melaniekrn97

Yes! I also work from home in case management. I said this exact thing to my husband yesterday. I am torn between the safety of my remote position and going back to acute care to help out.

Charting is definitely different, there is more emphasis of the patient's current/prior level of functioning. Can they dress themselves or do they need assistance? Can the prepare a meal or answer the phone? Stuff like that. A lot of this you will be able to observe while you visit the patient. Hospitals are concerned with patient's current condition, they don't care if they can dress or feed themselves. It isn't hard to pick up, just MORE to document, that's all. Each note must be able to stand alone and your supervisor should be able to read your SOC and tell what you did, why the patient needs home health and what the plan of care is. I still love home health. I like being with patients one on one and not having one ring the call bell for pain meds, this one needs to go to the bathroom and this one needs IV abx. I can focus on one person and it's nice to see them in their environment, meet their families and pets (hope you aren't afraid of dogs). Most patients are just grateful to have someone looking after them. There is lots of teaching involved, hospital nurses don't always have time to tell CHF patient to weight daily or Coumadin patients to take their Coumadin at night. You can probably find a sample oasis online I bet. Best of luck with whatever you decide.

We are not permitted to use automated blood pressure monitoring devices where I work. Even PT, OT, ST and HHA are required to do manual readings.

I also hold this position in the company I work for. However, I have been a home health nurse since 1998. That being said, I think it has the potential to be very overwhelming for a nurse with no home health experience. Most nurses that come to home health with no experience, leave because the documentation is so different than a hospital or clinic, much more detail is required. Do you know what software they use? I have experience with kinnser and home care home base. Kinnser is very user friendly and will make your SOC much easier. Will you always be finished between the hours of 8-5? not likely. Most patients do not like visits at 8:00am! I usually plan to see my first around 10, second at noon and third around 1:30-2:00 and plan to be headed home by 3:00-3:30. I often spend a couple hours in the morning documenting. I can get through an oasis very quickly now, I know the questions by memory. However, like the previous person replied, keeping all the details straight is vital. Do not think you will remember if this patient has MPOA or has had a pneumonia vaccine, write it down. I carry a notebook with me and I write down all the details of my visit such as pain, do they wear glasses/hearing aids/recent falls, who manages meds, appts, etc. The only thing I document electronically in the home is vital signs and the patient's signature is also electronic. I document everything else later from my notes. But you must remember what to ask. Make a list and ask because the oasis is very detailed and you will need to know about vision, pain, hearing, assistance from family, medical history, meds, etc. An oasis must be completed for each medicare SOC, ROC, recert or SCIC. I do on occasion admit patients that have private insurance and no oasis is needed so those are much quicker. Patients are all different though, you will have some that are so talkative and make it difficult for you to get through your assessment and ask questions and others that you have to pry information from. What information is provided to you on paper from the office is not always the picture in the home. I have spent 4 hours in a home before because things were a mess, meds had to be clarified before I left, dressings change, IV's inserted, etc. I have been in and out in an hour before. Also keep in mind that you may have to go to the office to pick up supplies if you will need to do wound care (it is appropriate to obtain enough supplies for the nurse that will see the patient next so they are able to do proper wound care), you may have to draw blood and drop it off at the lab. I would say that two hours between SOC is reasonable as long as you don't expect to complete your documentation in that time as well. See your patient, keep a notebook with all notes from the visit and plan to spend a couple hours at home documenting. You will likely have to give a report to the nurse that will follow you as well. You will need to call your patients for the following day. After I confirm my visits, I prepare my SOC paperwork, fill out as much as I can. Most documentation is electronic but there is still a paper consent and med profile and depending on your agency, there may be a few other documents to turn in as well. Organize, organize, organize and be time efficient is the key to being successful in home health but it does allow for great flexibility. I am able to attend all my son's school functions and pick him up if needed. Run errands during the day, etc. Ask to shadow someone like you mentioned. Make sure you know what software they use, it will be vital! Good luck on your interview and don't let fear of a change scare you away, give yourself a good 6 months to adjust!