Stressed out & Fuming

Liddle Noodnik · Dec 24, 2006

... I attribute the woes to poor management. What are my rights? Must I do all the after hour charting even when I'm not on-call or is it not managements job to decline referrals for lack of staff?
Would like to hear back from anyone on this. I enjoy reading this board of sympathetic eyes & ears.

Wow, does that all sound familiar! And down to the taking more referrals.

I absolutely enjoyed home health too, and my patients liked me a lot, I felt I did a good job, until a situation arose that was a lot like yours.

And then the owner of the company decided to "promote" the director of nurses of my home office to director of TWO offices. These two offices were quite far apart, and the second one was very rural - lots of travel time, etc.

I was expected, with 6 months (maybe!) of home health experience (including the paperwork) to essentially take over the director's position in my home office, be responsible for most of the paperwork, start "helping" the new office with their visits while they recruited and trained nurses (on top of my OWN too many visits...), staffing/scheduling/evaluating/dealing with staff problems and evals, etc. There were not enough PCA's, nurses' aides, or nurses. Triple the work and triple the FREAKING OUT! and the same pay (not that a raise would have made ANY of it more tolerable or safe!)

I told them that their putting me in that position jeopardized both the agency and my license, that it was irresponsible, and if they didn't get me some help I would have to leave. I finally did have to leave, very regretfully because it did seem like my niche...

Of course the "promotion" wasn't too great for the director either, twice the work, same pay.

AnnemRN · Dec 24, 2006

:angryfireI would like to know what rights I have to refuse visits.
Our office covers 2 counties and we have been short staffed practically all year. There is only 1 full time nurse and 1 part time (works half days 5xwk) making visits in our office. The 2 of us have rotated call every other week since March in seven day stretches. The part time nurse doesn't get full benefits, so that is REALLY piling a lot on her.
We are stressed out and burned out and management keeps taking referrals. I had 37 hours overtime in one week! We are behind on paperwork and the part time nurse may need surgery for a breast biopsy and she is pressured as to when to schedule it to accomodate our work schedules. (To heck with the employees! Our managers are all nurses too. I wonder where the compassion went).
There are several nurses who have desk jobs but they refrain from helping out--yet they are the ones who keep taking the referrals!
I worked my rear off to get some time off and my manager called me at home and tried to revoke my scheduled time off so that I would come in and cover 1 lousy visit. I did not go in, had I gone I would have turned in a resignation along with it!
I attribute the woes to poor management. What are my rights? Must I do all the after hour charting even when I'm not on-call or is it not managements job to decline referrals for lack of staff?
Would like to hear back from anyone on this. I enjoy reading this board of sympathetic eyes & ears.

You and the other field nurse should meet with your supervisors and tell them you can't continue at this crazy pace. Your supervisors should be going out and covering visits if they want to continue taking referrals. It is unethical and unsafe for both the nursing staff and the patients to keep accepting referrals without having adequate staff.

It's probably not in the job description for intake staff to make in home visits. Your supervisors should be pitching in, it would give them a realistic view of what you're dealing with.

I would threaten to quit if things don't change. I know the overtime isn't as important to you as your health or sanity,let your supervisors know. I hope things work out but, have a plan in case they don't.

DutchgirlRN, ASN, RN · Dec 25, 2006

I worked for just such a HH agency for a year. I quit. I am now working for a wonderful agency. Perhaps a two week notice would make them take notice since they are already understaffed?

Kymmi · Dec 26, 2006

You can only be taken advantage of as long as you let someone take advantage of you and trust me...as long as you allow it they will. Set limits and stick to them.

caliotter3 · Dec 26, 2006

I got unceremoniously let go from my hh agency last month and accused of walking out on a patient b/c I objected to being on the receiving end of sexual battery from the drug-taking/alcoholic friend of the patient. I was told that I would be receiving a call when the Director of Clinical Services made her big "decision" concerning my future employment. To date no call. If I had the cohones, you know the green kind that chill out in bank accounts, I would have already seen an attorney re wrongful termination. I have questioned that these supervisors take on some lulu cases (cocaine, marijuana, removal of children from households for sexual abuse, etc.) and that the agency, as a whole, promotes the practice of many of its nurses, RN and LPN alike, to augment pay checks by committing fraud in the form of billing for hours when they are no where near a patient, but it is a very nice fantasy to say, well go find another job. Guess what, there are not that many out there. And I have found out that interviews are not supposed to be ***** sessions about how bad your former employer was. A check is a check. When ya ain't getting one, suddenly everything that was wrong with the previous gang doesn't seem so unbearable. Hang in there!! Good luck in the new year! Maybe you can find a better employer too!

AmPmRnoncall · Dec 27, 2006

I know what you are going thru. I won't bore you with my own account. BUT, what comes around goes around. My old supervisor who kept putting all the pressure to do visits on me was terminated after I made an anonomys call to our compliance officer and our state board of nurseing. My ex boss is now working for our competitor and of course what I hear, messing up big time also. Hang in there kid. I've been in home care for 11 years now. Email me if I can be of help.

hopeful2 · Dec 27, 2006

Sometimes I cannot believe what I read on this site. I really can't complain about Nursing here in Australia, as compared to the States its a fantastic place to work as a nurse. If I were you, I would let the media know what is happening to you as nurses. Even just your local paper, surely the people of your Community whom you serve would stand by you?

Jo Dirt · Dec 30, 2006

I cover five counties and while it may not seem like I have a lot of patients (around 30) when they are 100 miles apart it gets to you.

Plus, now they are marketing hot and heavy for new referrals. It's Saturday and I have two that have to be done today that are not even in my area because the other nurse got fired the other day.

And 15 minutes before closing time yesterday we got doctors orders to do IV antibioitics daily for 7 days and I was out until 1:30am dealing with that patient, who is not in my area, either.

Right now it's just me, the DON and an LPN covering 10-11 counties. Everyone is overwhelmed with paperwork, resumptions of care are not being done and only the most dire skilled nurse visits are being done. Forget about supervisory visits. And the closer we get to the goal the owner of the company set for us then he will raise the jump even higher. I think we are close to the breaking point.

CseMgr1, ASN, RN · Dec 30, 2006

Not making light of anyone's situation here, but at one point during my (former) HH career, I was covering 22 counties in a large metropolitan area. That didn't last long. I quit after three months. Can you spell A-B-U-S-E?? :angryfire

caliotter3 · Dec 30, 2006

Gee, motorcycle mama, since your position sounds so desperate, and I am in need of a job, I should get in touch with you and apply to work at your agency. I ain't the best there is, but sometimes another warm body helps. Unfortunately, I would guess that you live in an area that I am unwilling to relocate to. Good luck. Don't let it get to you. When you have to take a break to breathe, eat, or sleep, please do so otherwise you might end up in the hosp like I did and then things just ususually get worse.

Liddle Noodnik · Dec 30, 2006

... And the closer we get to the goal the owner of the company set for us then he will raise the jump even higher. I think we are close to the breaking point.

This seems true of wherever you work - as long as we keep doing what we're asked, we keep getting more work, because "obviously" we can do it.

And it seems like the word "dangerous" doesn't bother them til it applies to THEM!