Quit or keep on going?

[Burlshoe114]

Okay, maybe I am just having a bad day... week... few weeks...

Today after work I just came home miserable and wanting to quit.

I have been diligently plugging away at my HHA job for 7 months now.

The territory I was promised when I was hired now encompasses remote areas I never even conceived of working in or even knew existed 7 months ago. And when someone else in the agency calls in sick, takes vacation, injures themselves, etc, we are all expected to pitch in and take up their slack. Even if that means a 1 hour drive from the south side of town to the north side of town, then back again just to take vitals on someone and ensure they didn't fall in their AFH over the past week.

I have started to dread discharges. Apparently, I am the only person in our agency who charts. Yet all of my charts are reviewed by a coworker who has no problem spending an hour of my morning picking apart my charting for any and all flaws, significant or just not. Then I must unlock my charts and go back correct all the 26 "issues" she has found, was uncertain about, or was unsatisfied with for Medicare purposes. (Apparently, "Taught pt about fall prevention. Instructed pt to take his time when attempting to stand to maintain his balance. Pt verbalized understanding." just doesn't cut it.)

My manager is non-existant. She schedules meetings, and we go out of our way to clear our schedules to be there. Then she cancels.

I'm told by management to keep patients happy. Part of the proven plan to keep patients happy is to schedule pt visits in advance and ensure I keep those times to make patients happy and provide consistency. Then when I do, I end up with unhappy schedulers because I have limited schedule flexibility. Or else I have to cancel and reschedule patients to accomodate new patients, which gives them the unhappy perception that I can't keep my commitments to them.

Then the charting.

OMG, the charting.

I want to cry when I look at it.

Again. And again.

Charting the same things over and over.

Again.

And again.

Depression - The patient doesn't have depression. I must still chart on depression. Pain. Of course the patient has some pain somewhere! They are 78 and needing nursing care! So we must chart on the patients arthritis pain with the same degree and detail as if the patient has new onset chest pain. Wounds - Does the patient have a papercut? We must measure it, chart it, and take a photo for the archives. Did I breathe today on the patient? I must chart that. Did I say "Hello?" to the AFH owner? I must chart that, too. And I need to call the doctor to inform them that I breathed and said "Hello," and then document that conversation.

I have at least one Oasis start of care, recert, resumption, or discharge every day. The key word being "at least one." In addition to my routine visits, which were all over God's earth.

Then I come home and get handed the kids, because my husband is "tired." So I watch the kids until they go to bed. Then I haul out my computer and chart.

My car looks like a bomb went off in it. My truck has no room for a stroller because it is packed full of catheters, gauze, teaching pamphlets, agency policy folders, and lab kits.

I don't know. I love the part of my job where I go see my patients and provide them care. It makes my day to bring a smile to a forgotten woman or man. I feel like I make a difference for them when I advocate for them and get them services they need.

But the rest of this is making me crazy!! Redundant charting drives me nuts, and Oasis has it is SPADES!! I feel like I have to exist in chaos every day to make people happy. Yet I must be 100% squared away.

I am almost to the point that I feel like leaving nursing all togeather.

I don't know. Anyone have any advice for a weary soul?

[jammycakesRN]

oh my gosh..these past few days I feel like saying "DITTO" to everything you just said.

[caliotter3]

You would greatly decrease your stress if you moved to an extended care job. One nurses note for the shift, completed in the home, and you are done for the day. One address each day, unless you want to work two cases at once. Complete days off in between shifts, if that is the schedule you want. Think about it. Would be worth the change.

[KateRN1]

Home health documentation is not going to change in the foreseeable future, and is actually like to get worse. If that is what the problem really is, reconsider if home health care is the right field for you at this time. Perhaps shift work would be more agreeable at this point.

[jmn126]

i like the way you put it KateRN1,,,it is hard to hear but it is the truth.....

[Isabelle49]

I feel your pain Burlshoe. Am getting out after 9 years, taking early retirement. Nursing just isn't worth it anymore.