SmittyLPN

I just want to thank everyone who posted on this thread. I appreciate your input and your suggestions. I spoke with the HH agency one last time today to clarify hours, benefits, etc and they had already dropped the number of visits to 15 instead of 20 and said it may go down from there. I have decided not to pursue this right now. Perhaps once both of my kids are in school and daycare is not an issue I will look into HH again. But for now it's back to clinic (and corporate) life for me. I will miss all the extra time with my kids but at least I'll be able to afford all of their sports and school activities now . Thanks again for all of your help!!

This drive sounds like what I would be doing. At least one day a week I would be driving what I call the "country loop", 117 highway miles round trip plus the miles for whatever stops in towns along the way. It's at least 2 hours of drive time but 2 hours in the car is way better than 8 hours confined to an office any day.

KateRN1 Thank you for your positive view on this. It is nice to read that someone really seems to have enjoyed this type of nursing and has actual experience doing it in MO. It is hard I think to compare apples to oranges (for lack of a better phrase). Your post reinforce what the other nurses were telling me about how much they loved doing this. You are encouraging my temptation to just go for it.

I am not so concerned at this point with what other home health nurses make. At this point I need to make a personal decision about whether I want to make a lot of money and work long hours or do I want more time with my young children. I know what the "going rate" for home health LPN's is in my area and I also know what my time is worth. I have other things that I want to accomplish every week besides being a nurse so I am trying to weigh the pros and cons of money vs time. I don't feel that taking less pay makes someone any less of a nurse, just depends on your career goals. I've got a pretty good career as a Mom right now and I don't want to screw that up just to make an extra $2.00/hr. Let's put the issue of what I "should be paid" to rest b/c the actual wage is no longer an issue.

Finally, an explanation that really makes sense! Thank You KateRN1, and no offense to anyone else who replied, I appreciate you too. Now I understand what this agency is all about. Your description, KateRN1, fits perfectly with the answers the agency has been giving me. I'd PM 'ya but I don't have AOL. I would really love to just jump right in and give this type if nursing a try, but the hours combined with the lower pay are hard to get past. The position is 20 visits a week but there are no guarantees and if they drop too far below 15 I barely break even with daycare costs. Of course that doesn't include the mileage pay (.48 per mile) but I can't expect extra money from that. (Although it is quite significant with all the country driving and I'd never spend it all on gas.) I actually accepted the clinic job and went to general orientation today:yawn:. The decision was solely based on potential income so I am not too excited about attending nursing orientation next week. Too be honest, all I could think about today was how much I'd rather be doing the other job . I guess that really tells me what I should do, but How do you cope the potential fluctuation of hours? Perhaps I am just over thinking things, after all my income is really just fun money and I did origionally set out to find a part-time job. Funny how an offer of better money changes one's perspective . . .

Caliotter3, Thanks for the explanation, it helps. Although according to your description it sounds like this agency has taken "continuous care" hours and spread them over the course of a month to allow for visits.? Each client has a HHA and the LPN's do 20-60 minute visits. Patients are not usually fresh out of the hospital, but instead are referred by thier PCP. Once the patients are referred to the agency they are a patient "long-term", usually until they can no longer be cared for in the home or pass away. There is no set time frame for completion of care. The goal is apparently to keep these seniors out of a nursing home as long as possible and keep "costs" of care down. I think I am starting to get the idea pf how this works and where it falls into "home-health" and "community outreach", so we'll see . . .

HmarieD (and anybody else who may know), I am also confused, but then I don't know much about home health, medicare or medicaid. Which why I started this thread to begin with. Is there some other kind of home care other than "home health" that nurses provide? When I spoke to the RN that manages the office where I interviewed she actually made the statement "we're not Home health" so what are they? They take only medicaid patients/clients that are "stable" and here's the exact description of their medical services off their website " Nurse visits offer skilled maintenance and preventive nursing services to clients with stable chronic conditions. Services include filling insulin for diabetics, setting up oral medications, monitoring skin conditions, providing diabetic nail care, and now, new medication management services." Please keep in mind that I am not an RN so I don't expect to be doing hospital type care in the home. But I don't want to end up doing HHA work either, and I am not a babysitter. Really it sounds like most of the visits fall into the above description and the rest are medicaid required assessments occurring either monthly or q6months. And I'd totally settle for that description but eveyone keeps telling me not to fall for it. Perhaps I just don't know enough about the medicaid programs that Missouri offers to know what is going on. I did find out that they actually do offer benefits incuding PTO and 401k, so now the only truly "bad" thing is the low pay. Aside from that this job sounds like what I've been looking for since nursing school 7 years ago, just wish I could figure out exactly what I'd be getting into skill-wise :icon_roll.

Ok I got a call back from the office. I was wrong. They are not medicare patients they are Medicaid. And they are basically well patients that just need someone to set up their weekly meds, may be draw labs, diabetic nail care, and weight checks. There's usually no wound care, there's no piccs, no trachs, not even tube feeders. Souds very basic and I thought for a second that maybe she thought I was an aid or a CMT, but she said she needs a nurse because they do weekly/monthly assessments. Basically we're there to make sure the patients do what their PCP wants them to do. These patients are with the agency long-term, usually until they need a nursing home or pass away. Paperwork amounts to a nurses note and a small checklist of no more than one page. Assessments are also a checklist. Sounds very easy and the workload seems to justify the lower pay. It's more like assisted living than skilled nursing. Guess I could do it for the extra cash and maybe go back to school.

Ok so there seems to be one thing that I definitely need to clarify. I do not want to work full-time so if I only have 15-20 visits a week that's fine. I do not want anymore than that. My full-time job is being a mom and any job I get at this point is just for extra spending cash. As for the other stuff, we are out in the country so 200+ miles a week is entirely possible going to all the small towns in the area. I would be the "traveler" in the office so the out of town visits would be mostly mine. This is a very small office with only 4 nurses including the supervisor/manager and I met all of the staff and all have been the a long time. Some 20+ years. The nurse I would be replacing has been there 25 years and is retiring. I did call around to the other agencies in town and none of them paid more th $18/ visit and the ones that paid $16 or more did not pay any mileage. I know it sucks but thats the way this town is, trust me I wouldn't live here if it weren't for my husbands job. We'd be back in Texas :). I have left a message with the office to clarify things about job duties, paperwork, mileage, and to ask for more money but no call back as of yet. I do know for sure that the office is closed on weekends and holidays so there are no nurse visits on those days. rngonnab - Do you work in home health? Sounds like you just don't like it? Most of what I've heard/read about it does not sound any worse that being couped up in a nursing home all day/night. I have been taken advantage off and walked all over at nursing homes so what would be the difference?

Thanks berube! Perhaps I'll go back and try to ask for higher pay. If they refuse then I can walk away knowing that I tried. The visits sound like they would be relatively simple. Sounds like they don't take vent patients or anything too complicated. You guys have got me thinking though and playing the interview over and over in my head and I do remember her sneaking the word housekeeping in here and there, perhaps I should ask about that to b/c I am not a housekeeper. There are only a few home health agencies in our town and they very rarely have an opening. That's the only reason I am considering this one. I applied at the other big agency in town and he said openings are rare.

Well, your basically confirming what i was afraid of. I'm just glad I have another option. Thanks again for your responses. I'd still love to hear from anyone else out there that has some insight. I have until Tuesday to make a decision.

I am in St Joseph and have been looking for a bridge program as well. There is a program at the Tech School in Maryville, MO that only takes 9 months, but you do have to have your prereqs done to get in. You also have take entrance exams and score well. I have done everything but take the exams and I may take them next fall/winter. The program only starts once each year and I've run out of time to be ready for this fall's start date. You might look into it. It's an outreach program thru North Central Missouri College. ANd if you need funding hte hospital in St Joe ahs a program to pay for it!

Caliotter3, Thanks for the reply. Do you know if there is a difference between pay for visits when the client has regular insurance vs. medicare? This agency only takes clients on Medicare. They are seniors and occasionally younger patients with MH issues. I was told that the majority of the visits would be pre-filling meds, filling insulin syringes, some wound care, PT/INRs, and monthly assessments. 15- 20 visits per week. The part-time hours are fine, I don't want to work full-time right now, and the pay is only $2/hr less than the clinic. It just seems like the pay is so much less than everything I've read on these threads. And for the responsibility of the position the pay seems too low. The woman I interviewed with said that pay is low because the companies funds have to pay for the food bank, the meals on wheels program, and all the other community services they provide. The organization is entirely church funded and supported. She says the mileage makes up the difference, but isn't mileage paid for a reason? And I find it hard to believe that I could drive enough miles in three days to make $500/month in mileage. I just don't want to end up working for free after all is said and done. We live in a small town about 2 hours outside of Kansas City so good jobs are hard to come by and most LPN jobs in the area do not pay more than $15.00 an hour unless you work the hours no on else wants (every weekend and holiday). Been there, done that, and I'm not doing it again. Everyone in the office says the job is so much fun and so rewarding. And I get the whole community service thing, but I'm not working for fun, I need a paycheck. Perhaps the idea that I could work and still have time to spend with my kids, and to workout, and to take care of my house etc, etc, is too good to be true.

Hi! I am new to this website and it seems like a wonderful place to get advice. I am getting ready to return to work after staying home with my kids for a year and I am nervous about choosing the right position. Most of my experience is LTC and Clinic, I'd say an even 50/50 split. I have no desire to return to LTC due to the hours and terrible work load so a clinic job was my first consideration. I have been offered a home health job doing visits and it sounds very intriguing but it also makes me very nervous. I would totally be able to work around my kids' schedules , but the pay is not good and there are no benefits to speak of. The agency is part of a churched based non-profit community outreach group so there is no room for negotiation on pay and likely no chance for future raises. They pay $13.50 per visit and claim that I'd make $500 a month in mileage . . . Can that be right? Do you experinced HH nurses make that much in mileage? I would have one day of country travel to several small towns, about 125 miles in one day. They also gaurantee that it's sooooo much fun, can a nursing job really be sooooooo much fun? And, how does HH LPN visits compare to skilled nursing as a charge nurse in LTC? Sounds similar but also a little scary. I have some hospital experience but not a ton (like I said, mostly skilled LTC)and I just hope I could make all the right judgement calls when I/m alone in the field. I've also been offered a clinic job with good pay and great benefits, but as always I'm sure it would get monatonuos and boring VS after VS after VS . I'd also have to rely on a lot of daycare for the kids. I'd love to get some opinions from other nurses out there, especially HH LPN's that do visits. Could I love it as much as everyone says or should I play it safe and go abck to clinic nursing?