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Libby1987 · Mar 23, 2015

The manager position sounds more predictable for you, HHC takes a good year before you will be able to flex your time. At first it's just going to overwhelm you and you'll likely be catching up after hours. If you can afford that time and have the energy and motivation, I would do HHC hands down.

Since you've worked as a HHA you know the patient contact part, it doesn't get any better than that. As you know nearly everyone in HH likes the patient care aspect. But there is no comparison in the paperwork required of a HHA and of a nurse, especially a case mgr.

Just know it's going to be tough for awhile.

JustMeRN · Mar 24, 2015

I started in home health 6 months ago, previously working an outpatient (phone calls) department for three years, and acute care hospital for 12.

In your management position did you do any hands on care? Or do you have hospital experience with hands on care? If not, I think homecare will be a difficult transition. You really need the assessment skills and experience that come with bedside or hands on care to be comfortable going into a home and evaluating someone.

I found scheduling at my at my agency to be amazingly flexible right from the start. As a per diem hourly employee I give them my days and hours available and they assign me visits. I work my days so that I have an hour or two beyond my given availability that I am able to work on charting or other tasks. I absolutely refuse to be the nurse that is charting and completing documentation late into the night, on weekends and days off. There are a lot of them that do, but it's not for me. And they are generally the ones who will have less job satisfaction.

There are are some negatives to me, but I think most of them are agency specific and related to the structure of the agency.

Jdeci · Mar 25, 2015

I started in home health 6 months ago, previously working an outpatient (phone calls) department for three years, and acute care hospital for 12.
In your management position did you do any hands on care? Or do you have hospital experience with hands on care? If not, I think homecare will be a difficult transition. You really need the assessment skills and experience that come with bedside or hands on care to be comfortable going into a home and evaluating someone.
I found scheduling at my at my agency to be amazingly flexible right from the start. As a per diem hourly employee I give them my days and hours available and they assign me visits. I work my days so that I have an hour or two beyond my given availability that I am able to work on charting or other tasks. I absolutely refuse to be the nurse that is charting and completing documentation late into the night, on weekends and days off. There are a lot of them that do, but it's not for me. And they are generally the ones who will have less job satisfaction.
There are are some negatives to me, but I think most of them are agency specific and related to the structure of the agency.

I do have previous hospital experience and though I was the supervisor I worked the floor quite a bit. I picked up extra hours as the charge nurse as well. We didn't have physicians on site so having good assessment skills was a must. This home health job is paying "per unit". Average is 30 units a week. How easy is it to pick up on Oasis? Sounds like it's the documentation that takes most of the time.

paulinejoyRN · Mar 25, 2015

OASIS documentation can be tricky to learn, but if you really invest the time in learning it in the beginning, you'll save yourself time in the future. There are books that explain the various intricacies of OASIS, e.g. when documenting wounds, what is classified as a wound, which I found helpful when I first started and continue to refer to occasionally now. OASIS changes every so often, too, but I don't think documentation requirements should stop you.

I think the most helpful thing I could suggest about enjoying home health and keeping yourself happy is to really focus on keeping your documentation accurate and limited to POS and during service hours. You have to be able to manage your time and your energy so that you can really enjoy the flexibility in HH.

As for "units", it really depends on your agency, but typically visits are assigned units. Example: regular visit= 1 unit, SOC/Start of Care (aka Admit) =2 units.

JustMeRN · Mar 25, 2015

As said, oasis can be tricky initially, it's not really an intuitive document, but once you figure out how to answer the questions it's really not so bad. Even when you get the hang of it it's a loooong document, so it takes time.

We are paid hourly, a regular visit is scheduled an hour, admits 2, and other visits might be slightly different. I have no difficulty completing a visit and documentation in an hours time frame. Admits take me closer to 3-31/2. The actual visit an hour and a half to two hours, then completing the oasis, writing orders and creating certs. It's not necessarily difficult, just a little tedious.

As as long as you have hands on care experience, set boundries, and learn to be done at the end of your day you will be fine. most of the negatives in home care I read are people who don't turn off at the end of the day, and who don't say no. I have no problem refusing an assignment that will run beyond my scheduled availability. As much as I enjoy it, it is just a job, not my life.