MeggyBeth

First, as for part vs full ... if you aren't comfortable with full definitely stand your ground. If this company pushes you into a position you aren't comfortable with right from the start you might want to consider if that's a place you want to work. (Personaly I think it's terribly short sighted of a company to think like that...I know there are part time nurses I've trained for my agency who've lasted longer & given us a better "return investment" than some of the full time nurses...) Second I agree with LinuxRN - different types of HomeHealth/Home Care are different. (Also there are many different charting/EME systems and all agencies don't use the same ones) The agency I work for for doesn't have to use OAISIS, and the EMR/charting system we have allows nurses to copy their previous assessment (the nurses should still be reviewing each assessment to make sure the copied data is still accurate & applicable...but it greatly reduces charting time.) So depending on the type of HH, the company's culture, and the EMR system you might find one place is a better fit than another.

Any Medication set-up nurses out here? What documentation form/system do you use? Our agency used to use an in-house generated document (looks like it's loosely based off the BRIGGS Med flow sheet), but we've since resorted to generating our own documentation inside whatever EHR/Documentation system we were using. We currently are preparing to on-board with yet another new EHR system and while they acted like they had other clients who utilized their system for medication set ups they now seem somewhat confused on how to help us build that documentation. They're working with us, and we've sent them examples of our previous paper form and the BRIGGS form, but if anyone has any advice on how things might be explained differently I'd be open to it. (maybe this question belongs in Informatic instead?) ?‍♀️

This may also be called Private Duty Nursing (PDN) - which is exactly like caliotter3 said - usually a set shift length of 6-8-10-12 hr with the client in their home. You still drive to to & from the client's home, but you're not zipping all over from case-to-case multiple times a day and there's usually some downtime throughout the shift to ensure charting gets done

Consider a Private Duty Nursing (PDN) agency vs a Home Health agency. You won't make as much as a floor nurse, but there's generally better flexibility. I started out as a new nurse saying I'd never work for an agency because all the agency nurses & HHAs I'd encountered prior were under-supported, and frankly quite sloppy in their work (which was probably due more to over-work & burn-out). BUT...I decided to give PDN a chance. I've been with the same agency for 11 years now. I started as an LPN, worked through my RN and a Pregnancy, and now I do Care Management. My DoN took a similar path as I did - she was a field nurse for this agency as an LPN, worked through her RN, eventually was recruited for a CM position, and is now the DoN (she's been with the agency for about 18yr now I think). You can do this if you want to. Not to make is sound trivial, but a lot of it is common sense. While PDN patients obviously need extra medical support, if they weren't in a stable condition they wouldn't be in their home (btw...don't use the word "stable" in your charting - insurance thinks it means the Pt doesn't need medical help/support). Be upfront with your questions & concerns. Will they provide you additional training if you feel uncomfortable with a specific aspect of care? (mine was the trach - I was so nervous with trachs....now I could probably change a trach in my sleep LOL) Do they have a 24/7 support line? How much experience does the office staff/support staff have? How long have the office/support staff been with the company? It's not for everyone and there is often a high degree of independence required - which can be intimidating, but could also be rewarding. Lastly, remember every agency is different (just like every LTC or hospital is different) and for every bad one out there, there is probably a good one too. ?

Home health and PDN will typically pay less that a hospital or facility position. (because medicaid/medicare don't reimburse as much for those positions as they do for a floor nurse). HH tends to be an hr or two in a Pt's home with lots of driving in-between Pt's. PDN is usually 1 Pt per day, and usually an 8, 10, or 12 hr shift. I'd say go into any HH or PDN interview expecting a lower wage - unfortunately that is the reality of health care. Different agencies do pay differently for same or similar positions (I just had an RN tell me she makes $3.50/hr more at another agency for the same job she does for us). Don't be afraid to ask up front about pay rates, but also ask how long their office/support staff/DON/CMs have been there. Higher pay is nice for the bills, but it may be hiding something internally (if there's a high rate of staff turnover that's a red flag ).

Hi Cookie - hope your interview goes well!! You might also want to look into an agency that specializes in wound care (wound vacs are my all time favorite LOL) or an agency that provides Private Duty Nursing. PDN is similar to home health but different at the same time. CONs to PDN that I've experienced - pay is usually lower because medicaid doesn't reimburse as much for a home nurse. The agencies tend to be smaller so they can't afford bigger perks & benefits. PROs - scheduling is flexible (and usually done for you). The agency I work for does monthly schedules so you know where you will be well in advance. You work a regular shift too, usually 8, 10, or 12hrs in the home and documentation is all done on shift in the home. PDN can also be a nice little side gig. You get 1-on-1 patient care in a laid-back home setting, but your main job can provide you with your medical benifits, tuition reimbursement for BSN & such. If you have any questions about PDN I'd be happy to try and answer them.

some of this is dependent on your state's Home Health guidelines, some of this is dependent on your agency's accreditation policies, but overall you should abide by your agency's specific policy. The agency I work for requires a signature for ALL medications (even a topical OTC like desitin for diaper rash). The nurse in the home is able to generate a Physician Order at any time, once that order is submitted in our documentation program we are able to print it off & fax it to the physician for signature. We generally run ER/ED meds through the PCP (because tracking down the ER/ED docs/PAs/NPs is a pain). Generally, like BBP42 stated, we run meds through whatever provider ordered them. The only exception I can think of is we generally run ER/ED meds through the PCP because tracking down the ER/ED docs/interns/PAs/NPs is a pain.