3rd week in home health, ready to quit

erroridiot · Nov 1, 2004

They want us to do as little as possible, and keep the visits down, but they want every cent of money they can rake in or fake in from Uncle Sam. The sad part is I work for one of the best in the state, much less area. snip...... "smart ones get out quickly."

First of all - good for you that you recognize the problems you are facing. That is the first step toward solving them.

Find out where the "smart ones" went. Maybe they aren't as smart as someone thinks they are.

Second - "rake in or fake in" and "one of the best in the state" do not fit together logically. Who said that a "rake in or fake in" home health agency is "one of the best in the state"? Did this person have a brain or know anything at all about home health?

I'll bet that there are some good agencies in your state - maybe even ethical ones.

Your orientation was deficient. Your supervisor is an egghead for talking to you like that. In fact, your supervisor should be reported to the state board of nursing as mentally impaired.

Your managers are a bunch of freaks.

Why not call your state board of nursing or a local school of nursing and ask them if they have any listing of home health seminars coming up in your area? Go to the C.M.S. website and start learning. It contains a wealth of information. T.M. Marelli has written a handbook of home health orientation for newcomers which is very good. You can buy it at amazon, barnes and noble or any large bookstore can order a copy for you (amazon usually has cheaper used copies). How do I know it is good? When an ignoramus D.O.N. started clutching at my copy mumbling "What is this? What is this?" I knew that it was good and that I would not dare discuss the contents or innards of any T.M. Marelli book with anyone who worked for that home health agency because they would probably fire me for speaking anything right, proper or just.

Home health in the field can be very rewarding and very sad.

You can find a better job.

Hope this helps.

ullnurse · Nov 2, 2004

definitely speak to your manager. I have been a HH nurse for 2 1/2 years. I've learned that you need to speak up when you feel like you are drowning. Otherwise people think you are fine and continue to add work to your schedule. Stick it out for a while. It's definitely overwhelming at first. Once you are comfortable with the paperwork, you get it done a whole lot quicker. As for ICD-9 codes, yes, that will also come with time. I still have problems coding and need to ask for help. Try HH for a few more months and see if it doesn't get better. :)

mattsmom81 · Nov 2, 2004

I tried HH and it was definitely not for me. I agree with those who asked how you enjoy your patients...this would be a key bit of info in deciding whether to give this more time. In my case, I was not crazy about the situations I walked blindly into every day and decided I prefered a facility type setting. We're all different. Best wishes whatever you decide. There is no shame in bowing out and saying you're sorry but 'this just is not a good fit for me now.'

Blackcat99 · Nov 2, 2004

I tried home health many years ago and I didn't like it. I always got lost trying to find the different houses. I also got sent out to the "ghetto areas" and I spent all shift worrying that someone was going to steal my car.

Wgbem · Nov 5, 2004

Please hang in there. IT was that way for me as well. I was very frustrated as I started working part time but felt like I was working a full time job. What solved it for me was to go per diem. I pay for my benefits but the good thing about this agency was that they still allow me to put into my 401K. It is worth it to me to have the flexibility. Now (1 1/2 years later), I feel very confident and love home health care. It is really rewarding but you must find a way that works for you. I have joined another agency per diem to make sure that I have the number of pts I want to see so it is all working out. :)

SRbear · Nov 11, 2004

And the saga continues....was told today I have to work the next 2 week-ends because the week-end nurse is taking those 2 week-ends off.. let me see if I can add that right...19 days straight before a day off. Oh, and this is the big one...the day after thanksgiving (which I have to work), they want me to run the office, because no one else will be there. I barely know what I am doing in the field...much less how things are done in the office......good grief. 2 full time nurses gave their 2 week notice this past monday..that leaves me (the only full time nurse during the week), and the nurse that works the week-ends. How many different ways do I need to say "I QUIT !" This is just getting to comical to be true.

BeachNurse · Nov 12, 2004

Wow. It sounds tough. I worked HH for a few months before finding my full-time job and I do it now on the side a couple times a month to supplement my meager research income ( :chuckle ). I could never do it full time because I got too caught up in my patients and their families. I also had a crappy "orientation" and they didn't seem to care that I was unfamiliar with HH or most of the equipment involved. They call me ALL the time and ask me to work extra hours..I rarely do because of my busy schedule.

As for your situation, I cannot tell you what to do, but the place sounds like it's a mess. Everyone is quitting, you don't get time off, etc. Doesn't sound good. Do what's best for YOU! Good luck.

erroridiot · Nov 12, 2004

And the saga continues.....

Find out when their next survey might be coming up. If they are in this much trouble now, wait for the "survey time freaking out" that will happen. Management will have "out of mind" experiences. The administration will have every warm body working 24/7 trying to fix the unfixable. And the saga continues........

You can find a better job.

Traveler · Nov 12, 2004

It sounds like you have gone from the frying pan into the fire so to speak. I have worked for two different hh agencies and have just realized that the love of the job depends a great deal on the company you work for. I stuck it out for 3.5 years with a company that never gave raises, paid lower than everyone else, and call was hell. I stuck it out because I loved my patients and the care I provided. Paperwork comes over time. I have always worked prn. Some weeks it means every day plus the weekend and other weeks it's just one or two days. With some HHA as a ft employee they seem to feel like they own you. Something is going on if two nurses just left. Perhaps there have been some changes lately that they did not like. If you're not comfortable taking care of the office with no help and training, refuse to do it. The last place I worked was getting sloppy in the office about putting orders in charts, etc. A nurse went to give the vanc and came back to the office. It was then that she was told they forgot to tell her the dosage had changed- order just hadn't been filed yet. Luckily nothing bad happened to the patient, but if it had it would have been on the shoulders of the nurse who gave the infusion.

There are some great agencies out there and some terrible ones. Do as much research as you can. Find out how long the staff has been there. Don't let them walk all over you because they will if they think they can.

First you need to decide if hh is for you. Do you like the patients? Can you handle all of the unknowns you walk into? Do you feel confident enough to deal with crisis situations in the home? Do you like to drive? When you get lost (we all do), do you get stressed out or do you look at it as an adeventure and go explore a little? Part of what makes a happy hh nurse is the personality. You can't be a good hh nurse if structure is what you crave. There aer many patients who have different values from mine. Are you able to through your predjudice to the side and get to know them and help them? Are you able to handle the paperwork?

I had 3 discharges, 1 recert, and 3 visits today. There was no way I could get that done in the office so I brought it home to do it. I don't love the paperwork, but I love the fact that I can do it at home.

I work usually two very long days a week. I see up to 12 patients with recerts, dc, admissions, and regular visits. I couldn't keep this pace up on a full time basis. I would also get burned out on a fulltime basis of doing this which is why I work two days.

Some personalities aren't conducive to hh like mine would not be good in ICU.

SES · Nov 12, 2004

SRBear, do I feel your pain.........and amusement at this point!! Like you I am in Georgia and was excited when I took a HH position, thinking that it would be much easier than a hosp staff job. Didn't take me long to find out that there was a lot more to it than just seeing patients one on one in the home. I loved the patient visits, but the continous paperwork is what done me in. Just couldn't stomach filling out one more OASIS. The '9-5' job turned into 10-12 hour days, after driving an average of 100 miles/day and trying to stay abreast of filling out form after form. The agency I was hired by was also sold 3 months after I started, just at the point I was becoming comfortable with the paperwork and agency policies. New agency had new paperwork and policies, which included having to code diagnoses. AGGRR!! I would have loved this job if I had had an LPN position, NO OASIS to fill out. I just wanted to be a nurse, not a secretary. Anyway, I left after six months, and gained my life back.

I cannot imagine being thrust into the position you find yourself in. Sounds like way more responsibility than you're trained/experienced for at this point. I was told it takes a long time to learn HH, found that to be very true, and in your case a month on the job doesn't even begin to break you in to the job. I would RUN from this job........like yesterday. Way too much stress involved. And I admire you for sticking it out as long as you have.

Hairstylingnurse · Nov 12, 2004

And the saga continues....was told today I have to work the next 2 week-ends because the week-end nurse is taking those 2 week-ends off.. let me see if I can add that right...19 days straight before a day off. Oh, and this is the big one...the day after thanksgiving (which I have to work), they want me to run the office, because no one else will be there. I barely know what I am doing in the field...much less how things are done in the office......good grief. 2 full time nurses gave their 2 week notice this past monday..that leaves me (the only full time nurse during the week), and the nurse that works the week-ends. How many different ways do I need to say "I QUIT !" This is just getting to comical to be true.

SRBEAR WHY ARE U TAKING ALL OF THAT ABUSE, DO YOU NOT KNOW HOW TO STAND UP FOR YOURSELF. Do you not know the word N-O-, or I QUIT!!!!. You know you was looking for a job when you found that one. HH is an awesome experience in my opinion. You are at a really crappy agency, so find another one. In the words of Dr. Phil" you teach people how to treat YOU. I can promise you if you tell them you refuse to take thier crap, they will treat you properly rather than lose you(especially if others have recently quit) and if not get a grip and get another job. Life is too short to take crap off people. I would really like to know why you feel you have to keep doing what ever they tell you, in the event you HAVE to stay at this particular agency. Good luck with your decision......

Justmeandmycat · Nov 12, 2004

I don't know if this will help or not since I don't do HH but I used to work in insurance and paperwork was the game. I was a contract analyst so whenever there was a change in benefits a form had to be filled out to change the contract-. Sometimes 15 different forms for one case and I had an average of 12 cases. What I ended up doing may help you organize yourself: get a three ring notebook and buy some clear plastic filing pockets. On the left side put in an example of an already completed form that you will see immediately when you open your notebook. Slip in a note or two regarding variations in filling the form out or particular situations in which to use the form. In the right hand side pockets have plenty of copies of the blank forms you have to fill in. If you blow one, you'll have a spare and if they update the forms, throw your old ones out and restock. Remember to keep your already filled out samples up to date too. The clear pockets are an advantage because you'll be able to see when you are running low and which forms need to be replaced. With a litte organization, you will save yourself hours of frustration. Hope this helps.