Private duty nurse? Home health?

[Avill, BSN, RN]

Hey guys,

I just got hired as a private duty nurse. It's still considered home health, but with only 1 patient (different kind of insurance). When I spoke to the case manager she said that the patient had 6 hours weekly but didn't have any specific care instructions for the patient. She said that when she was in the field a lot of the time it was just going to the patients home and just being there.... anybody ever had something like this?

[dianah, ASN]

Moved to Private Duty Nursing forum.

[Alex Egan, LPN, EMT-B]

If it's a skilled nursing case requiring a LPN or Rn there has to be a care plan in place. It doesn't matter if it's a six hour/week or a 112 hour /week case.

[Avill, BSN, RN]

True. The case manager was not very helpful. I asked if he had any wounds ect. She said no. So I guess I'll just wing it until the first meeting since I will be doing the paper work then. Thank you for replying.

[caliotter3]

Is this the way your employment with this agency has been going up to now? Is this the way it is going to continue? I would find a new employer. No 485 (Plan of Care) initiated by the RN doing the intake visit, no 'ghost' shifts worked by yours truly. And six hours a week? Are you supposed to support yourself working for this agency? If this is how they want you to play the game, then consider how they will be when something goes really wrong. Six hours of "sitting" with the patient is HHA level care, not licensed nurse. I would look elsewhere for work.

[Avill, BSN, RN]

It's a new job, new agency. I see the patient on Monday. If things seem fishy to me I will go back to the agency I was with working PRN. They were excellent in supporting me. This agency, not so much. Not yet at least. Even the case manager seems a bit off, like, just not really into the job, not warm. Not sure how to explain.

I even asked her if they will reassess if the patient needs less hours as time goes by, she said yes but that she's never seen the hours decrease. Only increase.

[Alex Egan, LPN, EMT-B]

If there is one thing I have learnt in This business over the last decade, it's trust your gut. Proceed with ******** detectors on high, and split when you know it's time to go.

[Avill, BSN, RN]

If there is one thing I have learnt in This business over the last decade, it's trust your gut. Proceed with ******** detectors on high, and split when you know it's time to go.

I did a bit more research about the type of insurance DEEOIC, and just like any other home health agency with any other type of insurance, this agency must have a referral from the provider and a care plan in place. So I'm going to ask the case manager before I go Monday.

[quiltynurse56, LPN, LVN]

Curious to hear how yesterday was for you?

I have a case where the main reason we are there is for the feeding tube.

[Avill, BSN, RN]

So I spoke to the case manager because both the patient and I were kind of confused on what I was supposed to do there.

They way she explained it is that the department of labor had given him 6 hours of nursing a week, so as long as I did one thing related to nursing services (infection control, skin assessment ect) the rest is up in the air. So home tasks are ok as long as the nurse was okay with it.

I'm still not too sure about the company since I am a full time school nurse and it may be a bit hard to schedule 6 hours weekly in the fall time since they eat out and the wife needs to drive when there is light. But as for now, I'm just going to wing it.

[Crystal-Wings, LVN]

It's a new job, new agency. I see the patient on Monday. If things seem fishy to me I will go back to the agency I was with working PRN. They were excellent in supporting me. This agency, not so much. Not yet at least. Even the case manager seems a bit off, like, just not really into the job, not warm. Not sure how to explain.

I even asked her if they will reassess if the patient needs less hours as time goes by, she said yes but that she's never seen the hours decrease. Only increase.

I'd be weary if the case manager seems off. They are your support on the job if something goes wrong or you have concerns about your client's changing condition. The first agency I was with, the case manager was awful. She was so uninvolved and didn't know anything. It was obvious she had no experience.

My current agency I've been with almost 3 years and I've had 2 wonderful case managers. My favorite was a woman who had several years of ICU and ER experience and was an WCC. She had a wealth of knowledge and was a wonderful teacher.

[Alex Egan, LPN, EMT-B]

Is this the USA? What state? I have never heard of the department of labor determining the need for SKILLED care. There has to me an MD order someplace. No one is gonna pay for a nurse and not want justification arhat the job requires a nurse.