what do you do in a shift?

Specialties Home Health

Published

hi all,

i'm new here and new to HH. just got a new job in this area and don't really know what i'm getting into. i was hired by cross recruiting and the recruiter's given me some examples of what's available but i don't have a clear picture of what my patients will be like. it will be shift work, mostly peds, shifts from 4-12 hours. he said they don't do trachs/vents, mostly tube feedings. my question is, what will i be doing? will the patient be conversant/able to play? what am i allowed to do if they are not? i assume i'll be doing a.m. care, diaper changes, meds, feedings, but that doesn't take 12 hours. am i allowed to read? am i allowed to bring a pot of coffee and lunch to the house? i guess i could ask my new employer but i feel awkward...the recruiter's not a nurse and i'd rather hear from those who have experience doing this. if this has already been covered, please tell me where to look. thanks!

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Get a copy of the 485 from the agency for the case(s) on which you will be working. The 485 is the form that contains the plan of care that is signed by the doctor. It will list all of the nursing care that you will be responsible for during your shift. Study the 485 and look up meds and procedures and ask questions of the supervisors if you see things on there that you are not certain about. In the home, you will find the field chart. The field chart will have a copy of the 485 and the MAR and TAR for the case along with other components of the field chart, such as a copy of the nursing care plan, fall risk evaluation form, etc. Basically, any questions you have about the case should be answered by the nurse or family member that orients you. When you go to the home, you will take your cues from the family. They will fill you in on the rules of the house and the care routine for the patient. Some families are more helpful than others, but you can generally count on them to help you out. Never be afraid to ask questions. And use common sense. Remember that you are a guest in the home and the family can ask you to leave at any time, for any reason, or no reason at all.

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Specializes in private-duty, hospital, LTC, clinic.

I've been doing private-duty for >5 yrs. Have had a number of cases over that time, d/t relocation and household dynamics. My current case is an A&O vent dependent adult, noc shift. They have wireless internet, so I bring my laptop, eat, exercise, read, stay awake :) My client pages me when needed, some nights are easy, he sleeps mostly if secretions are under control. Other night's I'm busy suctioning, repositioning, and other cares requested. When I've worked day shifts...in free time, usually the family has a TV on, or available for nurses. Reading is always good, and of course interacting with the client to the best of their abilities. The family will let you know the do's and don'ts of their home, although some will keep you guessing. When uncertain ask :)

I love it and wouldn't do anything else, now !!!

Good luck !! Oh yeah, and everything that caliotter3 commented about, as well :)

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thanks for your replies! starting to think i'm getting jerked around by this agency. when i spoke to the recruiter on the phone initially (he called me, found my resume online) he talked about home health, mostly peds. i told him i was not ready to go back into hospital nursing. when i got to the interview, he was talking about agency work in hospitals. i said "i thought this was home health?" and he was like oh yeah, right, sorry, i'm planning a birthday party, so my mind is on that, yada yada yada. he said everything was in order for me to do home health and i just needed to do a skills lab, one was happening the next monday but was already full. we'll call you when the next one comes up, probably within a month. then he calls me today talking about classes i need to take to work agency in a hospital! i said again i do not want to work in a hospital and he's like oh yeah, i remember you saying that, we'll call you when there's another skills lab, could be next week, could be another month. seems to me it's time to start looking for another place to work. is this typical? telling me i'll be doing one thing and then trying to get me to do something else?

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Sounds like you've been talking to a healthcare recruiter from Maxim. If so, run in the opposite direction.

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it's cross recruiting, who says i work for them and they contract me to "at home health."

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Specializes in med-surg, teaching, cardiac, priv. duty.

Caliotter3, your reply made me laugh (in a good way!). Isn't it amusing that when one hears about total disorganization and confusion in an agency, the assumption is that it must be Maxim! Maxim has quite a reputation! So frustrating to deal with them! Yeah, run fast away from Maxim if you want to keep your marbles or not develop anger management issues. :rolleyes:

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Or find yourself wondering if there is any good in human nature anywhere on this Earth. Maxim is the employer of last resort where I presently reside. Clients and nurses alike avoid them like the plague.

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HI, I'VE READ UR POST AND I AM ALSO JUST BECAME A PRIVATE DUTY NURSE, SINCE U ARE 5 YRS IN THIS FIELD, I WANTED TO ASK U AS AN EXPERT. SINCE IVE JUST GOT APPROVED BY MEDICAID AND I ALREADY HAVE MY NPI, DOES THAT MEAN I CAN ONLY BILL MEDICAID AND NOT ANY OTHER INSURANCE PROVIDER?, AS WELL AS HOW OFTEN I SHOULD VISIT PATIENTS, AND WHICH PATIENT I CAN VISIT?. ALSO WANTED TO KNOW IF U HAVE A BILLER OR U BILL IT UR SELF?, ALSO WHERE CAN I GET A FORM FOR THE PATIENT CHART, AND WHERE I CAN GET THE FORM FOR PHYSICIAN TO FILL OUT FOR PATIENT( SO THE DOCTOR CAN GIVE ME HIS PATIENTS TO TAKE CARE OF)? SINCE I LIVE IN NY, I NEED TO KNOW WHERE I CAN GET ALL THE FORMS THAT I NEED FOR THE PATIENT AND TO PUT IT IN THE CHART?

PLEASE CAN U E-MAIL ME THIS INFO , MY E-MAIL IS: [email protected]

THANK U, UR HELP AND ADVICE IS REALLY APPRECIATED.

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Specializes in private-duty, hospital, LTC, clinic.

Hi there,

I haven't billed a private insurer, only Medicaid, but I believe that you can.

Every state is different, I live in WI. and our website is very user friendly. It

has the plan of care form required that the MD must sign, the instructions to complete it are also available. You can use a billing service which are reasonably priced, but I bill my own hours because as I said, the website is user friendly. The hours required for each client is to be determined by the MD on the poc.

There are a number of nurses notes that are used, vent-dependent or not. Maybe you have a state association for private-duty nurses in NY. We do here, and they are an excellent resource, also provide CPR, and vent re-certifications. I would strongly advise you to find a local resource to make sure that you are able to meet all of your states requirements. If everything is not in order, you will not be paid or they also have the right to take back money paid.

As far as finding clients... check with hospital discharge planners, if you have a state association they may have a job board, check Craigs List, or also word of mouth. I see that the following post has offered to send you forms. Be certain of everything that is required, there is no almost when dealing with the government health care system. Hope I was of some help :)

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Specializes in private-duty, hospital, LTC, clinic.

Sorry that was a different post offering forms, but were for WI. You really need to find a local resource, I am not comfortable advising you about NY

requirements. Good luck !!

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