So I am the Clinical manager for a home health agency, and I love every part of my job... the thing is I feel like my job is super overwhelming, i feel like im doing the jobs of 2 people. I'm really just looking for advice on if this is normal and if its not, how can I make things better?
So, Our agency averages 5-10 admissions per week, and we have about 90 patients in our census. We have one full time RN and a case manager, LPN who assists with QA review.
My Office roles include chart reviews, which I do bi-weekly if I can, the CM does half. I complete all 485s and approve the rap, and review the end of episode and review for billing, to do both those items I have to ensure all oasis and evals are completed, and add the eval orders and goals to the 485. I am the person in charge of making sure and following up with staff for documentation completion. For end of episode I ensure all orders are signed and all documentation is complete, If we need orders signed I make sure the calls are placed to pcp for orders. I am the point of contact for our staff, so when there is a problem during the Home visit I assist staff to make appropriate contact with PCP and problem solve the issue if possible. I initiate all case conferences, well most of them, and help guide staff on how to address needs or concerns for recertification. I am also the point of contact for our patients, if they have a concern or a question that is specific to their clinical care they come to me. I do not review the Oasis or Code, but these Items are not done without me providing a report to those who do this documentation, and requesting that it be completed. Since we only have one Nurse, outside of myself and an LPN I do follow up visits and SOC... I have been averaging about 10 visits a week, but for example, this week I have done 5 start of Care assessments, and it typically takes me about an hour and a half to an hour to complete that. I am new to my position, and our previous DON was awesome... but disorganized and I have had to revamp alot of our orientation process, review standards of intervention and create procedures because we did not have them...Im not done with that. I had not previous HH experience before this
I love my job, i love making visits and i love how much i can help patients.... Alot of my patients tell their therapist that they feel so much more confident in their disease management after my discharge, and our therapist are always thanking me and complementing our agency on the nursing follow up provided (I get the feeling that in other agencies the Nurse is not as heavily involved in care, or doesn't focus on patient needs as heavily as we do) In some cases I will follow up with patients - pcps and case managers that are not personally seen by myself to re-inforce teaching or assist with medicare guideline education and plan of care information.
But I am so crazy over whelmed... I feel like I'm always making a compromise about what important this is most important, and i keep asking to hire another nurse on, but i feel like the administration is stalling
is this normal? what should I do?