Productivity in Home Health

[KalipsoRed21, BSN, RN]

We work on point system. A nurse is to see 6 points in an 8 hour day, 8 points in a 10 hour day, 9-10 in a 12 hour day. A nurse gets 1 point for a regular follow up visit, 1 point for a discharge, 1 point for every 75 miles, 1.5 points for a recertification or resumption of care, 3 points for admissions. Really, should the nurse only drive 75 miles, I find this to be a mostly attainable work load. But one you get into the 100 mile range it kinda isn't. It takes me 20-30 minutes to chart a regular visit. 1.5 hours to do an admission and about 2 additional hours to chart it, order supplies and call MD for orders and med reconciliation. I find that while I think these standards are reasonable that I'm only able to live up to them about 40-50% of the time. When you add in chart corrections that have to be done, follow up, meetings, getting to the office to turn in paperwork etc., that I really couldn't achieve these standards if I worked full time, fortunately I work part time, so I can do some of this without the stress of having a case load of patients to see. I don't know how full time people do it and have any quality time off. This would be an issue I have had with most of my RN positions, to have any quality of life I have to work part time and not get paid for some of my time so I don't have to be stressed to get this stuff done in a time limit I can't make. I try to keep talking to patients a minimum, I do chart in the home, but I could never be the nurse that is just there to do my job and leave. When I try to get compensated for the time I do actually take to get the quality job I do done, I get in trouble for bad productivity. If I just don't clock in the time I get annoyed at working for free. Does anyone else have this quandary?

[caliotter3]

Left intermittent visit hh for extended care hh. Shift work gives one time to get their charting done at work and going to and from work is like a regular job.

[nursenetta]

All of that and some... with only 4 weeks of orientation. 3 of the 4 were in front of a computer. SMH but trying to stay motivated.