vkunurse94

Be patient!!!! Work with the client. TEACH...TEACH...TEACH on the importance of sticking with med regimen. A lot of times patient's are taking meds and don't even know why!!!!!!!!! Help them understand the rational for each med and the consequences of not following these orders. If after a cert or two, you see that you are getting nowhere, it may be time to discharge. Sometimes it is just ignorance and/or poor teaching by various health care employees. Give your patient's a chance! If they obviously don't have any desire to change or receive help.....it is time to discharge.

One more thought....Make each nurse, HHA responsible for their own actions!!!!! They need to be trained to ALWAYS write their own omits. Always make them call the office and document who they spoke to as to WHY the omit or moved visit was ABSOLUTELY necessary. This should not routinely be the QA persons responsibility!!!! Only on a RARE occasion. I have become very strict on this issue, and it has taken alot of the load off of me. This should NOT be your problem. Each person needs to take responsibility for their own actions and/or problems. Otherwise, you will use your own valuable time fixing others problems!!!!!!! Don't do it!!!! As a QA person, you have plenty on your plate!!!!!!!!!!!!!:wink2: Good luck!!!!!!! QA is a very frustrating aspect of home health. Why can't nurses just do the "101" stuff without being told or reminded over and over????????????????????????????????????//

This problem is really very simple. Do not let your nurses turn in notes that were scheduled for the day without an explanation for each visit not done. If someone is not seen, they either need to write in comment section that visit was moved, or write an omit for that visit. Do not let them turn in a note unless one of these is done. Make the rules and stick with them. The person checking the notes in needs to report to you if a days worth of notes are turned in without some kind of explanation for each visit that was not done as scheduled. This will make it much more easy to track. Omits at a later date should rarely...if ever, need to be done.

It has been a couple of months since your question was posted, so I hope you haven't given up on home health altogether. If you are very organized and meticulous, the right home care company would love to have you. You would also probably LOVE your job. I have worked in home care for 13 yrs. Started as field LPN, went to RN school a few years ago, and am currently the DON at one of our branches. We have hospice as well. I still see patients in the field for SOC's after regular hours when needed, or occasionally weekdays if my RN's schedules are full. I don't HAVE to do that, but do it to help ease their load. That is what teamwork should be all about. Plus, I get the opportunity to put a name with a chart! I miss the field, patients, flexibility, etc. I have worked for the same company for 10 years. From the horror stories that come from some of our new employees, I have learned that the company you work for makes ALL the difference. I really hate to hear of people who are really excited about starting in home care, then get with a poorly ran organization. They usually quit with a really bad taste for home care and what it SHOULD be like. For a part-time employee, you are "case managing" WAY too many patients. There is no way that you can do a good, thorough job. And yes, you absolutely should be seeing the people that you case manage. Also, if you are an organized person, This kind of environment would drive you insane....to say the least. I would encourage you...if it is not too late....to ask around about agencies in your area with a good reputation. You may find a much more enjoyable experience and be able to say you LOVE your job. Good luck!!!!!!!!!

Thanks so much for your insight. I really think that I will enjoy working with children as well. I have done home health and hospice for the past 10 yrs, and am just ready for a change. Have a great day!

I am not new to nursing (14 yrs), but have always had a huge interest in psych nursing, and am ready to go for it. I am interviewing for the childrens unit this Tues. Is this a good place to start? What can I expect? Thanks