stress in home health nursing?

caliotter3 · Mar 31, 2010

There is little stress in shift work. Most of the "stress" has to do with dealing with unreasonable patient families and an agency that does not address the needs of their nurses. For the most part you can put up with this to the extent it is bothering you and the degree to which you need a job. If you can not cope with a certain family and patient, you can always request to move to another case. If you don't like the way the agency personnel treat you, you can find another agency. When you get a good case, it is great. When you have good backup from the people at the agency, that is greater still.

annaedRN, RN · Mar 31, 2010

A good many of the patient visits only take 30-40 minutes - do a brief head-to-toe assessment, focus on the problem areas (dyspnea, pain, infection, etc) and then provide the skilled need for visit - wound care, IV, catheter, med/diagnosis teaching, etc.. unless it is a SOC, ROC or a complicated visit- its not usually the whole hour. That leaves time for travel, charting, phone calls, offfice time, etc. The shorter visits help to balance out the longer ones. There are some days where it seems that there is alot extra things happening in each visit that mean extra time on phone with docs, extra travel for dropping off labs, or making extra visits for emergent issues with patients, etc...but overall with 5-7 visits, I get done in the 8 hrs time frame. Time management/being efficient with your time is a BIG help in reducing overall stress level.

I did shift work for a long time before going to visits. Definitely what Caliotter said...while with visits, you still have crazy families, unsafe environments, etc...it is only for a short time you deal with it..not for hours. I personally would have a little more stress and be able to enjoy the challenge and diversity of the visits. There is more acuity and use of different skills/needs with visits. I got bored with shift work and needed more. I have really enjoyed the change(over 3 yrs now) and wouldn't go back to shift work or the hospital. Good luck to you.

AnnemRN · Apr 1, 2010

I guess it depends on the agency. The agency I work for does not factor in travel time or the type of visits you're doing.

My agency does not differentiate a routine visit from any other visit. For example, one day this week I did (1) start of care, (1) discharge visit with labs, (1) wound vac change and (1) routine visit. Each visit is counted as 1.0, so to them it looks like a light day. For me, I'm going crazy and feeling very stressed.

Now, because I was on call they also added (1) resumption and (1) additional start of care. The points only add up to 6.0 for that day.

annaedRN, RN · Apr 1, 2010

That does stink...SOC and ROC counts as 2 visits for us...and recerts are kinda like 1.5. But RNs are salary- not paid by the visit unless they are PRN

Linda Lu · Apr 4, 2010

if you are a LVN and not doing OASIS, then 5-7 should be manageable. If you are a RN and doing OASIS, the paperwork will really slow you down and you will likely be doing 10-12 hour days depending on mileage. Hopefully you are not salaried.

ProBeeRN, BSN, RN · Apr 7, 2010

I usually see 6 "regular" revisits in a day. My patients are all pretty close together (urban area) so my drive time is only 5-10 minutes/patient. If we get a SOC, we get 4 visits (1 SOC and 3 revisits). Some days I'm done with visits by 2pm, some I'm still in a patient's home at 4:00. Depends on the day. I also case manage, which for me adds stress, I feel like there's soooo much responsibility on me.

Can't imagine having a SOC count as "one visit"!!!!