cathrn64

It depends on the type/steup of the agency. At the agency I work for, almost all of the RN's are case managers. I am responsible for my patient visits, coordinating the therapy visits. All of the therapist on the case (PT, OT, ST) are supposed to keep me informed of their POC's and I am the main contact with the patient, their Dr offices, etc. If I go on vacation, am sick or too full, than another nurse may see my patient. I am than responsible for telling the other nurse what needs to be done etc.

I Love homecare! I have been in homecare for 22 yrs. Yes, there is a lot of paperwork! There is also flexibility. If I choose to, I can see a patient and complete the charting at home or in my car afterward (My agency does electronic charting), or I can choose to complete the charting at the end of my day. (I usually wait until the end of the day.) When my kids were little, I could schedule my day around the Holiday Program and not miss it; I could go to conferences, etc. You have to be organized (and believe me, I was not at the beginning!) Seeing one patient at a time gives you a lot of time for teaching. (but don't get too emotionally involved because sometimes, no matter how much you teach or try to change a habit, they do not do it) Sometimes the most stressful part is dealing with Dr' offices and insurance companies. You spend a lot of time on the phone. I would not work for a company that did not give vacation time—sick time etc., just like a hospital (plus mileage for driving). I have worked in all of the different types of pay systems. (Salary, hourly, and pay per visit) Currently, I work for a company that pays per visit. It has its ups and down. I do get PTO, & if I am in the office for a meeting or class, I get an hourly rate. The downside is that if the agency is slow, your paycheck suffers. If it is busy, you can make some extra money. I always tell my orientee that you don't want to live paycheck to paycheck due to this. We work one weekend a month and 1-2 holidays a year. Weekends and holidays are mostly admissions, wound care.and/or IVs. The admissions require a lot of paperwork, and my agency counts them as two visits. I see 5-7 patient's a day, with six as the average. You sometimes have to do a lot of driving. I am very lucky currently; most of my visits are relatively close to home. I have co-workers who travel a lot and others who don't. Sorry- this was a little ramble y, but I put in as much as I could think of to assist you.

Suburbs of Chicago SOC =80.00 57.00 = RECERT 45.00 = REGULAR VISIT 50.00= High Tech Full, (but expensive) benifits (INS, Dental, Vision), PTO/SICK Full time employees can lease a company car- which at first sounds expensive, but works out well. It comes out of my paycheck, and includes gas, insurance and maintenance part time and those who don't want the car---millage reimbersment

Depending on your documentation system, it should get better! At my agency, I often hear new nurses complain that it takes them hours to finish a SOC. I can usually get out of the house in about an hour and a half. I finish the documentation in about another hour or so. 2-3 in a day is doable (3 is usually on a weekend)

Depending on the agency you work for, HH may be the right thing for you. Private duty is not the same as home health in my opinion. In medicare homehealth agencies you see "X" number of patients a day (the number varies depending on the agency, mine is 5-7). My agency expects visits to be completed within 24 hours. My kids are older now, but in the past, I was able to schedule my visits around conferences, holiday programs etc. You do need to know that your day does not end with your last patient. You will most likely be doing charting and phone call after hours. When my kids were little I would make my calls prior to picking them up (follow ups and appointment for the next day etc). I would wait until after they went to bed to finish my charting, It worked for me. I have been in homecare for 22 years.

My children are no longer small (15 and 18!). I have worked homecare throughout their lives. Depending on the agency requirements work can be very flexible. The 2 agencies I have worked for, both full time, did not mind if I scheduled my patients around conferences, school programs etc. Most days I work out my own schedule/times with patients. I am really lucky and don't have to travel too far to see my patient's. So, I could start after they went to school. When they were little, I did pay for after school daycare, because I could not be sure I would be home on time to get them off of the bus. Actually, it worked out well because I could either pick them up and finish my paperwork after they went to bed, or sit in the car (or McDonald's etc) and finish so I could devote more time when I picked them up. You will end up doing some stuff at home no mater what, (scheduling the next day, follow-up calls Md calls etc), but it is definitely doable if you stay organized! Good luck in your new job. I hope you enjoy home care as much as I do!

I am a HomeHealth RN. We teach family members to give injections/IV's all of the time! It is expected that a family member will learn certain injections like Lovenox. I have many patient's who have family members giving them B12 injections. There are many medications that Medicare/Medicaid cover. There are some that it does not cover like Nulasta for chemo patients

Susan317, I have never worked for any company where the IV company did anything other than drop off supplies. They have pharmacist's who do manage the dosing etc, but not anything in the home! OP, I have run into this situation and the main thing is to make sure the insertion site is covered and secure. I have worked in home care long enough that there were no securement devices. I have always used transparent tape or steri strips (which come in the sterile kit) to secure the PICC if there is no device

I do a lot of home health tasks on my knees (no dirty minds here!). I take a lot of blood pressures on my knees because it is easier on my back than bending down. I draw labs this way as well. I also can do wound care this way. I was once "marked down" on a performance eval because of this. I told the "supervisor" that the patient was laying on a low couch, how would she have done it differently? (the patient was on the couch, the wound was on his foot, the patient took up the entire surface of the couch. the complaint was that I put the supplies on the floor. The only other place would have been out of my reach, and I would not have been able to maintain the proper technique with the wound care supplies so far away. Back on topic, you will do things differently in order to maintain/help your back. It is not as hard on your back as some other forms of nursing, but there are still adjustments to help yourself and your back!

This is not quite the same, but I recently went to an MD office to get a DNR signed. The patient was a cancer patient and the Dr wrote an RX with DNR on it. This is not the correct way to have a DNR and the patient was not doing well. I went there (not something I would normally do) with the correct form and waited for the Dr to sign. After spending an hour of my (unpaid) time to do this, the patient transferred to Hospice the next day! (in the long run though it was best for the patient, and Hospice was where he/she belonged)

I misspoke (or mis-typed) The therapists actually do a re-eval prior to the end of the cert and than another eval after the next certification period starts.

The agency I work for pays one price per visit. There are different rates for regular visits, and high tech visits. Also for SOC'S Recerts and ROC's. I agree that it is not fair for those of us who have been working for a long time. Supposedly, they are working on fixing that. The agency I used to work for went from salary to PPV. They took the hourly rate and made your visit rate 1 1/2 hrs of your hourly pay for a regular visit. That seemed fair, and about right for the length of a visit plus charting time.

They do not have to do theirs until after the new certification period starts

I agree with the other posters here. I work in Home Care and my company requires at least a year experience. You will maintain a lot of your skills plus do a lot of teaching if you try Home Care. Be forewarned, there is a lot of paper/computer work and a lot of people end up leaving because of it. If you find your nitch, which I did, you will love home care and not even worry about being re-hired at a hospital. (When I started I did stay on as PRN at the hospital I worked at, just-in-case...., but left 18 yrs ago to do home care exclusively!)

I don't know about Illinois LPN's. The Scheduling coordinator in my office is an LPN and I know they do not have her taking orders. A lot of nurses come to home care and MANY of them leave because of the paperwork. Also because of the after hours follow-up. It is not what they expected! I precept many of the new nurses and it is something I try to cover early and often. It is disheartening when I have spent a month training and they leave a week or two after they are on their own! One good thing is my agency allows staff to mail in paperwork, and they mail you supplies. We have weekly phone conference calls. People have to come in to the office maybe once a month for in office staff meetings