RN w/exp. w/? about HH

[Gorngi]

I am strongly considering a change to home health. I have worked ICU/CCU/ACU (more stress than I cared for), currently am RN supervisor in Skilled/LTC facility (second one).....and I DO work a floor in addition to all the other duties.

I like the challenges of my job..... love...love ....love the residents, am skilled with all types of IV's, no prob. w/starting new HL, blood draws, etc., we have the usual g-tubes, ng tubes, trachs, etc. Anymore, nursing homes are expected to do a lot of the same work as hospitals. We have patients there from 18y/o to 100y/o.

I work midnights 10p-6a and every other weekend....feel I am stuck on that shift (have asked repeatedly for dayshift)....... and am so sick of the "butt kissers" getting away with some very, very poor and sometimes horribly dangerous nursing practices (not my shift when I'm there, cause my staff knows I'll always help/teach in a manner that is non-demeaning).......hopefully you know what I mean......chain of command is a joke where I work.

Anyway....I have really wanted to try home health but have some ??.

Do you get paid by the hour or by the case.

Without sounding "nosey" (I hope).... do you think $25.00/hr is too much to ask for starting wage on resume/interview for HH job? (assuming it's hourly pay).

If a client cancells for the day are you just SOL for that pay on that day?

If you have a few clients cancel for the week do they take away your health benefits if you fall under a certain amount of hours?

Is mileage reimbursement the norm for most agencies?

Do most of you have to work many night time hours....say after 6pm or later?

My clinical skills are good (see above) charting skills good, time mngmt skills, etc,.....is there anything else I should look into to add to my resume to help in getting a HH job?

I have been thinking about this for awhile. I've asked the opinion of many people I work with and always get very very negative comments no matter what HH agency that is hiring, so I feel discouraged and don't apply...........finally found out "through the grapevine" that this is done on purpose because they don't want me to leave.

Well, I know there are negatives to ALL jobs, but I'm tired of cleaning up inept nurses messes and covering peoples butts because management doesn't care so long as THEY look good.

Hope I didn't come across as arrogant............I'm not that way at all and work hard to learn something new everyday and feel that's the hallmark of a good nurse. That, and truly caring for our patients/clients/residents.......I always remember that I may be in their shoes someday and this keeps me humble. I just have too many in my workplace that think they "know it all" and unfortunately DO NOT........and I wanna get out of there before the crap hits the fan.............cause eventually it WILL happen.

Sorry, such a long post. I'm looking at two HH agencies in my area right now...2 different states but live right by both and am licensed in both. From what I understand I would be expected to have clients in both states regardless of the home state since we're so close. I want to apply really really soon....like yesterday!, but want to know a little of what to expect from all you with the REAL experience.

Thank you ALL:redpinkhe

[jenrninmi, MSN, RN]

Do you get paid by the hour or by the case. I get paid by the hour.

Without sounding "nosey" (I hope).... do you think $25.00/hr is too much to ask for starting wage on resume/interview for HH job? (assuming it's hourly pay). I don't think it's too much to ask. I guess it depends on what the cost of living is like in your area.

If a client cancells for the day are you just SOL for that pay on that day? No, they just give me another patient or I catch up on paperwork.

If you have a few clients cancel for the week do they take away your health benefits if you fall under a certain amount of hours? No way, again, they just give me more patients, lol.

Is mileage reimbursement the norm for most agencies? We are paid the federal rate.

Do most of you have to work many night time hours....say after 6pm or later? Never. And I work every 6th weekend.

My clinical skills are good (see above) charting skills good, time mngmt skills, etc,.....is there anything else I should look into to add to my resume to help in getting a HH job?

I think you should do it! I love it! Let us know...just do it! )

[AnnemRN]

Even though Home Health has it's stressors, it is the best decision I have ever made. Call and setup an interview where you can have all your questions answered, you don't have to commit. I am paid hourly, I work one weekend a month and my agency does not do on-call. Hours are 8-5p, I am salary so I don't lose money if patient census is low. You are very valuable with all of your experience and skills.

[nrsjen]

I think that 25 an hour is not at all too much to ask. I agree with the previous poster, with your skills and experience you would be an awesome asset to home care. Many of the skills and areas of experience you mention are those that are dealt with quite a bit in home care. I have been a home care nurse since 2001 and it is the best decision I have ever made. In talking with nurses that are looking into home care, the most common reasons for trepidation are 1. That you are out there in a patient's home "alone" and what if this or that happens, yaddah, yaddah, yaddah. Well, nothing could be further from the truth. You always have someone to call upon, be it the DON, another RN in an emergency or difficult situation, and if the situation is THAT bad, you just call 911 or send them to the hospital. The second reason for trepidation is the erroneous notion that home care nursing is not "real" nursing. I had a patient's son the other day ask me if I was a "real" nurse before I did this:angryfire Well, I have learned the majority of my technical skills while doing home care. We do TPN, vents, IVs, trach care, wound care, wound vacs, you name it. Not only that, but I think I have more of an opportunity to do some really good quality teaching, compared to when I worked in the hospital. In the hospital, it was more like,"here is some paperwork on diabetes, hope you don't die, have a great life" Because acute care is so stressful and crazy. With homecare, I can admit a patient that can hardly move around in bed without being SOB, and then 3 weeks or a month later they are up walking about, telling you not to come because they have a hair appointment. And you get to watch that whole recovery process happen. It is so rewarding. Acute care definitely has it's place in the world without a doubt, but home care is the best thing that ever happened to me.

As for our agency, If a patient cancels on me, I will either get a new patient, or see if I can see one from the next days schedule, or just take a bit of office time (I get paid by visit, but I am allowed a certain number of hours per week for case management). I was salaried at another job, but that was the biggest mistake I ever made! As for call, I alternate weekday call with the other case mgr M-TH. We have 2 nurses who take weekend call I will help on weekends if it is needed. And as far as being on call, I have never had to make a middle of the night visit yet (knock on wood I am on call this week) If they are bad enough to call in the middle of the night, they are usually gonna take an ambulance ride. Well, I could ramble on forever, I just love home health so much. But the choice is yours. I think you would be great, I just wish you lived here in Fla (we are short a case mgr) Good luck in whatever you decide!

[Jo Dirt]

This is about the only job where I think it can be good to be salaried.

The HH agency I work for is still fairly small, and some days there isn't a thing to do, other days I'm running until 10pm at night. Right now (and for the next two weeks) I have to make daily visits to a patient's house to assess the need for an in and out cath to check for residual urine until he goes in for a TURP. I get $22.50/hr right now (was supposed to have gotten a raise after 90 days but have been there more than that and haven't seen one) but seeing as sometimes the job is almost too easy I won't complain just yet. I get .32/mile. Sometimes I get $500 in mileage alone (though it all gets put right back in for my car-plus some).

The part I like about HH most (and maybe this makes me a bad person) is there is actually not a whole lot of hands on patient care. Your visits are generally short (though I had a wound vac patient I had to spend 3.5 hrs with one day last week) and mostly you fill out papers.

I like filling out papers compared to running the halls of a nursing home all day, though it isn't doing a thing for my waistline.

[jenrninmi, MSN, RN]

The part I like about HH most (and maybe this makes me a bad person) is there is actually not a whole lot of hands on patient care. Your visits are generally short (though I had a wound vac patient I had to spend 3.5 hrs with one day last week) and mostly you fill out papers.

I like filling out papers compared to running the halls of a nursing home all day, though it isn't doing a thing for my waistline.

See, it's not like that at the agency I work for. Although this agency is very large and we cover 7 counties. I get a lot of hands-on, a lot of one-on-one interaction with my patients...quality time. Yes, there's a lot of computer work,(we don't do paper charting), but it's not that bad if you're good with computers and know your stuff.