I've been doing home health for just over a year and for the most part it's been very satisfying. Prior to this I worked as a nurse supervisor in post-acute rehab for a couple years so the pace of home health was a much needed break. The hours work well for my family ( I have three young kids). The charting is extremely tedious. I try to do as much of it as I can in the home or in my car right after the visit. Oasis assessments I tend to do at night after my kids are in bed. I've become very disciplined in performing the charting the same day as my visit and this helps prevent me from getting buried in it. I have a pretty stable caseload and avoid a lot of missed visits by keeping track of all their appointments in a calendar and using that to shape my day. The driving is really pleasant in my area.
What's bothering me is my own lack of knowledge of the medications, pathophysiology and sometimes inability to draw a lab, trouble shoot an alarming PCA pump, fix a leaky wound vac, know how to treat a stubborn pressure ulcer, access a port a cath and there's no one there to help.... I know these things come with time and being a supervisor in a SNF really didn't provide a rich nursing experience (to say the least!), but still I'm bothered that I'm not able to give more to my patients. The office is able to provide support to an extent. I do call other nurses but at the end of the day, it very much feels all on me.
I had one today who was just readmitted to the hospital after I did her SOC yesterday for side effects from a new medication. In retrospect, it should have been obvious but I missed it. I have one very challenging, hospice appropriate s/p CVA patient who has every diagnosis known to man and his son gets frustrated when I can't give him lengthy explanations to all his numerous questions. He told the MSW that he's unhappy with me because I don't "know enough." I guess he just said what I was already feeling sensitive about.
Typically, when I need to know more on a subject I just pick up a book or research on the web. I'd love to watch some Khan academy lectures on body systems as a refresher (nursing school was a decade ago for me), but there is literally no time. I'm either working, sleeping or caring for kids. I'm exhausted and feel like I have nothing more to give. I told my husband today that I'd like go work for Trader Joe's or sell shoes or anything!
Sorry for the long monologue... I needed somewhere to vent. Especially after the "She doesn't know enough" comment. I guess the most challenging aspect of HH is being a jack of all trades. Much easier to specialize. Support/advice welcome!