behindthedoor

thank you

Greetings. I am trying to write an article regarding home care, OASIS impacts, computer impacts, and the suspicion I have that home care RNs are consistently working unpaid overtime. I realize that this might not necessarily be a scientific survey, but it will give me an indication if my suspicions are correct, and if I should proceed. I have distributed a similar anonymous survey at my workplace and found the answers extremely revealing, that is, 96% of respondents state they work extra for free at times or always. If you could answer the following three questions I would greatly appreciate it. 1. I work more hours than those in my assigned shift: 1. Never (0 days a week); 2. Rarely (once a week); 3. Occasionally (2-3 days a week); 4. Often (3-4 days a week); 5. Every day that I work 2. On my time card I put in for the extra hours that I work: 1. Never; 2. Sometimes; 3. Always 3. Management's understanding of nursing staff's workday is: 1. Very poor; 2. Poor; 3. Good; 4. Very good; 5. Excellent

Thanks for the clear reply. These expectations seem more than reasonable. If I understand you correctly, you would be expected to see two SOCs in one 7.5 hour day; three SOCs and one revisit in a twelve hour day. Do I have that right?

Certainly, the hospital is not the "be all and end all." The world of health care has many equally important facets. I do feel, however, that a solid clinical experience lets you bring more to the table. I myself never wanted to work inside a hospital or facility for my career, but I am very glad I had two years experience in the hospital and critical care.

Bravo. I especially concur with the 'undermining" thought. We must show solidarity here.

Yes, do find out about Labor Laws and use that to your advantage. We, as Homecare nurses are in an amorphous work place. We are not in an institution, rather we move about and then go home, where perhaps we feel that we are not really "working" but just completing our assignment in the kitchen. I don't see it that way

Kate and Indiana... I suspect that as we hear more on this that we will notice that this is a pervasive condition. At least this is my suspicion. I think we all need to stand firm and not give our profession away. Indiana, your perspective is interesting, in that you are doing all the work in the patient's home and still are pinched. I personally prefer to keep the laptop away as much as possible and have more face-to-face time with the patient. I suspect this may be a function of facility with the computer however. I think as long as some of us are working and not putting in for the time we will continue to be taken advantage of by employers who do not understand the time it takes to complete the duties asked of us.

Thanks for the reply. I'm more interested in hourly situations, let's say a 7.5 day with a productivity expectation.

"Extended care," meaning you are with one patient for a shift? I guess I am looking for feedback from VNA RNs who are seeing multiple patients in a day, and then documenting OASIS forms, etc. Thanks. Keep the faith.

Specifically, my question is, do you work 42 or 44, but only put in for the 40?

HELLO, The way I look at it, it's a short period of time, a leaning curve, before it becomes bearable (like developing a callous on the brain!) and then it will become rote. Personally, I would rather be seeing patients. This is the saddest thing about OASIS, the fact that it weighs my day in favor of documentation rather than hands on nursing. Thanks for the thread.

My experience would say that clinical (one year hospital minimum) experience is essential for a successful VNA career. GOOD LUCK

A quick question for all of you now struggling with OASIS and productivity. How many of you are working more hours than you are putting in for? Are you feeling this pressure, love your job, and thus more often than not, because of subtle pressure. not putting in for all the hours you have worked. Thanks

IMPALED What a loaded word. When I read it I jumped from the swivel chair in my office and began to hop around while making little pained noises as if I had just stubbed my bare toe against a brick. The hospital referral said matter-of-factly: “25 year old male who fell from second story window and was impaled on wrought iron fence.” Ahhhh! It went on – ”…into throat and chest and abdomen… ahhhh… feeding tube… ahhhh … collapsed lung… ahhh… needs teaching…” Needs teaching? What, about reducing falls prevention risks by not climbing out on a window ledge, or by removing iron spears from below your living room? I drove there but could not keep myself from repeatedly visualizing the event. Despite my attempts to turn it off, it kept looping through my internal youtube brain site with horrifying detail. However, when I got to the street, and then to the particular door, I could not even look at the aforementioned fence. I averted my eyes and began to whistle, looking down Myrtle Street like some lame shoplifter about to pinch a porterhouse. I rang the bell and slipped into the lobby with a palpable feeling of relief. Upstairs, Louis was standing inside the room waiting for me. He was Ichabod Crane tall, and looked even longer because he wore a large flesh colored hard plastic collar. He was loosely dressed like an NBA player, baggy shorts and shirt, with the bulge of a feeding tube noticeable beneath his silky, purple Lakers jersey. He was remarkably well, despite the fact that a few weeks ago he had climbed out on a stone window ledge to wash his windows, lost his balance, tumbled through the air for about twenty feet, and then was found by folks on the street, speared like a beast waiting for the rotisserie. He was fine! Of course, fine is a relative term. I mean he will need to be fed through a tube for a while, and will have to wear this bothersome collar, but the fact that Louis was standing there talking to me, and could pour his Ensure and hit the bulls-eye opening in the tube, was a bizarre miracle. But these miracles happen. The opposite is, of course, sadly true. Louis told me he was not lit the day of his flight, only hung over. I wasn’t buying it. But what does my opinion matter? It seemed my job there was redundant, because I felt Louis was already being shadowed by some benevolent force of nature. Nonetheless, I taught him how to operate the little pump that could deliver his supplements. However, he was not really interested in walking around with a cute little L.L. Bean backpack and a machine humming in his ear. This was just not Louis. Louis preferred the idea of dumping in a few cans at a time, like a college freshman pounding down a couple of Budweisers. He was not at all interested in going outside with tubes mysteriously snaking from a backpack and disappearing under his shirt. I didn’t argue with Louis. I left, wishing him good luck, and immediately thought how ridiculous that sounded. Louis needed good luck like the Pope needed another set of rosary beads. When I walked out the front door I looked to the left at the fence, then up to Louis’s window. He was standing there, framed perfectly within the rectangular sash. I noticed that the glass was very clean. Louis waved and smiled. I walked away, down Myrtle Street, past rows of wrought iron fences.