Published Apr 12, 2009
You are reading page 5 of So overwhelmed..any advice?
Sometimes easier said than done...you may have people that need to be done at a certain time so you have to race from one to another. I do the basics of charting in the home (VS, measurements, pertinent notes) and I usually do pull down the street and chart...IF its a regular visit. It really does not make your day any longer and it's nice to come home with that charting done...it's hard to get in that habit if you are used to just flying from visit to visit. BUT if it is a SOC, ROC or a recert (OASIS) then it may take 45min-1 hr to chart on it. Way too long if you are trying to see 6+ people in a day...either in the car or especially in the home. The more organized you are, the better it goes. It is also nice to have the option of coming home to chart...that way the dog gets let out, the laundry gets done, supper gets started, you see the kids get off the bus....
Well, I am still hanging in there, keep looking and no home health agencies to work at unless going to Atlanta metro area and frankly, that's not a commute I can make and then continue driving. I have to say that the paperwork is becoming easier as I learn more about doing it etc. Sunday I was scheduled to see 13 drove 8 miles out to see 1 and she wasn't home so I saw 12, and drove 100 miles. On saturday I drove 130 miles and almost got swept off the road during the flash floods, and saw 10 patients. Needless to say, since the load was so heavy, no charting in the home, it was all i could do to do a good assessment, wound care, etc, I shudder to think if I had done charting, even IF I could in my truck, can't get my laptop in a good position. So, got up at 4:00 am and charted, then back at it at 0930 am. Wow, I was hauling tail. But, I can say I enjoyed seeing the wonderful patients and I think I am getting the knack of it.
I worked for a CHC in Michigan that was growing exponentially. I was seeing patients in the greater Detroit area. I was responsible for case managing patients within 17 zipcodes! That was quite a large urban setting to cover. Additionally, I carried a caseload of 48+ patients with an LPN. I had not ever seen more than half of those patients. I routinely drove 150+ miles/day. I was required to complete no fewer than 6 visits per day and at least 3 of those visits were often OASIS visits. I was paid salary and was not compensated for hours worked >40/wk or >8 consecutively. Because all scheduling was done centrally, I had NO control over my schedule and could not make "geographic appointments". Because admissions and recerts were priority ("the more the monier") I was, on an almost daily basis, required to admit, recert, or do post hosp visits for patients outside of my service area, who were not in my caseload, and whom I would likely never see again. I completed the vast majority of my documentation in the patient home and if not there then in the car between visits...but...admissions are almost impossible to complete in the home in many instances. At this agency they required their dedicated "admission nurses" to complete no more than 3 OASIS SOCs per day...but they expected me to drive 150+ miles, complete 2 OASIS SOCs, discharge a patient and see 3 routine patients that I have never met before...all in 8 hours. Did I mention that the admission nurses made more money per hour/shift than the case nurses???
Needless to say, I no longer work for that agency. I agree that we are taken advantage of oft times because we allow it.
I think you summed it up pretty good. You were very much taken advantage of.... Hope you found a better place to work. One that respects you.
Wow, Tewdles, I need to shut up, lol! Wow, thanks for putting my meager patient load in prospective, as they say, somebody has always got it worse than you. My gosh I think I would have a nervous breakdown if I had to do what you did, it sounds horrible. I feel a lot better about my job now, thanks for enlightening me!
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.
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.
Just curious--do you work for a large hospital? Which state? I was thinking about going to work for a large hospital here becuase I thought maybe it would be run better than an agency.
Nursing is not a well appreciated profession by too many employers...taken for granted.
chenoaspirit, ASN, RN
I was on call last weekend and had to go out to another county. now this weekend, Im doing an admission on saturday with an infusion. The boss agreed to do the infusion on Sunday because I refused to work Sunday too.. I too will have to learn to say "no". I was just saying today that I feel like I never have a day off and its getting old fast.
If you were on call last weekend, why do you have to work at all this weekend? Get the on call nurse to do your admission on Saturday with an infusion.
Have done home health care for 20 years and will not take a salaried field nurse position. Nothing like paying overtime gets management to hire more help! Change is difficult, but often the pain of change is rewarded --- with a much better situation! Good luck. Don't give up on home care.
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