Silverblitzen

Nope, no scorching from me, only a hearty agreement. It's why I just left nursing. Our central agency was offering our company everything that came down the pike and our company accepted EVERYTHING in order to keep the contract, even if there wasn't staff to deal with it all. Money is the bottom line. Consequently my teammates regularly have 10-15 clients a day, are constantly sick, and work till the wee hours of the morning doing paperwork and faxing. I refused. I asked a friend on the team how many she's usually assigned and she said from 12 to 15 clients a day. That's starting at 7 in the morning and not finishing with the clients until 9 or 10 at night. That is not including the following paperwork. She's just handed in her resignation and has accepted a position at LTC where she'll work her shift and be able to interact with her family and not be called to do visits on her days off. She's done this schedule for the last 3 years, as are some of the other team members. One just came back from an extended leave, with a doc's note that she not have over 4 patients a day. She's regularly being assigned 10 "because there's no one else to do it". This is unacceptable and if nurses continue to put up with these conditions, not being paid for all the work you do, it will continue. Most of you are not unionized in HH and it's showing. You NEED representation! Me? I've gone back to school, yes, at my age and I'm following my bliss. I've started in an enology and viticulture program (wines and vines) and dream of owning a vinyard of my own someday. I may be broke now, but I'm much, much happier. :yeah:All the best to you all. Sue

"It is too bad that agencies "give up" on these patients and will not allow nurses to continue to try and educate their patients." Hi Anna, You can only do so much with the time you have. For every one of the non-compliant clients, there are so many more that will love to see you, listen to what you say and care about their health. I'd say a safe measure would be the 3 strike rule - 3 teaching/reinforcement sessions and if they still don't follow the med regimen, they're discharged. Save your energy for those that care enough about themselves to follow what you're saying.:selfbonk: If there are other obstacles to their understanding, then other agencies may have to be called in, but you, as HH nurse, only have so much energy to give. Give it to those that are trying to help themselves because you'll soon find yourself burned out trying to force someone to be compliant who just doesn't give a rat's patootie. And you'll resent them which is counterproductive to that therapeutic relationship we're all supposed to have. So, rule of three and set them free! Yah! Best, Sue

Arwen, Well said. I couldn't add any more than what you stated. Sue

Hi Cookie, You have to be careful and really watch for burnout. I didn't catch your age, but those kinds of days can wreak a toll on your body. I did the same till I came down with pneumonia and was out of work for a month. I had to drop to part time and it's better, but those days I work only remind me of why I did it. Please be careful. Best, Sue

Uh, I think you're right about the CG not wanting to leave the little cabin in the woods! The body could be days old and she'd still be saying the poor thing was just sleeping! OMG! Let us know what happens? Sue

Ya know, I tried to pick just a paragraph to quote in order to save space, but that whole situation was just too much! I couldn't pare it down anymore:eek: What a horror story! Is she still with us? The CG sounds like a trip. And she knew nothing of how to take a pulse? How does one get a position as CG and not know how to take a pulse??? Sue

I've got to check in on this topic. Since I'm not a spring chicken anymore, I have to pay a bit more attention to the tootsies so..... I paid a visit to the orthotics store next to the hospital. While there I was directed to a brand called Naot. I bought a pair of black oxfords, not the most stylish shoes, but like wearing slippers with support! They have a removable cork insole and I can walk all day in them. Love 'em! Sue

Hi, I always take my shoes off in my house, and therefore, I take them off in client's houses. It's a long standing habit from when I had horses and also had a mud room outside the kitchen in which to take them off. So, I carry a pair of hard soled slippers to wear in client's homes. They seem to really appreciate it, and it's such a small thing to do. And it gives a good impression right from the start. JMHO Sue

I never thought I'd wax poetic about a PBJ, but with Fieldberry jam (Smuckers), and the crunchy style PB, OH MY! Sooo good. I try to make it a bit more nutritious by making it with flax/sunflower seed bread. Ummm. Sue

Yes, Ontario. I do think home health is the way to go, but there has to be some consideration to the amount of work one can do in one day. I'm past wanting to do 60 hour weeks anymore and that is what full time (anything over 22 hours a week!) had turned into. They'd continue taking cases, wanting to get to 100% acceptance (i.e., take any cases given to our group). That's a fine concept in principle, but if you don't have the field staff with which to do it, it's insanity! :heartbeat Sue

Hi Os, Nope, not prn. Regular part time. Our company doesn't offer benefits. We were promised a new contract by July 1 that offered 8 hour shifts, comparable pay to hospital nurses and paid benefits. Guess what. We got a 3% raise. Nuff said. I can start off the day with 6 patients and end up with those and 2 admissions thrown at me at midday. It's 2230 and I just got home and now have to do my calls and faxes. I have a nice glass of Cab sauv in front of me however, and the paper stuff may have to wait till the AM. Thank you for the kind suggestions. I need to think some more about all of this. Sue

Hi, If you figure on 8 visits a day at $21 a visit, that's $168. Adding the $48 in mileage for the 100 miles (hypothetically) gives you the $216. Of course if you live in your area and only do 20 miles a day, that would change the outcome. Still, you're getting compensated for whatever mileage you put on, and have the opportunity to make more money by doing more visits. If they pile the work on and give you more than 8 visits a day, it's even better. Of course, it'll depend on your client preference in the end because you have to be happy with the decision. Best, Sue

Hi all, I've been in HH for 4 months, started full time and am now part time. Even at only 3 days a week it's burning me out more than anything else ever has and the kicker is that I love this kind of nursing! I took an $11 an hour pay cut to do this, but my main complaint is that it takes over my life! The day off before I work, I'm doing admission paperwork, schedule adjustments, faxes, phone calls to schedule appointments and the list goes on. We have no benefits, no paid days off, no paid vacation time and we're all afraid to call in sick because our team members would have to pick up the slack. All my team members are physically sick and I don't know how much longer they'll last, but I can only change MY situation, right? What to do? Hospitals are crazy. :hdvwl:LTC, unless you get into a supervisory position are extended med passes and kill my legs. I have an ADN degree (AAS nursing) and I'm 58. I wish I could retire, but that's not an option. Any suggestions out there? Sorry this is such a whine, but it's good to vent now and then. I hope with all the accumulated wisdom out there, someone may have an idea of where else I could turn..... Many thanks, Sue

Well, I think it comes down to what you'd enjoy doing. Company 1 will probably offer more diversity but longer, fewer visits. Number 2 offers a more stable roster of patients, but less time on each and so more you can fit in per day. Lets figure on you driving 100 miles a day (it's possible!). That's going to take, what, 2 hours+ drive time with town traffic, stop lights, etc. Company 1 gives you 6 clients for the day so you have 180.00 so far in visits. Figuring each visit averages 1 hour, that's your 8 hour day. Period. Now look at company 2. Driving 100 miles will give you $48 more towards your day. With half hour visits, you may be doing 8 or more (our RPNs regularly do 16 visits a day! ) and that comes to $168 just in visits. Time-wise, driving the same mileage as #1, you've put in close to 4 hours in visits with the same 2 hours driving time and you have $216 with fewer hours. With easier paperwork, a more stable case load and more money, you're way ahead with company 2. Just my most humble Sue, who is about ready to jump in the shower and go do my 8+ hour day as road warrior!

In this case, no, I wouldn't call 911 but you now have a baseline with which to compare. He has edema and crackles so you know the heart isn't working at its maximum capacity. If he's up and feeling great, just continue to keep an eye on him as you know that he functions at this level. Beware of any changes, however, and if things start to go pearshaped and he's in danger of crashing, and you know a call to the MD isn't going to help the immediate problem, then call 911.:redbeathe Sue