So overwhelmed..any advice?

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Does anyone else feel as though they are working almost 24/7 doing HH? I started doing HH about 1 1/2 years ago long story short our agency is short staffed we are seeing 7-9 pts daily 5 days a week. I am salaried to see 5 pt's daily but lately haven't felt like I've had no other choice to see more because I want my pt's to be seen. I am feeling like all I do is see pt's and come home and finish up charting and phone calls until bed time. Has any one else ran into this issue? I have spoke to my manager about it but she just blows it off with the same response "We are thinking about hiring another nurse" . How many pt's do most of you see? And is that is that enough or do you feel overwhelmed too?

NURSEBY07,

I am glad that we have this place to share. There are horror stories, but then there are the stories like yours that give some of us hope that there are companies out there that do care about their patients and their nurses. In all honesty I have been so down about my current job situation that I've been thinking about taking a break, not only from HH, but from nursing all together.

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i can tell you that not every agency is like the ones mentioned above....and i know. i've worked for both types. i currently work for one as a prn employee, but can do as many or as little as i want. i have my insurance through my spouse, so i don't have to worry about that. the company gave me my own cell phone, and i get paid well over what i was making. now, we are currently on "paper" but hopefully, that will change in the next moth or so. i also work with a great bunch of lvn's that also know there stuff especially about the medicare guidelines and keep me informed on my cases.

let me tell you what has happened to me: i went to admit a dm pt that needs qid insulin injections and wound care. when i went, i asked how long the pt has been a dm, to which he said 7-8 years. i then asked, well, how have you been getting your injections. he said, i give them to myself. i have a chart that i can fill out, and even know when i need to take a snack, etc. well, guess what? he doesn't meet medicare guidelines! when i called the office, i was told, "no way can we admit him!" now, when i worked for amedisys, we did not do qid injections, but we once did a bid injection patient. and after telling my director, several times, the patient is capable of giving her own injections, it's been documented that she has been wittnessed as doing so, and she just doesn't want to, i was told "no, you have to do it"

it is not worth my hard earned license to try and meet some "quota" for them. and this was the same company that had me on call every other weekend---driving all over god's great country!

now, my new place repeatedly told me how sorry they were, and assured me i would be paid for a "non-admit". i will bend over backwards for someone one that respects me, my license, and treats me fairly!! i will not go back to someone who works me like a dog, doesn't care about my license, and doesn't care if it's my day off. no one should!!!!

people will only abuse you if you allow them too. first time, shame on them, second time, shame on you.....

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Specializes in oncology, trauma, home health.

I've had similar things happen to me with the same responses from both employers.

There really have to be limits drawn. I think in general nurses want to support one another, even when

they become supervisors. I too was on call constantly at the above mentioned company. I'm sure I told the story of coming home from my 8 hour day and at 5:02 pm my phone rang. It was the on-call service. A pt's cath had come out that morning and when they called the office the supervisor told them to call back that evening for the on call nurse.

I was highly perturbed.

My current job has after hours nurses. Nobody does call. It is glorious.

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What about this situation, I would like some advice..... when you work for an agency that has questionable practices and does not support you as a nurse, but you do not want to quit for various reasons, can you somehow write "notes for the record" about the situations you encounter, what you did, and what the response was?

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obviously that would be the very least that you could do. however, if you know it's fraud, i think you are liable also. not sure about this, or the terms, but say you admit a patient that is not homebound etc, then you are guilty also. whatever the reasons to work there, i don't know. but are they worth "questionable practices and the lack of support"? lulu-you deserve better!!! good luck.

someone else agree/disagree with that?

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Specializes in Home Health, MS, Oncology, Case Manageme.

A therapist told me that nurses have a real problem with codependency. The definition of codependence is: Always putting ones needs above your own needs. Feeling/thinking that someones elses needs are more important than your own. She said nurses have a bad habit of accepting assignments/workloads even when though they can't handle or don't want the workload. Their reasoning is "my manager wouldn't have asked me to do it unless it was really important", or "if I quit the agency because they treat me bad, it will be the patients that suffer". I'm sure you have all heard the rationalizations before. Personally, I started at a new agency 3 weeks ago. I really like it so far but I have set my boundaries early. I found that if you set your boundaries early with your manager, the less trouble later on. For example, I am very pleasant, but I made it clear that if I work the weekend, I need 2 days off during the week and only on very rare occasions will I work more than 8 hours per day. Just something to think about.

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I do home health and love it. 7 is the most I've seen a day. It's usually between 4-6. Three admissions at the most. I'm a flex nurse, so I get paid per visit equivalent, admissions have more VE's, DM visits (because I'm a CDE) have a certain number of VE's etc. I've been in HC for almost two years. This year I started pulling over somewherea and doing my charting after each visit (not always possible for admissions). I was becoming burned out going home to finish work. It's great now to get home and not have to think about anything work related.

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Specializes in OR, HH.

tjccde

Does everyone in HH do the same paperwork? Oasis, etc....

How long does your paperwork for an admission as opposed to a visit take you to complete. I am starting HH this Mon and have heard all kinds of stories about the paperwork taking forever.

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Specializes in LTC/hospital, home health (VNA).

OASIS is Medicare requirements for HH reimbursement. My agency has just adopted the OASIS assessments for all admissions, recerts, resumptions and discharges...unless it's a pediatric or maternal/newborn assessment or a big exception to the rule ( a one visit only admit or something) A regular visit paperwork takes 15 minutes or so. Paperwork time for an admission is an 45 min to an hour give or take..initially more than an hour. As you get used to the questions, it becomes much faster. As does the actual visit itself. That is why my agency counts an admit as 2 visits. Anyway...give it time, it will get easier with time! Don't be afraid to ask questions...and you can refer to this HH forum on OASIS tips to help you out. A big help is also fazzi.com for OASIS questions. Good luck to you!

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You must be a RN/LPN.

I wish I got that many hours. Unfortunately, in my state, I only get one or two patients for a couple hours a day.It's really hard to find good hours as a HHA out here. I still wouldn't trade it for the world, I prefer this to being in a nursing home.

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How long do you spend with the patient? Just wondering.

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Specializes in Home Health.

I am a new RN trying to get into home health and I see that some people complain about all of the paperwork and time it takes, and not being fairly compensated. I want to know why some or shall I say most nurses wait until they get home to finish paperwork instead of doing it in the patient's home or doing it in between each patient (like in the car or something)? I am just trying to get an understanding before I get into it. Please help me understand!:sstrs:

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