deefizzle

At this point I am dreading it. I'm in a very rural area so my patients are 30 minutes apart. Half the time they don't call me back or agree to the time I suggest, so I'm spending a lot of time driving aimlessly. Today for instance I have a SOC and 2 revisits. I called all 3 last night, with plans to start at 9am. No one has confirmed. I live 40 min away from the first visit. Then the next one is 30 minutes further. Close to an hour from me. Then the next is 40 minutes away. They are so spread out its making it really hard to plan my day. I'm sitting here in my kitchen now just waiting to hear from someone. When I send the visits back to the office due to non response they will send me someone else in the opposite direction! I agreed to this position but I did not realize they would be sending me all over a large county where the patients are so spread out. I assumed I'd have some kind of territory. IF I see all 3 today, IF they call me back, I will have driven a total of 2.5 hours.

Probably a little of both. I am and have always been a people pleaser and don't like to be a bother. I sent out an email earlier to my team and asked for tips for scheduling patients and manipulating the schedule as needed. Everyone has been nice. I'm just not used to being so independent and not having coworkers around to bounce things off of. I feel like I am emailing and calling my manager constantly.she always says that it's no bother but I feel like her tone says otherwise. Then again I am sure that she is completely swamped with work and just trying to get a quick answer to me.thank you for the feedback, I really appreciate it.

I am new to home health and I'm doing full-time case managing. I'm only a month in and I am seeing up to five patients a day. I have also done a few starts of care which take me hours to complete. I want it to work and home health partially due to the flexibility of the hours, but I am still out of the house until about five each day and then coming home and starting until 8 PM. I have no time to clean or spend with my children.I'm extremely overwhelmed and have tried reaching out to my office and don't feel like I'm getting much support. Everyone just keeps telling me it takes timeand I will eventually get it.However I am struggling with getting my patients scheduled when they don't live near one another, are never happy with the timeframe I give them, and don't always answer calls. I am working in a county 30 minutes away from my home which doesn't help. If I send a visit back to the office due to no response from patience, sometimes they will send me another visit to do and that one can be up to 40 minutes away. I don't know how I'm expected to see all of these people and get them scheduled in a way that works for The patient as well as myself. I am seriously considering going back to my old full-time job. They still have a position open for me. has anyone else had problems like this? Did you stick it out and end up being successful? If I do decide to leave, would I be expected to give a notice being that I'm still in my 90 day probation. And have only been working independently for about 2 to 3 weeks? I know that overall it will get easier with time but I'm just not sure if I'm willing to stick it out if I'm so unhappy.

I am brand new to HH and just finished week 3 of orientation with my preceptor. I started seeing patients last week with her shadowing, so on Monday I am going to see 2 patients completely on my own, with the plan to case manage them going forward. I'm nervous. My preceptor, while very nice and great with her patients, was not the best educator and I feel like there is a lot I still don't understand, in terms of how HH works. Whenever something unusual would come up, she would pretty much take over and handle it without really explaining much to me. I've been a nurse for 6 years (acute in-patient rehab and urgent care background) so I'm comfortable with the actual nursing aspect, but just feel very unsure about the HH aspect. My manager told me to expect 6 months to a year before I feel completely comfortable, and that the office is always there to support me and answer any questions I have. I just don't want to look like an idiot in front of my patients. Some examples in particular. On Monday I'm drawing labs on a patient (which BTW is NOT my strong suit) so I'm already feeling stressed about that. The results get sent to the PCP. I'm used to seeing those results and reporting them to the doctor. In this case I won't actually see them. Then the doc is going to adjust the patient's coumadin based off the INR results. I'm assuming they communicate that directly with the patient? Then I find out from the patient what the adjustment is? We also saw a patient who was new CHF. We are monitoring cardiac status. His BP was 200/110. No chest pain or SOB, lungs clear, trace edema. My preceptor said we will see you next week to recheck BP. In my opinion that is something that should be reported to MD. I'm used to: if BP is that high, we at least do an EKG. Obviously I'm not doing that in home health. But at least we should call the doctor right? See if they want him to come in? EKG in office? Labs? Or get an order to monitor? Just looking for some thoughts, tips, words of wisdom...thanks

I have a phone interview tomorrow with a home care company, and am really excited. From what I understand, I would see approx 30 patients per week and get paid per visit. For those of you who do home health, how long do you usually spend in each patient's home? Do you get your charting done while in the home? What kind of duties do you perform? Also, is home care different than private duty? From what I have researched, private duty is more of a long shift spent in one patient's home, while home care is more of a "visit". Is this correct?

Thank you all. You have been very helpful. And I will be sure to look into purchasing my own malpractice insurance for the future.

So should I wait for Risk Management to contact me? Or should I contact them first? Should I speak with them prior to contacting the attorney? And since I am not named in the lawsuit, do I HAVE to speak with the attorney? The letter I received on Saturday was the first I had heard about any of this. Thanks again for all of your input.

Oohhh ok. thanks!

What does that mean?

Thank you so much RiskManager. You have set my mind at ease quite a bit! It's a scary situation when you receive a letter from an attorney, esp when it pertains to my job. Its something I've always dreaded but hoped it would never happen to me. I appreciate your feedback.

Thank you for the info. I actually do NOT have my own malpractice insurance. But I will be sure to find my own attorney.

Got it. Thank you Rose_Queen.

I left my previous job approximately 6 months ago. It was an acute rehab hospital setting, and the patient acuity was getting higher, patient load heavier, and staffing shortage was just out of control. I no longer felt like it was a safe environment for either my patients or for myself. Today I received a letter from an attorney who is apparently representing my old employer in a case of patient negligence. The letter says the lawsuit does not name me directly, but that I was employed at the time of the patient's hospital stay. His name does look vaguely familiar so I am pretty sure I did take care of him at some point. The attorney asks that I call his office for discussion. I am freaking out. Has anyone had this happen? I'm assuming I have no choice but to contact the attorney. I was considering calling the Risk Mgt manager at the hospital prior to speaking with any attorney. If anyone could give me some feedback or speak about your experience with lawsuits involving hospitals I would greatly appreciate it. Thanks.

vspaniel I live in S Jersey. I wouldn't say its a BAD idea. I will say that most LPNs make between $18 to $23 an hour and most full-time nursing jobs are less than 40 hours a week (anywhere from 32 to 36 hours usually). Agency and per diem nurses make more but depending on if you need health insurance that may not be an option for you. I worked at an acute rehab hospital and half of our nurses were LPNs. We were basically a mini-med surg floor. There are also doctor's offices, LTC, homecare, wound centers, etc that still hire LPNs. Most hospitals are looking to hire Bachelor level RNs at this point.

This is something that really bothers me. It really is becoming more important to satisfy the "customer" than it is to treat the "patient". I had a patient recently who called our office DEMANDING (in her words) to be rx'd a certain medication because another doctor suggested it previously and she apparently declined it. There's no record that the initial doctor offered to rx it, but now she wants the doctor on duty (I work in urgent care and we have doctors rotate through) to prescribe. He does not feel it's an appropriate med for the diagnosis. After MUCH drama, my supervisor encouraged me to go back to the doctor and basically beg him, because "this is becoming a customer service issue and we want the patient to be happy so they come back." On one hand I get it, because we need to "bring patients in" but on the other hand, we are allowing the patient to dictate her own care at the opposition of the physician. Does anyone else experience this?