JensiS

Hello, I am an old nurse new to home health 1 year ago. Skillbuilding has been quite a year. My experience strength and hope program: I find myself in the same position as Discouraged at times, every few weeks. Factors: I live far from the office (about 1 hour, 50 mi). Some patients are in my area so I can see them on the way home, or on the way in. I have a huge territory (3-4 counties because the other psych certified home nurse is out sick). Driving isn't too unpleasant, because I talk on the phone to patients, families, doctor's offices, the office, and of course my friends... and I always have an audio book to listen to. That is a must. However, being a psych nurse, even with my non psych patients, I tend to talk (and mostly listen) too much. I do a ton of teaching each visit. I spend too much time at each visit. Our agency says 30 minutes in the house, 15 min. charting is a good goal for a regular visit, 1-2 hours for an admission (ha ha) or a resume. and an hour for a recert. Well, admissions take me 2-3 hours plus HOURS of paperwork and looking up codes. (codes are going much faster now than they did). A regular visit for wound care or teaching usually takes me 1 hour plus the charting. Sometimes, several non-visit discharges can get added to me. Looking up new patients in the office, pulling patient ed material from the files, hunting for proper supplies, and being nice to everyone in the office add to my time tribulations. I know these are not optional!! I have gotten behind in handing in paperwork when I have complicated admissions and have been in some trouble about it. Everyone says, "Oh, your charting is so good" but my efficiency factor in getting it done and in is poor so I am not pleased nor is anyone else. I have tried a timer (just for my counseling psych patients) but I lost it and didn't really like it. Ding! This is what I am trying. I must set better priorities before the visit: -determine in advance which subject or subjects to cover in teaching (or counseling) and don't let the patient derail this too far. -make out a route and try to stick to a schedule for each visit early in the day (I have been off by as much as 4 hours when trying to predict my day) and use a timer or my watch to announce "I must wrap this up". -tell each patient about how long the visit will take including the vitals and the teaching, and then stick to it. -Not try to be super home health nurse by perfectly teaching each person all that they need on the day of admission. (They need their meds straight, not memorized on day one). That is really it. Being supernurse. I think my Codependency is really the center of this. Like many in the helping professions, I achieve a lot of my self esteem at work. The more I do, the better I must be! But this has thrown me out of balance in life in the past, and it is doing it again. :monkeydance:So, with my peers out there, I am resolving "one day at a time" to abstain from supernursing, and take care of myself and not burn out on the schedule. I will do the above resolutions and be just fine anyway! Thanks for listening. JensiS in Tennessee