Thinking about making the switch to home health...

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I've been a nurse in med-surg for nearly 3 years now. I work 12hr night shifts 3 days a week at a small hospital. I recently just had my 3rd child and I'm thinking I need a little more structure at home. I'm looking for an 8-5 job, a job that allows me to do hw with my children and have dinner with my children and put them to bed. A job that will allow some flexibility to squeeze in a school activity in between pts. I love m/s but I'm sad that it doesn't give me the family structure that my children need at this crucial time in their life. Am I being unrealistic thinking that a Case Manager position in home healthcare will give me what I'm looking for?

So, I interviewed today and I'm going back for my 2nd interview tomorrow. I hope that it all works and can soon call myself a HH nurse :)

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You want to make sure that you're with a good agency that *supports* its' nurses and auxillary staff. Most places have computer-based charting nowadays in the field; if you're adept with technology, it's easier for you.

Do NOT put your bag down in a home with bugs. Bring wax paper with you (better than paper towels, which absorb fluids).

Make sure you check all the meds a patient is on, especially what's in the medicine cabinet. There are people who hold onto medications and ointments from so many years ago that you swear they're growling at you.

Communicate with your staff, HHA and others working with you, especially if there's a large dog, a mean dog, or a mean in-law in the house.

good luck!

-girlpolice

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One thing to consider if you have small children- will you be required to take call? For a while about 12-15 years ago, it was popular for the hospitals in the region to have their own home care department. The nurses were required to be on call for a week at a time. I did a very brief stint in home care prior to children. I know nurses who got out of home health care because they wouldn't see their children for a week straight- doing visits all day and going out to on call visits all evening, then back up again in the morning. Then weekends were a nightmare with one nurse on call and had to open all the new cases that were discharged on Friday evening.

Up Vote Up Vote ×
You want to make sure that you're with a good agency that *supports* its' nurses and auxillary staff. Most places have computer-based charting nowadays in the field; if you're adept with technology, it's easier for you.

Do NOT put your bag down in a home with bugs. Bring wax paper with you (better than paper towels, which absorb fluids).

Make sure you check all the meds a patient is on, especially what's in the medicine cabinet. There are people who hold onto medications and ointments from so many years ago that you swear they're growling at you.

Communicate with your staff, HHA and others working with you, especially if there's a large dog, a mean dog, or a mean in-law in the house.

good luck!

-girlpolice

Thank you for your reply, girlpolice! I did end up getting this job with a local agency and start at the beginning of next year :) I'm excited, scared, nervous and all the above! Lol I just hope I love it!!!

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One thing to consider if you have small children- will you be required to take call? For a while about 12-15 years ago, it was popular for the hospitals in the region to have their own home care department. The nurses were required to be on call for a week at a time. I did a very brief stint in home care prior to children. I know nurses who got out of home health care because they wouldn't see their children for a week straight- doing visits all day and going out to on call visits all evening, then back up again in the morning. Then weekends were a nightmare with one nurse on call and had to open all the new cases that were discharged on Friday evening.

Thank you for your reply! From what I understand we are on call 1 day a week and that is just until 10pm and then you work every 3rd weekend.... I hope this job doesn't turn out this way because it won't workout for my family :/

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I've been doing homecare for a couple of years now. Best to find one that pays by the hour, hard to do. But I like it and the pay is comparable. Less stress, less time on my feet. We rotate weekends and holidays. I stay at the hospital contigent for experience, fall back plan and occassional spending cash. I see 3-6 patients a day which is considered a full day when you add in drive time and admissions. Be careful, many agencies will try and suck the life out of you. I read here someone had to see 14 patients a day, unrealistic if there is drive time. Considering you must spend 40 minutes per patient and there is always emergency etc... Good luck.

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I agree with the above poster....pay by the hour is waaay better. When you have spent 30 minutes round trip driving to a pts house, another 45 sorting them out and then do not get paid for any of it because they NTU(not taken up), you will not be happy when you do not get paid for your time and expertise. Pts can NTU for a variety of reasons....refuse care, not homebound, no skilled need, already on with another agency, unsafe home enviornment (for the HH staff). Many times you do not know that they are an NTU until you actually meet them and get to know their situation. My time is valuable, and I wanna be paid for it. It takes just as much clinical expertise to decide an appropriate plan for a pt that does not come on to service as one that does....if I make the wrong decision and do not open someone that really needed us and something bad happened, I would be at fault. HH is wear and tear on your car that is generally not reimbursed, though gas usually is. I have been doing HH for 10 years now at a great agency, but I am on my third car, and this time I decided to go with a lease. I worked out my average milage over the years and that is part of my contract with subaru. I only work part time. so my mileage is less than many folks who work in HH. My plan is to turn my car in after three years and lease another. I am sick of making car payments for years and then by the time they are payed off I am paying for constant repairs. This way I am constantly paying yes, but I always have a nice new car to drive, plus I have full warranty and maintenence included in my lease along with 24hr road side assist. Don't know why I brought up cars specifically,

right now except that they really play a *huge* part of you life in homecare. You *must* have reliable transportation.....we go places where believe me, you do not wanna be stranded. Plus, you will spend at least 1/4 of your work day in your car, so it needs to be comfy on your back etc. I figure I spend that 1/4 of the day driving, 1/4 seeing pts, 1/4 documenting and the other 1/4 on the phone (arranging my day, calling docs, calling pts, giving report to the case managers). The uninterrupted one on one pt contact I love. Taking call can be a pain, but it can also be a great way to earn extra money. We make abou $100 a night baseline for being on call. If you get any phone calls and start interacting with patients, then the money starts to pile up. We get time and a half for any time spent dealing with pts including phone calls, documemtation, driving to the home and of course the visit if one is warranted. We bill for that in 15 minute increments and even if you just get a couple of "I need advice" type phone calls and then document on them you can make several hundred in just that night without ever leaving your house.

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I left my hospital position for sort of the same reason. I wanted a more regular schedule in order to have more time at home for my family. While I love my hospice/home health job in general (the patients and families and what I do from M-F 8-4:30 are incredible) the on call hours can be horrific. I found that the 40 hour work week is actually a joke and I am working 55 to 65 hours a week. I am also really irritated by how much I am expected to do off the clock. I am putting in about 5 hours a week on my own time which is just expected of everyone. So if your expectation is that you will be working 40 and then done this is a pipe dream in home health if you are expected to do call in the position. I am currently looking for something else and still seeking that more regular schedule for my family. I don't want to talk you out of it because there are some really great aspects of it, but if I had known how many hours I was expected to put in I would not have gone in this direction. Wish I had asked some more specific questions in my interview. Good luck.

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Thank you all for your replies! I really, really hope that HH works for my family and I and that I really enjoy it! I've purchased the book "Handbook of Home Health Standards" by Tina M. Marrelli that I've read on here will help me out being that I'm new to HH. I'm hoping it gets me a better insight into HH...Are there any other tips or recommendations as far as car desks, apps, or websites that'll help me make it a little more of a smoother transition to HH from Med Surg?

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I know this post is old but it came up in my search. Mommy22 are you still in home health? Do you like it? I recently accepted a position with a home health agency that has a good reputation here. I will be paid per visit and I feel really good about it. I am currently working on a tele/med surg floor and the stress is burning me out and also being that I have two kids, I'm also looking for something that will leave me more flexibility in my day. I will have to be on call mon-thurs night every 6 weeks and a weekend every 6 weeks. But they said that it's rare for you to get a call to a house in the middle of the night unless it's something very important and that all of the calls go through the office first before calling the nurse. I hope you get this message as I'd love to hear how this ended up working out for you!

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Hi MyusernameRN! So before entering home health I was very much warned about how difficult it was and was told it would take about a year before I become comfortable and begin to understand. Well, it's been 9 months since I started and at the beginning for about the first 7 months there were many times where I'd cry and feel completely overwhelmed. Not until recently have I felt a little more comfortable. There is a TON of charting and as long as you stay up with it and your organization you should be fine. Also we are still ALL paper charting and will be getting tablets next month, YAY! This will cut down hopefully on a lot of unpaid office time, as we are only paid per visit! The flexibility of Home health is definitely there but at first for me it wasn't. It takes time as your learning the ropes for it to become flexible. Now, after 9 months I can definitely say I'm happy with being a HH case manager. Don't get me wrong, I still have TONS & TONS to learn and I'm still learning on a daily basis! I hope this helps you, feel free to message me if you have any further questions :)

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Thanks for your reply Mommy_2_2! I start in a few weeks. I was told all of their charting is electronic, but it's on a small phone/handheld device. Hopefully it's pretty straight forward. I'm looking forward to the change, but hope that I catch on quickly. I'm a little nervous as I get closer to starting, but I think it's time to get out of where I'm at. The company seems to be really good and the people were really nice. They have a good reputation too. Well, thanks again! :)

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