ksb13

Have worked for 3 agencies in 20 years. All were Sun-Sat. I can't imagine trying to keep it straight the way you describe.

I am scheduled 72 hours/2weeks and I never work more than that. I might work more than 8 hours one day, but have less than 8 another day. I am salaried, so can't put extra hours on time sheet My manager has a good understanding of my work load Hope this helps, although I can't answer the exact questions.

I just started a position with hospice 3 weeks ago. I have done home health for the last 15 years, but had moved and was driving 50 miles one way to the office, and serving 9 counties. This position pays much less (about 25%) but it is for ONE county. The office is ONE block from my house. There are 3 full time RNs, 1 per diem RN, 1 LPN, 1 personal care aide, 1 clerical person and the coordinator. The coordinator and the perdiem nurse do call from Friday until Sunday am. Each nurse takes call one night during the week and one Sunday every 4 weeks. The pt load is about 4 visits a day, occasionally more if things are hectic or someone has to have multiple visits. We do schedule visits with the aide to do together, which has been wonderful for me. She is GREAT and there is no better way to assess skin, etc than when assisting with a bath. I am loving it. Have been told that sometimes it gets really hectic but usually short term. The nurses have a "caseload" but share patients so that every one knows each pt at least minimally. Have the ability to "flex off" with or without pay if things are light and get a minimum of 2 hours call back pay if called out. It has been worth the cut in pay, to have good team mates who are not burnt out or overly stressed, although I know there will be times that census goes up or the week from chaos appears.......

I don't work in hospice, but have done home health for 15 years. We went computerized 8 years ago. THe first 6 months it cut my productivity and my satisfaction in half. However, after lots of practice and increased typing speed it actually was better and easier than paper. Have talked with other home health nurses who have gone computerized and the consensus is the same. At first it is horrible, then bearable, then wonderful.......but it does take time. You might have your management team talk to the vendor for your program. We were able to get several very time consuming things changed in the program. Took some doing, but it really helped. Meds were one of the things that we had changed. Hope it helps. Hang in there.

If you want to give me your email address or email me I will tell you what I know about Lourdes and WBH. Haven't worked IN either, but have done home health for both. [

I don't know anything about any of the L'ville hospitals but would also be glad to get any information. Might make my job hunting in the spring a little easier.

Did talk to JSMC and was offered a position in home health, but it was going to create conflicts with my teenager and he comes first, so still doing the home health thing for Baptist. I have not worked in the hospital at either Baptist or Lourdes, but have done home health for both. They both have good points, but at this time I am more content at Baptist. I think the plan is still to move to Louisville in the late spring. My teenager is applying for a new residential high school in Bowling Green, on WKU campus and if he is accepted , I will move to Louisville to be closer to the older two kids. There are many more opportunities in that area than are available in Western Ky. Plus, I miss my kids! Even if they are grown.

thanks for the info about trigg and JSMC. I have an interview with JSMC on Wed. Waiting to see what they offer. I am still thinking about moving to the Louisville area in the spring. My adult kids live there and was there this weekend. Lots of offers in the paper there. Still working prn for baptist out of Paducah and enjoying that. Luckily in nursing the options are many!

Hello, another West Ky nurse. I moved from Paducah to Murray about 5 years ago. was at Lourdes until about 8 months ago. Now doing home health for Baptist on a prn basis. I needed to be at home more than I needed to be driving all over the state! Would like to find something a little more "scheduled" Maybe 1-2 shifts a week. JinJerEvans, how do you like Trigg and JSMC? Have thought about both of them. Could you give me some info on them? I have thought about the RN to BSN at Murray, but need to wait until the last teenager is out of the house....

Hello and welcome to the area. I live about 60 miles northwest of Fort Campbell. The closest options for you are going to be Gateway Health Systems in Clarksville (I hear they are building a new hospital), Jennie Stuart in Hopkinsville, Western State (state psych) in Hopkinsville, or Cumberland Hall (private psych) in Hopkinsville. There is also Blanchfield Army at Fort Campbell. Nashville is probably about an hour away and several there both big and small. There are also some home health, etc available but I don't know much about them and very little about the hospitals. Do you have both your TN and KY license? You are going to be on the state border so that would increase your options. Not sure which are the best areas to live. Good luck.

Hello, I currently live in Western Ky, about an hour from Fort Campbell. There are several hospitals in the area. Nashville has a VA hosp, Vanderbilt, and St Thomas, along with some others. Fort Campbell has Blanchfield Army Community Hospital, Clarksville has Gateway (which is hear is going to build a new hospital), Hopkinsville has Jennie Stuart, Western State (state psych) and Cumberland Hall (private psych)........ those are all probably within drivign distance of the Clarksvile/Fort Campbell/ Hopkinsville area. Good luck and email if there are any other questions I can help with. I will be moving to Louisville late this spring, so will appreciate any comments/hints/tips on the Louisville area!!!

I have checked at a couple of the hospitals and Our Lady of Peace and Jewish both offer a work on weekends program. I think Norton's does also, I have not talked to them yet........they are on the list for the next time I visit Louisville as is Baptist. I suspect Louisville is like any place. There is crime and there are some areas that you don't want to be walking around in at night, but a little common sense goes a long way. I currently live in a very small town in rural KY, but being in such a rural area........we have meth labs blowing up fairly frequently........so all in the perspective. I enjoy Louisville, it has a lot to offer, including some great schools and that is important to me. My high schooler wants to go to a magnet school.......and my adult kids live there, so it is the obvious choice for me. Hopefully I will be there by June 1........soon as the school year ends here.

Does anyone here work for Gentiva Home Health? Know much about the home health work in the area? Also, anyone work in psych? I did that for 8 years and enjoyed it, so it is also an option. Salary scales seem to be a bit lower than I expected. Are there many open positions? I am looking forward to the move to Louisville and plan to make a few short trips to talk to employers, etc. Just trying to get as much info as I can beforehand. thanks to everyone

Thanks for the info. Still trying to decide if I am going to move or not. I may do the agency thing or the WOW thing. Have also considered going back to psych nursing. I did that for about 8 years. Have worked in HomeHealth for the last 14 years. So, lots of things to think about. I appreciate any and all input about working in Louisville. Thanks so much!!!

I am also planning to move to Louisville in the near future. Any suggestions on which hospital systems are the best? Any one working in Louisville? Tell me what you like and dislike about your employment. My adult children live there and have finally persuaded me that I should move. Will probably be moving this summer and would like to know if there are places I should definitely apply or avoid. Thanks.

I also call the night before, however in Ky you have to be homebound even for Medicaid, unless you are a waiver pt..... and then you are the waiver teams pt. If you are receiving skilled services, you must be homebound and our Medicaid pt have to have auth for each visit. My agency also will dc if you are not homebound, even if you are pysch, because the same guidelines apply. We generally allow one missed visit if for a good reason (funeral, unexpected out of town family visit) but the second one, we discharge the patient. I have found that going over homebound guidelines on admission helps a great deal. Don't give up on homecare, it is the best job I have ever had, even with the occ problem.

That sounds wonderful. The main complaint from staff and pts has been that a computer "gets between" the nurse and the pt. I can write and look at the pt and talk, but harder to keyboard in or choose options and maintain eyecontact. The good part has been many of our pts are very interested in seeing the computer and I let them watch me enter vital sigsn,etc on their chart. That seems to help. Tradeoffs in everything I guess.

We are on our third set of laptops. The first ones were very small and SLOW, the second ones were better, and the ones we have now are notebook sized, have wireless modems and are almost as fast as the desktop pc. Our server problems have decreased, but the agency have put in new T1 lines and that helped tremendously. The learning curve for PTCT has consistently been about 6 months. The first 6 months you are lost and then suddenly it makes sense. We have had numerous upgrades and changes. We were (and may still be) the largest agency on PTCT, so have a lot of input into the changes. Our system also interfaces with billing and intake. Makes less paper and easier to get info. I was on call last night, had to go see a pt about 10 pm and could easily pull the chart over, get travel directions, orders, etc and know the pt history. That makes it much easier, makes the documentation easier and helps in continuity.

The more I read here the more I realize that I work for a very good agency. The fact that our productivity requirements have changed in response to RN/LPN input and that our agency does see pt who have no payor source, and I have a supervisor that LISTENS and tries to resolve situations in a win-win way. Makes me very grateful I work where I do and with the people I do. Our agency also makes a profit. Not a huge one, but we are in the black. No lay offs or cut backs, no decreases in salaries or benefits. I am so very grateful. Shows it can be done.

Our admit nurses are a lifesaver.........we have two and both are long time (greater than 12years in homehealth) nurses in home health and understand the area, docs, pps, the computer, etc....... it works for our agency. They can do SCIC and ROC if no admits to be done. We still get some overflow, but not as much and that makes the scheduling easier...... we also have 12 hr shifts on the weekends for those visits....again, long term home health nurses. It really helps when we cover a geographic area that reaches >100 miles north to south and >75 miles east to west..... we cover a LOT of territory in western KY and southern IL.....

Our agency gives each licensed person a cell phone. Bills are audited by the team manager, but the cost savings is good. We no longer carry beepers and since we live and work in RURAL western KY... the phones reach more of the area. As long as we are not WAY over the "designated minutes" (400 I think...) then no problems..... the agency does get detailed billing and personal calls are a no-no unless an emergency..... but I think we all have personal phones for those.... it seems to be working well. No bill to the individual and the agency has the detailed bill and can address individual instances where it is abused.....

I am not sure what our agency census is because we are so spread out, one main office and 3 branch offices, but in the branch office that is my home base, we have 4 RN positions (my partner and I share a fulltime position) and we average 22-27 pts per full time position. We have LPN availability but that fluctuates depending on private duty cases, etc and different branch needs. We are a hospital based agency and our hospital is a not for profit, so that probably makes a big difference. One of the local for profit agencies has been bought twice, in bankruptcy and is now losing staff left and right (rumor is newest buying company is overextended and closing offices). We are the oldest and the largest agency and have more specialty nurses than the other local agencies. We probably do a 50-50 mix of office and pt care for the most part. I for one love home health, but not enough to work the hours some agencies seem to require........life is too short and I have too many other things I enjoy.

visit and chart time are usually about 2-3 hours, depending on the type of admit, IV, wound care, CHF teaching, etc. I cover one county in Western Ky, so driving may or may not be an issue, usually I cover the southern part of the county and my job share partner covers the northern, but we do see each other's patients and do admits for each other. My driving time is calculated separately and units given for over 300 miles/week. As I am 3 days a week, my calculations are pro-rated. Luckily we have dedicated admit nurses and I don't usually do the admits. I generally drive between 150 and 300 miles in a 3 day work week and get 1-3 points for travel time. Hope this hasn't muddied the waters.... actual time in the home with the computer is usually 1.5 to 2 hours..... another -.5 to 1 hours for "finalizing" the paperwork, phone calls, setting up with infusion company, MD calls, scheduling, etc.

My agency has been on computer since 1998. We use the PTCT program and for the most part it has worked well. We started with 4 nurses and trained 4-6 new clinicians approx every 4 months until we had everyone on computer. All licensed staff are on computer, SN, PT, OT, SLP, MSS, RD. We are on the third generation of computers. The ones we have now have wireless modems for the office and phone modems to import/export from home. The first year was NOT fun, but most of the bugs have been worked out and at this point it works well for us. Our agency is a hospital based agency and PTCT interfaces with the billing and the hospital medical records system. Oasis is still a pain, but with the computers we can look at the patient history, past visit records, etc while in the home and that helps tremendously. Hope this helps.

I work in extreme Western Ky. Our agency covers 6 counties in Ky and ?3 or 4 in Southern Illinois. We have a main office and 3 branch offices. Our productivity is based on points also. Admit=3, recert, dc, scic or roc=2, revisit=1, supervisory=0.5. Meetings =1 (no matter how long or short). Back up call=1 and precepting a new employee=1 point for each day. We are expected to do 30 points per week. Travel is taken into account if you travel more than 300 miles a week. Our agency also takes any time you have to spend on things not related to pt care out of productivity...such as if you have 1/2 day doing clinical chart audits, or working on a QI project. I have been doing homehealth for 12 years and we have seen this system evolve slowly. All in all I think it is a very fair system for where we live. I am also part time, I work 3 days a week job sharing with another RN and our productivity points are pro rated. I usually am somewhere between 90-110% of productivity and between 22-26 hours, so I think it works out fairly for me. We also have 2 dedicated admission nurses and so do not do the majority of our own admits, occ we do, but not as a rule. Hope this helps some.