is just too constraining and leaves the tendency to be abused in order to meet PRODUCTIVITY. The current company I work for has a productivity quota of "30-35" visit points per week. All other agencies I have known have a 30 point requirement. I also believe the "30-35" is much too high of a margin before getting bonus pay. So, you can make 30 points, earn an additional 5 points and get paid the same amount. It just doesn't figure right.

[Libby1987]

I have begun to believe that possibly the ONLY method for a Home Health RN is to work on prn basis for 2-3 different agencies rather than become a puppet to make quota. I don't have this option because I need to have the group benefits. It seems this "salary thing" is just too constraining and leaves the tendency to be abused in order to meet PRODUCTIVITY. The current company I work for has a productivity quota of "30-35" visit points per week. All other agencies I have known have a 30 point requirement. I also believe the "30-35" is much too high of a margin before getting bonus pay. So, you can make 30 points, earn an additional 5 points and get paid the same amount. It just doesn't figure right.

30 points, which is what I average, puts me at 104K/year,* paid by the visit. I have long, short and normal days. 35 points would put me at 118K which would fantastic if I could sustain those numbers.

I've been salaried and while my particular agency did not expect more than 25 points it locked me into an 8 hr day and set income, great for keeping the lights on, not good for making any additional income when an opportunity arose. PPV is the only way to go IME.

*affordable part of California, nice income, not stellar

[outside_child]

Yes ma'am Prn is the way to go for any job if you have insurance already. I do PRN at an LTACH and HH agency. I was off every weekend at hospital, but now HH PRN requests on call 1 weekend a month. I never had so much freedom in nursing.