This is a horrible change! What do you think?

[paradiseboundRN]

I have worked in home health for almost 8 years with various agencies. Last April I started with an agency that is a "corporation" which means that no one is allowed to think for themselves. Anyway, things had been going ok. We do 5-6 patients or points per day. SOC is 3 points. The contingent nurses were doing most of the SOC's unless the full time nurses had room that day in their schedule. After the SOC the full time nurse continues with the revisits. This week the "corporation" decided that the full time nurses should do their own SOC's and give the revisits to the contingents. So every morning at 8 am they call the FT nurse and ask her to "give up" 2-3 of her scheduled patients to do a SOC. The corporation states its because of the Oasis C that is coming. I think its because they have to pay contingents hourly and the FT are salary. Either way, the patients are furious because they have no continuty with their nurse and they have no idea who is going to show up at their door. I have let my concerns be known but of course, "the corporation" could care less. I am now considering going contingent because I don't want to case manage patients that I don't even know. What do you think? How does you agency handle it?

[caliotter3]

I believe you hit the reason behind the change spot on. Money matters drive the agency before any consideration about administrative concerns. I also think you are right to go contingent in order to attempt to avoid being caught up in this and losing wages. However, they will probably stick to their plan and the full time nurses will be getting used and abused in time. Maybe you should look around for better opportunities. As far as I know, since I don't case manage, my agency is here today, gone tomorrow, when it comes to case managers. Most people don't express satisfaction at the low wages.

[annaedRN, RN]

That does stink!! If the reason for that change is money, they may be disappointed in the long run because patiwnt satisfaction as well as the nurses' will go WAY down!!! My agency case manages - either I or the weekend RNs do the SOC and then they are mine to follow up with until discharge. We work with RN/LPN teams so the same few nurses are in and out as much as possible. We have a 99% patient satisfaction rating too...it helps make sure everything on the POC is carried out most effectively. Hopefully your management will come to their senses soon!!!

[berube]

as a casemanager i (we) have to do all our own SOC's, the only time we don't is if we have more than one a day, then and only then can we give one up,,,and there are occasions when the PRN that is working won't do an admission!!! we can give up 2 but then only IF we have help, otherwise we get it all.

[KateRN1]

I've had it done both ways and even though I absolutely dread doing a SOC, I would rather it's me than a PRN person. Most of our PRN people are former full-timers who now work for the same corporation but in different offices. They are not so great with the communication and although they turn in their paperwork in a timely manner, they don't give any sort of verbal communication to the case manager. I once had a PRN nurse go do a ROC for one of my patients, thought nothing of it. A week later when I hadn't seen the patient on my schedule, I ased the scheduler who was seeing this patient. It turned out that the PRN nurse only wrote orders for 1w1 for the ROC and no one caught the error. Pt ended up going to another agency.