tinyRN72

HI, I've been where you are... in home health. I've worked for a couple of different home health companies and it was always the same... they want you to work all the time. I've left companies for this reason - not respecting my time off. It's hard because you can feel like you are letting them down, but you have to take care of you. If you get so burnt out that you can't work anymore without going crazy, then they are in a worse situation. It always seemed to me that they accept all patients, even when they can't cover them, then they beg people to work extra. I have been given some really high bonuses for taking on extra patients in the past, but you have to say "yes" only when it is worth it to you. Someone else said it best- they will not hire if they can get the current employees to work OT because it is cheaper for them. Maybe you should offer to help train new employees when they hire some ? . No one can be expected to be overworked all the time and remain happy. That is just the way it is.

Hollyhocks720 I've had a few career changes. Nursing now after years of no medical management and customer service. What got me the most about nursing is the way so many hospitals treat nurses as disposable. "If you don't like it here you can just leave" is that attitude regardless of how unfair or unrealistic the expectation is. Luckily for me, I found a place where I really like working... So far... It's only been 3 months. The problem here is the pay is low... I may love it, but may not be able to afford to work here long term. It's always something.

Wow... Just wow. When reading your comments, I assumed that it would be without an assignment. All I can say is good luck ... To the nurses and to admin because I don't think it is going to work out.

Every nurse has "a thing" that bothers them. For many it is mucus. For me it's vomiting. I can't watch a patient vomit without almost joining in. For this reason, I would never work in GI. You may have to avoid areas that will be harder for you, like ER or trauma. Also, many nurses have a buddy that will trade duties when possible. I enjoy wound care, so I'm willing to do wound care in exchange for someone doing me a favor. Moral of the story is that it might not be as bad as you think, with some options in mind. My biggest fear for you is putting in IVs or giving injections, but you may find that once you do it, it gets better for you. I would not bring it up to anyone, just see how things go. Nursing has so many options that you will be able to find a good fit if you keep your mind open. Good luck!

I agree that self care is very important. I own a wellness center, and advocate self care to my clients in many ways: stress management, exercise, fresh air, eating healthy, taking time to have fun, and others. For me personally, I gave up sugary drinks almost a year ago.... No more Coke, sweet tea, or even sports drinks. It only took a couple of months to find that after going without it for a short time, I no longer like the flavor of these things. I was never a water drinker before, but now it is my preference. I also practice Mindfulness and I meditate daily... Which are two of the things I promote to my clients heavily. Self care allows you the mental and physical capacity to care for others. You can't even realize the difference it can make in your life until you experience it.

I don't see anything mentioned here about pay. I am sure that nurse's salaries vary greatly from state to state, and from hospital to hospital. Where I am, I could seriously work in a good restaurant and make the same amount of money that I do as an RN BSN. I don't do it because I love nursing, and I love the 12-hour shifts and the life/work balance that it offers. However, a few months ago, I was really ready to trade my scrubs in for an apron because the hospital I was in was so terrible. I am thankful that I found a hospital where I really do enjoy my job again, but the pay is so low! My 30-year-old daughter with no college degree makes the same amount of money that I do! She does not save lives! She saves accounts by retaining clients for her company (Account Manager). There is something very wrong with this.

One of the things that keep me working in hospitals is the ability to work 12-hour shifts. I love the freedom of having 4 days off every week, or to be able to pick up a day, enjoy overtime, and still have 3 days off. I can make more money with less stress in other careers. If I were forced to work 5 8-hour shifts, I would look at other options.

I'm really sorry that this happened to you and that you are experiencing so much stress for yourself and your baby. I have had a similar situation. I was once splashed in the face and eyes (thankfully I had on a facemask, so not the mouth) with urine. The patient was MRSA and ESBL positive in his urine. I was freaking out too! I did not even try to get to an eyewash station... I ran right to his bathroom and flushed my eyes out for about 10 minutes, then went to the eyewash station, flushed some more, then went to the ER. They drew blood, wrote up a worker's comp form. They did not swab my eye or anything. I was really worried. I did talk to an ID MD who I really trusted, and he assured me that the eyes are very good at protecting themselves and that there was almost no chance that I would get an infection from it. And he was right, I didn't. It was about 2 years ago. For you, HIV is more scary, especially while breastfeeding. I understand your panic. I'm no expert on this, but I think you will be OK. I know that you will not really feel safe until you get the results. You're in my thoughts... try to keep the panic as controlled as you can. I would call my pediatrician and ask about breastfeeding until you get the all-clear, just to be safe.

Keep in mind, the per diem rate is usually a set amount that is the same for everyone in your job class. A full-time rate will be based on your education and experience level.. and your negotiation skills.

Just an update for anyone who might be interested.... I did take the hospital job and I did a week of orientation. To my great wonderment and utter surprise I REALLY think I will love this hospital!!! My husband who is not medical has cautioned me that I may be setting myself up for disappointment, but I really have all the warm fuzzies about this place. I went in sceptical with a "I hope they are not bs-ing too much" attitude, but so far they have done many things that truly make me feel really good about it. Wish me luck!! And BTW this will give me more days to focus on Etheria Wellness, which is one reason to get out of home health.

Yes and they will. I did this at one job. Seasonal with no benefits was $45. Per diem (also no benefits) was $35 and full time was $29. Keep in mind, I am in a low pay state.

If it doesn't work, you can always keep looking for a full-time job. Per diem usually pays quite a bit more, so theoretically you can afford to work less. When I was doing it, I wasn't making enough to buy insurance on my own, so that was an issue for me. I did enjoy the money while it lasted and now have a full-time job and work the per diem as I please.

Wow, I know that this has to be stressful for you. Based on what you've said a few things come to mind. Maybe it is a follow-up from before to review your improvement. Possibly, they feel that you are not a great fit for your current role, but want to offer you a change that might be more suitable. Sure, if they are not telling you anything it is going to weigh on you. I would be a nervous wreck too, but you may be surprised at what happens, and as others have said, it might not be about you. If it we're about someone else, they would not tell you... That way you can't talk to the other person about it. Please do keep us updated, but continue to be careful about what information you give.

I ended up turning the job down, but I will try to answer your question. It's a bit broad. One thing that I would expect is they always treat patients with kindness. We all have bad days, but the people we care for should not know that we are having a bad day. I would expect my nurses to work as a team and let know if they are having a problem. I can get them help or would help myself. This makes the day better for everyone. If one person is struggling, I would expect others to help out. Everyone will have one of those days, and we can all work together to make it better. I would expect people to avoid using their phones for private use. They are great for looking things up, but should not be used to check in on social media, chat with friends or personal phone calls while working. These are the first things that come to mind. Do you have a specific question?

I've applied with insurance companies a couple of times. I got an interview, but not the job.

Yes, you can plan your day that way if you want.... But for an admit you would be there for 2 hours. Then your day in the field is just longer. I do document as much as I can in the home, but if I have too many patients, it isn't practical. Sometimes you choose to do it at home where you want be interrupted as much. Most times there just isn't time to spend so much time at one home.

HH doesn't work that way unfortunately. I am paid by the visit and things have to be done. If I have time to call MDs between visits then it have to do it at the end of the day. Some days are light and I can, but others not. Also reviewing charts has to be done sometime before the visit... So before starting or the night before. This is just the nature of the beast and the only way to reduce it is see less people, which equals less pay, which isn't an option. More time to get my business going is the reason for returning to hospital work.

I see that you have gotten a lot of advice from fellow students and that is great! But I thought that you might want to hear from an experienced nurse too. First - I LOVE having students assigned to my patients. I love teaching and sharing tips and tricks of the trade to young minds. There are many nurses who will be happy to have an extra set of hands. My advice is to be available and willing to help. Let your nurse know that you want to do anything and everything that you are allowed to do - also that you want to watch anything that you are not allowed to actually do hands on. They will appreciate your desire to learn. Be happy if they ask you help by being a runner. It may not be your top priority to run for towels or get water for patients, but these little things ready help the nurse and having a good attitude about it will take you a long way in the eyes of the nurses on the floor. We always have students that we look forward to working with because they are helpful and make our day better - be one of those students and you will be treated better and learn more. On the down side, some nurses just don't like working with students. Don't worry about them. It isn't personal - they simply don't appreciate how much you can assist them while you are there. In this case, just ask questions of your clinical instructor instead of the nurse when possible. It's ok to let your instructor know that a nurse isn't particularly warm to students. This helps them with planning future assignments because they want you to have a good experience. If you find those nurses who enjoy students, try to get assigned to their patients if possible. Try not to interrupt if the nurse is busy. If they are on a computer, don't walk up and just start talking. Wait for them to signal they are ready to listen to you. Also, don't interrupt them while pulling meds, let them finish then speak to them. Remember to ask often "how can I help you?" I wish you the best of luck! It is not going to be as bad as you think it is - I promise!

Well, with the current job offer, I asked for ER, ICU, and dialysis.... They would not train me for any. I applied for a CM job with Humana, but after getting a computerized text prescreening, I have not pursued further. The hours are aweful... And seriously - a computer texting me questions? Ugh

Sadly that really is the truth.

You are correct! Home health is full of this type of behavior! These are great suggestions, thank you.

That was a great way of expressing some of the things I have feeling. I have one offer on the table now. It is not my dream position - med/surgery after years of cardiac step down? They would not train me in ER or ICU, even though I would be quick turn around to independent in either of these positions. However, I also applied for a supervisor job at a SNF/rehab. They called after I got the other offer, and I interviewed today. I am expecting an offer.... I am not sure how I will chose. AND I don't want to burn the bridge to the first place. Oh, why can't I just win the lottery... Then I could just go around volunteering to what I want when I want it! Lol

Thanks to both of you. I know that can not works PEDs. I solute every nurse who does because you must be an angel. My heart would just break too much. I know job changes are not good. I don't think the travel part hurts, because that is the definition of the job. However, looking for a new job after only a few months isn't helping me. I have to though... Not getting enough hours. To further complicate things, I have an interview today which is only going to confuse me if offered the job... I will have a hard time choosing between the two offers. But, I'm going anyway.. so it's all on me.

I have never worked in a rehab, nor have I had a management role in nursing. I was in management for years before nursing. I feel comfortable taking a supervisor role, but I really don't know what to expect. Can anyone offer insight about this type of job? The fact that it is in a nursing home leaves me uncertain about the job specifics. Thank you in advance!

My career has been marked by one main constant - change! Can change really be constant? Read my story and decide for yourself. I started my career as a home health nurse. I was really happy with it for a while because I got to spend one-on-one time with my patient and I made (what I considered at the time) good money. But after about a year, I was looking for something else. Home health nursing was wearing me and my car out. I was putting about 600 miles on my car every week and I was working about 80 hours a day. My poor husband told me, "I feel like I live alone because you are either at work or working at home." And he was right! I had a huge territory, and I saw 7-10 patients a day. I was constantly being asked to pick up extra work because there were not enough RNs. This got old, and besides, I became a nurse to work in a hospital. This led me to my second job: working on a cardiac step-down unit. I loved this too! My job was 10 minutes from home, I didn't have to bring home any paperwork or documentation, and (what a privilege!) I was given health insurance and paid time off. I thought I was in heaven (again). So what happened? I was working with some really snooty nurses who didn't like new people at all, it seemed. This made me feel sort of lonely for 36 hours a week, and my pay actually went down. My husband and I had always wanted to do travel nursing, so I got signed up with an agency and off we went! That was a really fun time in life, filled with so many adventures, good pay and more choices. Travel nursing is full of change: a new hospital every 13 weeks. This was good for me. I guess I'm sort of gypsy at heart. I loved moving around all the time. I loved the change. Every new place was a new start and by the time I started being temperamental about the hospital, it was time to go and start over again. What could possibly go wrong, you ask? Well, living in an RV or a hotel most of the time started feeling cramped. I missed my (grown) kids because I was away from home so much of the time, and about this time I was also feeling really burned out in hospitals. To give myself a new change, I decided to go back to home health. Here is my current problem. Working in home health requires being available 5 days a week to make enough money. I thought it would be a good trade-off for the reduced stress compared to the stress level I was feeling hospitals. But it has been less than 6 months and already I am tired of working 12 hour days 5 days a week. I am tired of having to call doctor's offices on my days off. I am tired of working all day in the field only to come home and have to document, answer emails, call patients to set up my next day, and I'm tired of being tired. I miss having 4 days off every week. Yes, I have applied and been offered another hospital job. Will this make me happy this time? I sure do hope so. Before the comments start - I have considered other types of nursing. I have looked at and applied to many non-hospital and home health jobs. Unfortunately, I have not been able to get an interview for a single one. Additionally, I really do love 3-12s, and I have only seen that in hospitals. I realize that I am going to have to accept the fact that no job is going to be perfect. I think I've done that. I hope I've done that. If I am to be 100% honest here, I know that working for myself is the only answer that is going to make me feel satisfied in the long run... and I am working on it ?