jlmanzano13

I work full-time Mon-Fri 8-5 at the other agency, but you're right, as long as it doesn't interfere with my full-time job.

I been with this home health agency for 9 years, secretary to LVN. I just got my license a month ago. I do QA work including coding of the recerts. I asked my boss if I can see 1 or 2 patients on the weekends. He said he would think about it and let me know, I asked him twice, and still hasn't said anything. He did mention something about worker's comp, and that me working in the field is something totally separate. I'm also thinking he doesn't want to pay overtime since I get 40hrs/week, and those visits will count as extra time... So I decided to apply to another agency, and I got hired for the weekends or after hours, and will get my first patient next week. I'm a little disappointed that my boss couldn't give me at least 1 patient, especially that I've been a long time employee.. Anyways, they pay me well for the office, and won't push the issue further, should I tell them of my new part-time job?

I work for a home care agency, and yes sometimes it seems like they want miracles to happen. Patients that we take under home health services need to actually have a need for skilled nursing visits like a wound, unstable BGL's, unstable B/P, etc... these are all easy examples that will definitely need improvement, wound starts to granulate to completely healed, and BGL's and B/P stable and pt/cg knowledgeble on management and prevention. You're right we can't treat "old age" =) So the home care agency needs to specify at the SOC (most important) what is being treated.

I'm an LVN, officially received my license on 01/06, and I too also finally got a job offer for a home health agency doing part time visits on the weekends after applying to several home health agencies. Most agencies in California require at least 1 year experience. I currently work for a home care agency in Los Angeles as a QA, but my employer doesn't seem too happy about giving me patients because of extra expenses with worker's comp, and overtime since I get 40hrs/week, unfortunately. So I decided to look elsewhere. Our pay rates are broken down by types of visit. For RN, eval = 100.00, f/u visits = 50.00, IV visits = 60-70.00. LVN 30-35/visit. I'm a LVN, and make 28.00/hr, but only because I'm doing RN work as well which is reviewed and co-signed by a RN (coding of recerts).

For keeping track of hospitalizations, two people are assigned to manage any patients admitted to the hospital. A list of patients hospitalized are kept in excel form which looks like this. PATIENT NAME/FACILITY WITH PHONE#'S/ADMIT DATE/DISCIPLINES ON CASE/NOTES. The facilities are called mon/wed/fri by one person to locate our patients if SIH, list is then updated, and given to another to staff ROC's. For following up with SOC's, I know the intake coordinator logs it in an "admission book" with disciplines on the case, and is followed up 1-2 days later to make sure it was opened by either the intake or the DON, so two people help with following up. Try to assign the responsibilities to different people, 2 people should be sufficient, you and another, to spread the work so that one isn't too overwhelmed. =)

california =)

california

we normally use "qd x "x" amount of days if there is a need for consecutive visits - daily injections x 4 days, or daily IV x 4 days

soc consists of: forms to be signed or filled out by patient/cg: consent form medicare payor screening form emergency plan form route sheet (end of visit) Sn paperwork: SOC OASIS md order - to state frequency and orders medication list abn form (completed upon dc) other paperwork to be left at patient home: emergency protocol for patient handout basic home safety precautions handout vital signs sheet sign in sheet

I work for a home care agency as an LVN. I code the recerts and QA the charts, and make corrections for the nurses. Regarding the frequency, missed visits, and reporting to MD. If a frequency is given 1wk5, visit are 1 visit per week for 5 weeks. If you are unable to do a visit for whatever reason, patient cancelled let's say, you have to write a missed visit report for that week and yes ideally you have to report to MD (our missed visit reports have check box if notified to MD). I prefer to use a MD order/Communication note together that way MD is notified via the order and signed - I don't feel that it is necessary to notify the MD verbally on a missed unless it's something that needed to be done specifically like a lab, injection, or IV. You do have to write an MD order IF you decide to extend the frequency. In this case, since you missed a visit, you probably plan to go an extra week to make up the visit, MD order would be to continue 1wk4 starting week of so and so. If you decide not to make up the visit, no need to write an MD order, a simple missed report should be sufficient, but remember to document well why the visit was missed, because if the patient goes to the hospital that week when a SN visit was scheduled, you don't want any questions to be raised. That's why they want the MD to be notified. Our daily patterns end Saturday, since Sunday is the start of the week. If freq is daily x 4days and visits start Thursday, freq can be written qd x 3days (thurs/fri/sat), 1wk1 (sun/start of new week).

Thank you, it makes me feel much better, I am scheduled to see 2-3 other patients, wound care, insulin, colostomy... and will schedule more (trying not to overwhelm myself). I have nurses here who are ok with me tagging along to observe the home health procedure, I also just spoke to another nurse who said she went straight to home health, she started as a CHHA then transitioned to LVN. She started of with wound care, and diabetic patients. She did 1-2 supervised visits then was on her own. I guess it depends on the nurse, and who you know. I've been established with this agency for a long time. Like the other nurse I mentioned; she has been working as a CHHA for several agencies and has established her reputation with them. But I do have to say, you have to have really good assessment skills.

thanks for the information, so the next question is, are there any nurses out there who went straight into home health, despite the 1 year minimum clinical experience?

I am a new LVN, but working in the home health field for 9 years in the office coding, developing plan of treatments, auditing charts, staffing, etc... I finally got the opportunity to do a visit with one of the RN's. Patient needed a Coumadin check and straight catheter for UA C&S. I observed the whole process which was quite a good learning experience. In a way, I hoped she would have asked me to try and do it myself while she guided me. I know I have to take into consideration the patient as it may make the patient feel uncomfortable. She did offer the patient that "maybe she can do it the next time", but the patient said no, unfortunately. I am a fast learner, and if I were given a patient I would know what to do. I want to ask my boss to give me a patient or so on the side, I feel this is the only way I'll be able to do it on my own, because going with another nurse to see his or her patient just might not do it, like what I said, the patient might feel uncomfortable especially if aware I'm simply "practicing". Anyone ever simply observe a procedure and did it on their own? (home health visit)

Yes I did note "clinical experience provided by my college". I even noted "observed catheter insertion"... HR manager told me that if the interviewer called me then she must think I meet minimum requirements and the fact that she gets at least a hundred resumes shows something, I had asked them to check my qualifications...

28.00/hr - homecare agency/case manager/coding/QA, I was making 21.00/hr as a QA (without license), then got a raise to 25/hr when they switched me to coding (still without license), then 28.00 hr after I passed my nclex, I start my field training in a month. Working total of 9 years for the company.