Recently switched to home health and....need advice please.

Specialties Home Health

Published

Specializes in ER.

I recently switched to home health after working in a very busy pediatric ER. I've always enjoyed working with adults especially the more mature set. I was also looking for a better work life balance and hopefully less work related stress. I seem to be putting in a lot more hours these days hence the whole work/life balance goal has not been achieved. There are many things I like about home health..the autonomy, making my own schedule, and of course the time I get to spend one on one with my patients. There are a few things about HH I'm not digging. HH seems inherently disorganized although I do work for a pretty supportive agency, there is some frustration about getting my day scheduled only to have the office call and undo all of my planning. I'm fairly flexible and don't have a prob switching gears as I know pts. needs come first, but that's not the type of having to reorganize my day that the office is calling about..seems to be a lack of planning on their part. So when I need to revamp my whole day, it puts me running late to pts and late getting home and then a few hours with the paperwork..no work/life balance. The paperwork is a whole other deal, it just plain stinks d/t the shear volume of it. But I'm getting better at it.

My base is 30 units a week which is doable. Averaging 90 miles a day even when I sort my day by zip code. And yes they pay .445 per mile. Cell phone stipend and what I thought was a good salary. Yes, I'm salary. The stress is less than in the ER for sure and most likely less than Med/Surg (did that too), but I feel like I'm really not making the money I was at the hospital given the number of hours I'm putting in and then I'm bringing work home with me. I recently worked 12 days in a row. Worked on my on call weekend and in order to make my numbers was not able to take a day off. That was really exhausting. Seems I could have taken a day off, but then would not have been paid the per visits I did on the weekend. Hmm..work all weekend (2 days) for one day off during the week. Not at all sure I like that.

Just wondering what you HH veterans thought.

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The real pay cut you mention is something that should be considered before anybody used to good wages switches to home health. I used to be able to earn a decent pay check when I was paid for overtime. But those days are gone. My present employer does not allow overtime and refuses to pay it if it occurs out of your control. Since I do not want to work in a hospital at this time, the tradeoff is neglible to me. But I could see how there could be a shock to someone used to it. You should try to gain more control over your schedule. If the problem is bad enough, you could consider going to a different agency where you have more control over your day.

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Specializes in ER.

Thanks Cali. I've read many, many of your posts and always respect your insight.

And yes it has come down to working more and earning less if you look at it from an hourly perspective, which I am. The work itself is less stress than the hospital environment hands down. I know I need to decide if that's the trade off. I do sometimes miss the faster pace and that ability to clock out and leave it behind until the next 12 hour shift.

HH offers a different set of challenges, primarily an uncontrolled environment and then there's the non-compliant pt that you do your darndest to keep out of the hospital even if they are hell bent on self destruction..lol. Still searching for my "fit" in this wonderful profession.

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I usually suggest extended care rather than intermittent visits. Less stress and less work. You have time to complete your one nurses note during the shift. When your eight hours or twelve hours are done you go home and don't have to be doing paperwork at home, uncompensated, on your "free" time. If your present agency can't do better to work with your schedule, you might consider switching to extended care with them or another agency. Just something to think about.

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There are a few things about HH I'm not digging. HH seems inherently disorganized although I do work for a pretty supportive agency, there is some frustration about getting my day scheduled only to have the office call and undo all of my planning.

I just went back to a home care agency I use to work for and they are messing with everyones schedules in the morning and I can't stand it.....I have to wait for them to decide what is what and before you know it 2 hours has gone by......I hate that part of home care, but until management realize they are wasting a lot of money (I'm paid hourly) then I guess the morning chaos will continue. It's still better then floor nursing any day!

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Specializes in ER, L&D, ICU, LTC, HH.

I am trying this one last agency in hope of finding continuity of care, a set of patients I see on a regular basis with no admits so I can sleep at night lol. If I do not find the schedule I can finish before I get home and a more consistent type job I will go back to some sort of hospital care. They have promised 31 points of visits a week with my own territory where I receive patients from an Admit Team and then I follow them to discharge. People promise the moon so I am in wait see mode. I love the actual care just not all the bull that seems to go with it sometimes in HH.

Keeping Fingers Crossed =)

~Willow

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Specializes in ER.
I just went back to a home care agency I use to work for and they are messing with everyones schedules in the morning and I can't stand it.....I have to wait for them to decide what is what and before you know it 2 hours has gone by......I hate that part of home care, but until management realize they are wasting a lot of money (I'm paid hourly) then I guess the morning chaos will continue. It's still better then floor nursing any day!

Totally agree with you here!! I find most patients, even thought they are home bound...their caregiver is not, like to know when I'm coming. Calling them the morning of hasn't worked out well for me as the pt and/or CG get irritated.

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Specializes in ER.
I am trying this one last agency in hope of finding continuity of care, a set of patients I see on a regular basis with no admits so I can sleep at night lol. If I do not find the schedule I can finish before I get home and a more consistent type job I will go back to some sort of hospital care. They have promised 31 points of visits a week with my own territory where I receive patients from an Admit Team and then I follow them to discharge. People promise the moon so I am in wait see mode. I love the actual care just not all the bull that seems to go with it sometimes in HH.

Keeping Fingers Crossed =)

~Willow

No admits would be great. I spent a whole weekend doing admits that I would not be compensated for because the previous weeks census was low. So I worked a whole weekend, 12 days in a row....if I were paid per visit that would be another story, but I'm salary because I case manage. One of my admits had inaccurate info on the referral. The address and phone number were wrong, the pt lives in an ALF, etc. Keep in mind that these referrals are supposed to be "verified" with this info. Not qualifying d/t non homebound status I get and probably wouldn't know until I made the visit..that's OK. But having to spend an hour chasing down this SOC, getting there and after talking with the pt realizing that she was in a ILF/ALF facility utilizing the ALF services (duplication) was 2 hours of my time for which the DON gave me a .5 unit to make up for that time...seriously? I guess I should be grateful she gave me anything at all. But as a new hire, according to my hiring agreement, I have 90 days to be pulling 30 units a week and case managing..but after I questioned no compensation for the 2 days d/t low census (not in my control) I was told that I "was" expected to be pulling 30 units a week..so no compensation. I've only been in HH for 5 weeks and still well within the 90 days. I felt like I was being penalized for being new at this.

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I do sometimes miss the faster pace and that ability to clock out and leave it behind until the next 12 hour shift.

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Oh my, I could've written your post! I also miss being able to clock out, walk out, and forget work while at home! I miss that CLOSURE of being done.

How long have you been doing home health?

There are definite perks to home health. It really is nice to be able to talk with your patients without getting interrupted by your pager or someone else in the next bed. I can't believe I'm saying this, but after having worked in a hospital setting for 10 years, it's hard to get it totally out of your blood and I actually found myself missing it today! (or more accurately, the 3 12's)

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