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Thank you! I did not realize that

Hello fellow nurses! I am hoping someone out there has some experience with home health. I am in my first year as a home health nurse and wondering if anyone else has any advice on how to handle demands that could put a nursing license in jeopardy. At the company I currently work for we are required to take on call 3 times a year. This involves being available 24 hours a day for 7 straight days and doing a full time patient load . If a pt calls with an emergent need we are supposed to go see them. This means that you work 8-5 and answer calls all night for 7 days in a row. I had my turn on call this week and by day six I was irritable and delirious from lack of sleep. I missed one call at 1 am that night because I could not stay awake any longer. I received a reprimand by email the next morning. I think this is horrible for the patient who did not get the call answered. Luckily the patient improved at home and did not require a visit. I feel this puts my license at risk. I have heard that being overly tired is worse than driving drunk. Has anyone else had this problem with home health nursing? Do all companies do on call this way? Can you invoke safe harbor to protect your license in this situation?

Thanks so much for your positive feedback! I think changing to a pay per visit system is a good idea. I was just worried I would not get enough work. I don't need benefits but I was told I had to take a full time position because I had not had previous home health experience. I would much rather do per diem as long as I could make enough money. It seems that they try to overload the full timers and give the per diem people the scraps left on the weekends and after hours. It sounds like it may be time to have a discussion with my manager and see if there are PPV options for me. Thanks again!

Thank you so much for your feedback! Yesterday I tried a new tactic where I planned out my day the night before and said no to last minute scheduling requests. However I found new decubitus ulcers on 4 of the 7 pts I saw. Some of these people had just been seen 2-7 days previously. It's possible that they just occurred but I think that the need for speed is preventing the time needed to accurately assess. I then got an email the next day saying that the pt I had put a hydrocolloid dressing on had breakdown with no dressing. This probably means that one of the multiple caregivers removed it. So I am going to use your suggestion to use a desktop folder for teaching templates. The copy/paste feature will definitely help me free up time. I will also begin saying no more often. I tend to take too much on. I am looking forwarded to streamlining my processes in the next 6 months and getting through this first year so I can enjoy those days when 3 pm comes and I can relax!!! Thank you again!

I am posting this in the hopes of getting some feedback from seasoned home health nurses. 6 months ago I took a job as a home health nurse. My career previously had been all hospital based. I decided to make the switch because I wanted autonomy, challenge, and a chance to be able to spend more time with patients providing better quality care. I love teaching and that is a big part of home health nursing. I do love the freedom to make my own schedule. I love being able to be totally present while in a visit and not having to answer calls from other patients or the tele room while trying to provide care. What is not going well is everything else. I have had to give up all hobbies, interests, friendships, and family time in order to complete the work assigned on any given day. We work on a 27 points a week system. I am salaried for 40 hours but I consistently find myself working 12-16 hours 5-7 days a week to complete the documentation. I am determined to find a way to create an efficient work flow that generates quality work in 40 hours a week. Has anyone been able to achieve this in home health? I have not found any other coworkers at the company I am currently at who have any sort of work/life balance. It appears that the work culture thrives on its employees boasting about how many hours they spend working per week. Since this is my first home health position I am unsure whether this is a company problem or a problem unique to home health in general. Any feedback would be greatly appreciated!