squeegee

I started working full time in HH last July after 5 years of medsurg ( that seems to be everyone's breaking point!) - I had been doing per diem work for the agency prior to that, but wow! it was still quite an adjustment. I am still trying to hone my time management skills so that I'm not bringing as much work home. I am also salaried and am expected to do 30 visits a week - anything beyond that is paid the per diem rate. An admission is considered 2 visits. The things I've learned are you've got to be flexible! At my agency, there are schedule changes all the time. Same day admissions really throw a wrench into the works. My agency is small - our census is around 90 pt's and we have 2 full time RN's plus our per diem staff. We have another RN that does on call every night and does every other weekend. We do computerized charting, which is great. I make my own schedule, but I'm still learning how to be smart about it and not be putting in 100 miles a day if I can help it. I love being able to case manage my patients and see them from admission to discharge with all the services they need to stay at home. As far as clinical skills go, you aren't going to see the action you might have had in the ICU or ED, but all in all I'm doing the same if not more when it comes to wound care, and some of the skills are just different in the home setting, like administering IV meds and lab draws.

I'm glad you are still with your agency, for your patient's sake, anyway. It's possible to do a SOC/ROC in 30 minutes, but you would never be able to do a good or thorough one in that time frame. How can you develop a plan if care if you don't know anything about your pt or haven't done a complete head to toe? Your patients are lucky they have you!

I'm glad to share! It isn't anything too complicated, I literally just opened an SOC OASIS and copied down the questions. Just PM me and I'll send it to you!

It takes me between 1 to2 hours, depending on how much teaching is needed or how complicated the admission is. I recently had a pt with a new ostomy that was a mess and was there for 2.5 hours, but that's rare, thank god! I don't go thru the OASIS on the computer in front of the pt - I'd much rather do the computer part in the comfort of my own home with my feet up! I have a cheat sheet that I take to each admission that has all the OASIS questions on it - I just go down the list and write the answers to all the questions. On the back I write the pt's version of what sent them to the hospital. It's worked great and I have a hard copy to refer to for the rare corrections they ask me for!