sjsap

bravo, nursieme! hear hear! it is too bad there aren't more like you around, brave enough to tell it like it is!

I hear you! I work per diem for a home care agency and get a per visit rate- so no matter how long it takes me, I only get a set amount. I travel between 50-130 miles per day and get paid $.32/mile. The agency is currently short-staffed, so I am filling a full time position and have 5-9 visits/day. I supervise and LPN who does visits on my patients, so when I give her visits, I lose $, but I don/t make myself crazy about it, because I usually pick up admit visits for other staff. (they pay me a higher rate for admits than they do for regular visits) But fulltime staff have a "productivity" of around 24-30 visits/week. Admits count for 2 visits. I complained that I was the only RN who supervised an LPN, it would make more sense to me to link her up with a full-time staff nurse, but the regular staff is difficult to work with (?burnt-out) and won't take on the extra responsibility of an LPN. There is a disgusting amount of rather redundant paperwork- duplication of "homebound status" on 3 different forms, rewriting orders, SCIC forms, Transfer oasis, D/C oasis, recert oasis- it is enough to drive a sane person crazy. I also do a larger amount of paperwork at home because the office is no place to get anything productive done. I am not paid for office time or charting time at home- in the eyes of the boss, we are "supposed" to get the charting done in the home during the visit (OH YEAH, that really makes the patient comfortable) I guess I never really looked this closely at this before- it is time to go back to a job I can do in 8 hours/day and go home to enjoy my kids......... What keeps me sucked in is the patient- there is nothing more satisfying than making a true difference in the life of your patient, and I have been honored to have met and cared for most of the patients to whom I have been sent.

WHere I work they pay mileage at $.30/mile, but they won't pay if you go to the office at the beginning of the day or go home from the office. So, we see patients on the way to and from the office, usually. They also deduct 20 from the mileage total for the day and pay the remainder, which I think is not fair, but at least they pay something for the mileage. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "It is not enough to be busy; the question is, What are we busy about?" H.D.Thorough