joy09

Redo nurses notes? I wouldn't do that. Stay away. Don't let them drag you back into that mess. I worked for an agency that assigned holidays without compensatory days off. The scheduler told me the other nurses worked right through. That's12 days on. People are damn crazy especially when it's someone else being abused.

This is a great thread you have provided, especially with your updates. I heard HH nurses are the most abused in the profession and I now see it and believe it. I work pediem and take up to a full load with the same results. I cant take a fulltime job because I just cant do it. Im going to refer a coworker to this thread. She is constantly hounded about OT. She refuses to work for free. The other nurses cut corners to get the job done or dont document all of their time. Glad you sre out. As soon as I find another job, I will be too.

How many patients do you see?

Fulltime? No.

The elephant in the room is that home care nurses are supposed to get six-8 patient visits, documentation and travel done in forty hours per week with few exceptions. Some agencies pay a salary to avoid OT. In my personal experience, observation and discussions with other home care nurses , anyone who can do that is cutting corners or working hours daily for free. The one scenario which is unrealistic is having stable patients who need only a basic assessment and easily understand basic teaching. They also need to live within a few miles of each other!

I burned out in five weeks covering for a full time nurse. I can't handle exactly what you describe. I do per diem while I look for another fulltime job.

I do alot of SOC. At first it took me 3a hours visit and documentation. Now, most of them are one hour in the home with some documentation and one hour to finish documenting unless it's a vac, significant wound care or other direct pt care or hands on with teaching.

One hour total for a basic visit. 1/2 with the patient and 1/2 documenting average.

Wet to dry and wait until morning unless assessment indicates need for a visit. I would not send a patient to the ER.

Can't beat that story! Imagine what you can accomplish in 8NO years with your health. Repost then!

Per diem used to mean you work the shifts you want to. No more in my neck of the woods. I must do weekends, holidays and call as scheduled which is equal to what the regular staff is required to do. When I am get called out on call I get paid mileage and for the visit. The regular staff gets time and a half from the time they leave the house until the time they return. What's the practice at your agency?

Toomuchbaloney is right. You need to draw boundries. Why are you putting your safety at risk in high crime areas, neglecting family time? Keep looking for a job and take the risk of honoring your priorities. You are entitled to and deserve a reasonable work schedule and to feel secure. Speak to the DON. Non nursing personnel don't have a clue and they think nothing of compromising you to fill the staffing holes. Short staffing is their problem, not yours!

I don'think there is a protocol but this is what would be done: PT eval on admission; the HHA would call the supervisor who would advise her until a nurse could get there (or would be directed to stay with patient and 911 called if necesary). RN would evaluate patient,and provide appropriate interventions; HHA/RN would submit incident report and it would be reviewed by supervisor; RN would notify the MD and patient contact andPT make recommendationsit to themPT and theWITH patient; everyone documentsrefers the hellPT out ofPT it.All of this would be documented.

Excellent post by Yosemite. I'll add that you should do as much documentation at the visit as you can. Don't get into the habit of taking notes.

I am paid like you: same pay for a short or extended visit. In the end, it should even out. Consider taking the patient just to help out and to get experience if you don't have it with the skills the patient needs. I would decline a two hour visit knowing the regular staff gets paid by the hour. That is too much of a discrepancy in pay to make it reasonable. Rarely make it about the money though. If you also have a scheduling issue, make it about that for now. BTW, I feel I can do this because I have taken many hour plus cases and have helped out in other ways that wasn't crazy about.

I am paid like you: same pay for a short or extended visit. In the end, it should even out. Consider taking the patient just to help out and to get experience if you don't have it with the skills the patient needs. I would decline a two hour visit knowing the regular staff gets paid by the hour. That is too much of a discrepancy in pay to make it reasonable. Rarely make it about the money though. If you also have a scheduling issue, make it about that for now.

I hope you find the standard and rationale in the literature. That is the way to go about it. A stron willed nurse needs more than say so to change practice.

I live in Pa suburbs and get paid by the visit. I don't get travel time, just mileage. I take four patients a day and clear around $950 biweekly. I get $35 per visit. I do a little better if I do 2 admisiions at $75 each. I can do my visits anytime. I put in 6-7 hours to get that accomplished. I review charts, set up appointments, travel, visit and finish documentation at home. I give myself one hour for each visit, two for an admission door to door.

I wish you luck. I turned down a clinical supervisor position because I didn't have experience. I've been doing field nursing for almost 2 years and still have a lot to learn. I have been a manager and educator and feel most comfortable when I know the work first hand. I recommend you spend a minimum of a fulltime week with the field staff, preferably more than one nurse so you get different views and see different ways of doing things. Find out what they think they need to learn, what they find helpful in a manager. Become familiar with OASIS and your company's charting system. That's what I would do and, as a staff nurse, would hope someone in your shoes would do. Same goes for understanding your clinical supervisors. Perhaps they are your experts. They are in our office. Again, good luck to you and congratulations.

I learned oasis by using HomecareHomebase and from inservices and my clinical manager. I have some cheat sheets but have never used any books. In my bag I have hand sanitizer, papertowels, gloves on the outer pockets. My equipment pocket with stethesope, oximeter, thermometer, bp cuff, scissors and disinfectent wipes. Clean pocket has 2x2 drain and plain, 4x4 drain and plain, unsterile gauze 4x4 and 2x2, rolls of kling, 1" and 2" tape, saline, a bag pf alcohol wipes, adhesive remover, suresite and bandaids. In my car I keep back up for my clean pocket, container of disinfectant wipes, extra hand sanitizers and thermometers with covers, boxes of gloves, container with bloodwork supplies, sharps box, ace wraps. I also have a supply of the paperwork I need. I have a small supply of wound care products such as xeroform, maxorb and foley supplies (insertion, irrigation kits, 2 foley caths, leg strap and bag, gravity bag

I start my morning at 8am. I get my assignment on my droid st that time. I review my charts, make my calls to schedule visits. That takes about an hour. I start my visits at 10.

If I have to work more than 10 hours a day in an 8 hour day job, that is too much. I just left a full time job because I was documenting into the evening, working up to twelve hours per day by the time I was done. Ideally, if I am paid for eight and it's a salary job, anything over eight is too much if it happens routinely, especially if you don't get lighter days.

If you ever get the chance to teach techs, I hope you will think about it. Your standards are just good patient care. In the meantime, you should have a discusssion with your manager and see if there is a way to bring this up down the road so it isn't directly linked to you. I've found it's better to do that first, before talking to your peers so the message isn't coming directly from me. Good luck.

I don't know about Gentiva but I just left a fulltime job at another company because I was documenting until 8 or 9 oclock at night and still not finishing. The patient load was only going to get worse. There was no on call but it was eating, breathing and sleeping home care documentation once I saw the patients. I would believe what you read about the documentation and not being able to have a life. I believe home health is notorious for that. I would definitely talk to the person hiring you before taking the job. The person I interviewed with told me one of the dissatisfiers of the job was "the work day doesn't end at five." I got paid a salary for 8:30-5. I figured maybe 6 or 6:30 would be what it would be like but I was working 12 hour days. The thing about the salary is they can overwork you and never give you a break with lighter days. I am currently thinking of doing per diem so I can call the shots when it comes to the number of patients I will take. I still have to take call one weekend a month and one night a week as well as two holidays a year. I have heard that homecare is the most abusive specialty in nursing and I'm afraid I believe it. Another pet peeve is you may get cents per each mile and visit pay but if you sit in traffic, that's on you're own time. I hope the answers here help you out. Sorry to be the bearer of bad news but it's a reality check.

I have an opportunity to bid on a hospital based hospice RN position. I have decided not to continue in a physician office because of the multitasking, fast faced environment. I don't have the same level of mental and physical abilities I've had in the past few years. I am looking for something to do and grow in over the next 5-15 years. I have a master's degree and could pursue advanced practice nursing in this field after I have experienced the direct patient care/staff nurse role. I am concerned this area would be too stessful and I am not looking for that. I want minimal technical tasks but enjoy physical assessment, teamwork and dealing as much with emotional, spiritual and mental health as with physical condition. Does it sound like this would be a possible match?