Should I try home health?

caliotter3 · Oct 14, 2009

Hi. Think you will find home health to be a welcome relief. When you look for work, ask for extended care or shift work rather than intermittent visits. You will only have to go to one client and provide care for, typically, an eight hour shift. You will fill out one nursing note and that is it. No driving around all over and worrying about finishing a stack of paperwork at home on your own time. Pay will probably be a bit lower than what you are used to from the hospital, but you are only working with one patient. You can still get benefits if you work a certain number of hours each week. One of the best advantages is that you can tailor your schedule to fit your needs. You can find lots of threads on this forum that address making the switch. HTH

emidianeRN · Oct 14, 2009

Thanks for your reply. I will read through the other threads too, thanks. I definitely love the idea of a more flexible schedule. These 12+ hour days are killing me. I would want to work even shorter shifts during the day, maybe 4-6 hours. Would agencies really be that flexible? I think a PRN position would be a nice change for me. ( I have full time benefits at my weekend hospital job..which unfortunately I can't afford to quit for at least another year.).

caliotter3 · Oct 14, 2009

Four to six hour shifts are possible only to the extent that such a case presents itself. Possible but not very common.

emidianeRN · Oct 14, 2009

What is a typical day/patient like when you are doing shift work/extended care? I can't imagine having just one patient for 8 hours but it sounds awesome?

caliotter3 · Oct 15, 2009

For the most part you are talking about routine care for stable patients. Actually most of these cases are considered to be at the LPN level, which accounts for part of the reason for a lower wage according to some employers. You go in and do whatever is called for on the care plan as far as skilled nursing duties along with activities of daily living. Trach care, GT care and feedings, ventilator monitoring, med administration, treatments like resp nebulizer treatments, dressing changes and wound care, as well as general hygiene throughout the day, transfers to wheelchair, ROM exercises, general care. If they go to appointments you would accompany them. You monitor them for change of condition and take appropriate action. Take appropriate action in emergency situations. If you work night shift you can have a lot of downtime while the patient sleeps. Lots of these patients are peds kids with cerebral palsy, people on long term (permanent) vent assistance. Having them stay at home is considered a better situation and it saves money in the long run. HTH

emidianeRN · Oct 15, 2009

Thanks for describing the duties for me, that does give me a good idea of a typical day. That helps!

HmarieD · Oct 15, 2009

I made the switch from hospital to home health and never looked back. I have not done shift work as caliotter3 has, but saw several different pts each day. If you are looking for a flexible schedule with possible shifts of 4-6 hrs, this might be the way to go for you, as prn staff.

Like you, in the hospital I never felt as if I gave any one person everything I would have liked to or that they deserved. Home Health was a godsend because you only have one pt at a time and can give them your full attention. The biggest downside to HH is, in most people's opinion, the paperwork, and it is demanding, but certainly not impossible. And, of course, some of the homes we go to are less than ideal. HH is also heavy with regulations and very detail-oriented, but if you are organized and can be self-motivated and manage your time well, you will not have a problem.

I will never do anything else. No way I could or would go back to the floor.

emidianeRN · Oct 15, 2009

Thanks! I really think I'm going to try it. I don't like the sound of all the paperwork of course, but it's also become really intense (charting) at the hospital too. I love the idea of doing the charting in the comfort of my own home, or at least in a quiet spot, instead of under the bright flourescent lights of the nurse station with the phone ringing off the hook and the telemtetry monitors alarming non-stop.

Now, I just need to revive my resume! If anyone knows a good agency in the NOrthern VA area, or DC, please let me know!

Sarahtonin · Oct 28, 2009

Hi there, I am a new nurse... very new- just graduated 6 months ago! I currently work in LTC and my case load is ridiculous. Even for an experienced nurse I think it'd be difficult. I have 31 patients, all their meds (scheduled & prn, patches, creams, eye/ear drops, breathing treatments, inhalers, etc), treatments, insulins, etc. I have to deal with the doctors calling, the family asking questions, other nurses wanting to know what's going on and wanting your help when you have a (rare) free minute, the nurse's aides, etc. It's nuts!

I went on an interview today at a local home health place, and it sounds really promising. I did home health as an aide while I was in school, and I really really enjoyed the 1-on-1 interaction I was able to have with patients. You get to know them, their families, their habits, what works for them as individuals. That way, you can tailor your care and make it specific to them.

If I get this job, I will be travelling to see 6-7 patients a day. Each visit should last about 30 min.-1 hr. Maybe more, maybe less, depending on the patient or situation. It's Monday-Friday, 8am to roughly 4pm. She said there are many days I might be done at 1pm and just need to finish my paperwork. They give all their nurses laptops to work on, and I can go home OR to the office to finish the paperwork, or just finish at the patient's house before I leave. I'll be on call every other weekend from 5pm-8am, but I was told it's somewhat rare to actually have to go on a call in the middle of the night. A lot of times, you can advise them what to do over the phone, or if it's a true emergency, advise them to call 911 or go to the hospital. (I also get $2/hr just for being on call...even if I don't deal with any patients!)

There are also some perks that I thought were pretty great: they pay your cell phone bill every month since you use it in the day to talk to patients/the office, take on-call calls, etc.... 50 cents/mile reimbursement, free medical coverage if F-T, travel time is paid (which was a benefit I never had being a home health AIDE).

Look into home health agencies around your area... see what works. The place I interviewed with is locally owned & operated by a family, so I get a sense that it's an intimate setting, not too driven by ''corporate'', etc.

All I know is that I can't take 11-12 hour days anymore (especially when my shift is only 8, AND especially since my facility cut overtime. I only get paid my usual rate, not time & a half). They also just cut the shift differential, and are sending nurses home due to low census. I need to get out! Haha

GOOD LUCK!