Should I go salary or stay pay per visit??

[AZMOMO2]

As a Homecare LPN who is transitioning to RN now what is your advise? RNs have the option of being salary... that sounds like a good idea, based on a low client census I would get a guaranteed rate and all... but then I feel like that can actually come back to bite me because the idea of working so much that my average per hour ends up in the toilet is also a big consideration.

This is my second job btw, my other is a per hour shift position with another Homecare company... so I have a set time frame I would need to keep to, but for the most part my schedule is pretty flexible... which is why I chose to stay in Homecare instead of transitioning directly to acute care in January when I take my NCLEX.

Thoughts?

[nursynurseRN]

I think that u can make more per patient or hourly, but if u want to be safe I would take salary.

[eaduarte]

I agree. I have done both and depending upon where you work and what the caseload is like, I think that staying per patient pay would be better than salary. I know that having a salary would be nice since you know for sure how much you will get each paycheck, but for me when I was working 60+ hours per week as a salaried employee I was getting burned out and bitter because I was working for less than what a CNA made (at least according to my calculations)...so I suppose it depends upon the census and how many patients you typically see, but I do know that given where I have worked (2 different places) I am much more satisfied with the per visit pay than being salary. At least with per visit you can add a couple of visits (if you can) if you want a little more money. Whereas with salary, they can add patients to you and just EXPECT you to do it and be happy about it cause you are salary.

I think the general consensus from my coworkers and others I have talked to who have worked home health is that you should stay hourly or per visit because the duties and requirements never go down once you are salary and the caseload and responsibilities just compile and make the salary pay ridiculous.

[AZMOMO2]

Thanks... I think that is exactly what I was thinking. I am in a contract negotiation... wondering if I can include a patient load stipulation in it. Who knows, we shall see I guess. Thanks again.

[JZ_RN]

I am salary and work 12 hours more a week now for less pay than I was making hourly. Plus I get dumped on during breaks, holidays, etc., with zero ot because I'm salary.

[eaduarte]

AZMOMO2, I think you should definitely have something in writing regarding the caseload expectation for a full time nurse. Of course it won't always be the agreed upon number, but say if it is 6 to 8 patients per day, then you will know how many you are to see, then if for some reason you are always having 10 per day and you are overwhelmed and getting burnt out then you can call it to your supervisor's attention that 10+ was not whatever you signed on for (I am just making up numbers just for sake of example).

Also I just know from my own personal experience, I was MUCH HAPPIER when I was hourly because I would say to myself "well if they want to pile it on, then they are going to be paying me for it" rather than how I felt when I was salaried "I work all the time and never get a break and make pretty much nothing for the stress."

While the job is the same essentially, I am a MUCH HAPPIER employee now that I am hourly (my current place is hourly, and I had worked as salary for them before). I actually volunteer to take some of the crappier assignments and do some overflow because HA HA I am hourly and I get paid for every minute I work. I have to say my attitude is WAY BETTER being hourly (or per visit) than when I was salaried.

And by all means make any expectations/negotiation about your role known...have it out in the open so that there aren't any "surprises" later on down the road.