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Time spent on charting

Posted
traylee traylee (New) New

Hi all !! I work as a home health case manager. Usually i see 6 pts a day or 1 SOC and 2 regular visits. Doesnt sound too bad but it takes me forever to get all my charting done. I work longer than my 8 hours after making phone calls and scheduling issues, We are supposed to have 6 reg visits or 1 SOC plus 2 reg visits to justify an 8 hr day. However, I am sittin gup late at night finishing my work. Does any one else have this going on ? thanks in advance for responding !!

I<3H2O, BSN, RN

Specializes in Home Health.

Yes! I try to finish SNV charting in the home. I only take home OASIS visits. When my agency made the rule that snv needs to be completed in home it really helped me. :)

Your documentation needs to be point of service...otherwise you are likely giving away your time.

What employers want and what is realistic are often two different things.

I left visit work because of this and because I was not being compensated for mileage. With extended care, there is no reason why I can't complete my notes while on shift.

I left visit work because of this and because I was not being compensated for mileage. With extended care, there is no reason why I can't complete my notes while on shift.

This is a favorite trick of for profit home health agencies. Require an impossible visit schedule so that all documentation time is unpaid. It is quite a bargain for them but takes a huge toll on the professional and contributes to the poor outcomes that Americans enjoy in our capitalist health system.

SeaH20RN, BSN

Specializes in ER, Forensic Nurse, SANE.

I love when they say, " take the day off and get your paperwork done." haha! some day off. I do love my job, so what is the answer to avoid staying up late doing paperwork.

anh06005, MSN, APRN, NP

Specializes in Cardiac, Home Health, Primary Care. Has 6 years experience.

What all are you charting?? We have paper charting as follows: check boxes for assessment info by body system and common symptoms (like irregular heart rate, chest pain, dyspnea, cough, sputum, vertigo, constipation, diarrhea, etc.) and then about 1/4 of the page is an open box for our "note". Unless something big happens our notes are usually to the point. "Pt says he is feeling well today. Went to MD yesterday, reports increase in lisinopril to 20 mg daily. Instructed on keeping BP log to monitor effect, s/sx hypotension, low Na diet, per MAR, caremaps, to call H/H PRN. Verbalized understanding."

We have pre-made caremaps we pull on SOC visit and if needed throughout care so we just have to date and initial what we taught on that day.

Let me also throw in that sometimes you get faster as time goes on! I've gotten to where I can knock out a SOC (non-complicated) with an hour visit and maybe 30-45 minutes more of paperwork!

I love when they say, " take the day off and get your paperwork done." haha! some day off. I do love my job, so what is the answer to avoid staying up late doing paperwork.

What portion of your routine visit documentation cannot be completed during the visit? Why can you not complete it during the visit?

ratgirl63

Specializes in Home Health. Has 3 years experience.

I am going with the see a patient, chart a patient way of case management. This includes OASIS documentation. My charting is done in a timely manner by doing it this way. I can’t see as many patients but “oh well”! I don’t want to take home work if I can avoid it and management keeps telling us to submit our documentation same day. So there you go, see a patient, chart a patient. Then move on to the next.

I am going with the see a patient, chart a patient way of case management. This includes OASIS documentation. My charting is done in a timely manner by doing it this way. I can’t see as many patients but “oh well”! I don’t want to take home work if I can avoid it and management keeps telling us to submit our documentation same day. So there you go, see a patient, chart a patient. Then move on to the next.

This is a sensible approach.

NurseCard, ADN

Specializes in Med/Surge, Psych, LTC, Home Health. Has 13 years experience.

Wow my day generally consists of 7 to 8 visits, usually at least two of them are oasis visits, one of them may be a SOC. A SOC does not bring my visit number down. Whomever works for the company that gives them a SOC and two regular visits and that's it... I want to know what company you work for.

What all are you charting?? We have paper charting as follows: check boxes for assessment info by body system and common symptoms (like irregular heart rate, chest pain, dyspnea, cough, sputum, vertigo, constipation, diarrhea, etc.) and then about 1/4 of the page is an open box for our "note". Unless something big happens our notes are usually to the point. "Pt says he is feeling well today. Went to MD yesterday, reports increase in lisinopril to 20 mg daily. Instructed on keeping BP log to monitor effect, s/sx hypotension, low Na diet, per MAR, caremaps, to call H/H PRN. Verbalized understanding."

We have pre-made caremaps we pull on SOC visit and if needed throughout care so we just have to date and initial what we taught on that day.

Let me also throw in that sometimes you get faster as time goes on! I've gotten to where I can knock out a SOC (non-complicated) with an hour visit and maybe 30-45 minutes more of paperwork!

now...that all does make sense, but in practice, many nurses, myself included go in with good intentions...meaning i'm gonna be fast and efficient, and before you know it, one hour and 45 minutes have gone... I want to find a way (or ways) to teach myself (and my staff) how to be efficient more times than not. I think it's both a mindset, and tools (like you say: care maps, etc.). But it's easier said than done...

Wow my day generally consists of 7 to 8 visits, usually at least two of them are oasis visits, one of them may be a SOC. A SOC does not bring my visit number down. Whomever works for the company that gives them a SOC and two regular visits and that's it... I want to know what company you work for.

our agency considers 6 SNVs a full load...of course, nurses do get days of 7 or 8. a SOC and 4 is also supposed to be manageable. problems come with the mix of acuities you may get, and amount of driving.

When you are completing focused home health nursing you MUST be focused in your visit. You are there for very specific reasons and it is not a grab bag of care.

Get in, be pleasant, take care of business, document the duty, get out.

I had a client who refused to allow me to be focused unless I was listening to her complain. She dragged each visit out longer than it needed to be, yet would actually use her remote to increase the volume on the TV when I was trying to provide teaching or otherwise verbally interact with her. Finally, when the agency found a different nurse willing to travel the distance, they replaced me on that case. I guess the client extended her complaining to calling the agency and complaining about me.

RN In FL

Specializes in Managed Care, Onc/Neph, Home Health. Has 30 years experience.

At my company, completing the OASIS is not the problem, its the 50 million other pieces of papers the agency has us to complete. Therapy triggers, Adult assessment, Discipline coordination, Chart Audit, 60 day summary, MD order sheet, Supply List, Medication List, and the 9 wk calendar. I know one day last week, I had 4 RCT, and 2 visits. No way you can do all that in the home. We are salaried, I am tired of staying up late, I just cant get caught up....:arghh:

Exactly, I just took a homehealth position and they told me I would get paid per visit. Now I am wondering what about all of this paper work. If I do the paper work and if it takes me longer will I get paid for it.

RN In FL

Specializes in Managed Care, Onc/Neph, Home Health. Has 30 years experience.

Exactly, I just took a homehealth position and they told me I would get paid per visit. Now I am wondering what about all of this paper work. If I do the paper work and if it takes me longer will I get paid for it.

If you are paid per visit, I bet you won't...I would sure check it out. I have been on my job since Jan. and am seriously looking. Only RN's can do the SOC, ROC, and RCT's. Its too much when you are a small agency, and the admits are steady flowing in. I think I am done already