Get wound care certified (WCC) eventually if you do decide to continue working in home health that way more wound patients are assigned to you. I say this because wound care patients are the easiest to care plan for, they all have the same goal...heal the wound. Alot of the referral sources and patients will request for WCC nurses ONLY. My last company actually paid for me to go to the class and take the exam. Also make cheat sheets for your documentation and include a skill or teaching on each note. I prefer not to chart inside of the patient's home and just use a pen and paper to make notes and start knocking the notes out as soon as i get home or in the car between visits. Lastly, if patient has a change in condition call the MD in front of the patient this way if the MD doesn't call back at least the patient knows you made the effort.