Question on Charting and Organization

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From the glancing through I have read, it seems in general I have it pretty easy for a work load. We see 4-6 pts per day, but we do all the case management for each of them.

My question is on charting and organizing. I will have a year in HH next month. Just when I think I have things almost figured out, my boss brings me another chart that she has taken a comb too and told me I am incompetent and can't get the charting right. Now if it was just me, I would think there is a problem. But this is what she does with 3 out of 4 of us. The 4th person actually started there before our boss did.

So there are 3 of us, who before starting in HH, thought we were organized, good at time management, thorough in our charting. Now EVERY DAY, something is wrong, missed, etc.

How does one get it all? Is it possible? I am so flustered after this week when I was told "It isn't getting any better and we may have to give a warning."....

This last one was because I didn't have a signature on a COPY of a plan of care. So my boss wanted to know "How am I supposed to know if it is a copy if there is no signature?"

Also, is it normal for case manager to do all the insurance pre-approval?

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I thought the insurance approval stuff was done by someone in the office, not the field staff.

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I thought so as well. But that is just something else I "do wrong" on a daily basis. We do the insurance as well. Some days it takes a good 2 hours just to deal with one patient...

I am just trying to figure out if this isn't the field for me or am I just in the wrong place? I have really enjoyed this kind of nursing. I am just getting beat down for there always being something wrong with my charts, my patients, etc....

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You are in the wrong place. If the constant negativity is getting to you and affecting your work as well as your mental well-being, I would consider looking for a new agency. Start out doing a shift here and there with another agency or an on-call type situation, then you can make the switch, once you find out that the second agency is not a clone of this one (or should I say, this person). Then hope she doesn't move on to the employer you have moved on to.

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At the agencies I have worked for, the Intake dept gets the first approval for insurance (ie: 1 rn eval + 3 additional visits) After that it is the field staff's responsibility to get more visits. Plan on waiting awhile on the phone with some insurance co's. I usually make sure I have other charting to do while I wait.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

you are working for a bad manager...bottom line...

I would find another job if I were you....lots of HH agencies needing experienced nurses with new ones cropping up all the time.

wun fowest, wun

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