5 top things

Specialties Home Health

Published

What are 5 top things to know before entering home health care?

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1- You will be loaded up with tons of paperwork

2- You may drive 300-400 miles per week (I do)

3- You will most likely not know when your day will be over til' it's over

4- You will be exposed to disgusting filthy homes that make your skin crawl

5- Bring a medication book with you on visits

6- If your patient is a psych, sit in a chair closest to the exit!

I think that's enough to chew on.... and yes, I've had it. After 4 1/2 yrs I don't think I can do this anymore. I'm looking for another job but it's not easy. After 12 applications I got one call back and interview last week, but still waiting to see if I got it.

Good Luck to you

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1 The freedom of being in your car,no body telling you when to take lunch, when to pee!

2 The freedom to make your own schedule.

3 The smile on your patients face when you arrive.

4 The relief they feel when they know help has arrived and they can relax.

5 The relief you feel when you know that you don't have to live in the environment that you just entered,that's the patient choice to live like that not yours. I'm sure I could come up with more, I love home care.

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Specializes in COS-C, Risk Management.

1. It takes at least 6 months of full time case managing to get really good at being a case manager, sometimes longer. It doesn't matter how long you've been a nurse or under what circumstances you've practiced, home care is another beast.

2. You have all the tips, tricks, and tools at your disposal to help patients change their lives and live better--but only if they choose to do so. You will not be able to help them all, but you must try anyway. Sometimes, just when you're ready to give up, they have an epiphany that you really are trying to help them and they start making an attempt at being compliant. And sometimes, no matter what you do, no matter what you teach, they will not change their lifestyles. It's not about you.

3. The OASIS is not just a bunch of questions that you can take at face value. There is a whole lot more that is counter-intuitive and you have to understand what the questions are really asking, not what they appear to be asking. There is a rationale to it, it's just really hard to understand. But once you get it, you really get it. Don't get upset with the QA or clinical review nurse who tries to talk to you about your scoring--it's not personal and it's not about you. It's about outcomes and to a lesser extent, payment. Keep an open mind and try to learn why your scores are being questioned.

4. Learn about your co-workers. They will be your best help or worst enemies, depending on your relationship. They can help you learn about your patients or let you sink because you're the "know-it-all" case manager. Tandem visits with a PT, OT, ST, or HHA can help you understand more about your patient.

5. If you don't already have a GPS, get one. You will need it. And keep the maps updated. And a car charger for your cell phone. If you don't already have an unlimited minutes plan, you will probably need to change or risk overage charges.

6. Take the time each weekend to go through your supplies, removing anything that's expired and making a list of what you need to pick up from the supply closet at the office. Make sure that you have everything you need for the upcoming week. A little bit of planning and organization will save you a lot of back-tracking later. Keep extra paperwork, pens, pencils, batteries, anything that you use regularly in your trunk.

Best of luck to you!

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Hey sorry for my negative post earlier....bad week, bad month.... well you get the point.

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Specializes in Home Health.

You will find yourself doing a lot of freebies for the company. After 9+ years, I have stopped with the freebies. There is now a price tag for everything. If the company doesn't want to pay then I don't have to work, since I am semi-retired and can very easily say, "NO!"

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Thanks everyone for you feedback I am glad I got both postive and negative feedback about what it is all about. I am apprehensive about doing home health because of walking into strangers homes you can never be prepared for what you are going to see. But when you are working in a hospital setting the previous nurse warns you. I do like the pros of sort of being my own boss nobody telling me I must be done in 8 hours and no overtime accepted. I also don't like not being able to get to know my patients anymore. That is one of the most important things and we don't have enough time to just sit down with them and talk. Thanks again!

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Specializes in Hospice, home health, LTC.

Wasn't negative at all...just factual. I totally concur. Use every ounce of time mgmt skills you have...I love home health, but it definitely has its challenges. You are seeing patients as they live - not in generic hospital gowns lined up in rows of tidy beds. You can taylor your teaching (somewhat) to their circumstances and call them on the carpet as well; in that gentle, loving, non-judgmental way we have ;-) It is frequently a brain-drain for me and can be heart-breaking. But really if it wasn't, I should quit nursing.

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1.You will address non compliance daily

2.Good luck with administrative/cm support-esp if the pt has private ins vs Medicaid

3.Did I mention non compliance?

4.General disorganization

5.Greater focus on consistent,persistent pcg education

p.s. and HH employers will prohibit OT as disgustingly as any other organization!

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Specializes in LTC/hospital, home health (VNA).

I would agree that there definitely are the negative factors that RN 1263 listed - however, it is not true every day or with even most patients. On the bad days, or weeks... it is so easy to focus on those. But honestly, if you believe and love what home health nursing does - Susan's list is what keeps you going!! Kate as always was spot on - but I would have to say I only organize my supplies about every 3-4 weeks. If I use something from my car stock, I keep a list and reorder it.

If I made a list trying to focus on different things from what the others said it would be...

1. Be organized. Plan ahead as much as possible. Call a few patients the night before It WILL make your day go much more smoothly

2. Learn to be efficient. Chart as you go. Learn to chart and listen at the same time (hard to do and still make your patient feel #1)

3. Keep Lysol wipes and extra clothes in your car...you never know what you will find in a home

4. If at all possible, have an iPhone (smart phone) - use the apps for pill identifiers, meds, lab results, email, map/GPS - has been invaluable to me!!

5. Know that even though you will often want to pull your hair out dealing with noncompliant patients - the rewards of helping patients in their own home - you will have those few that tug at your heart strings and those success stories that keep you going (I had one 375 lb patient that would not leave her home...now 3 years after I showed her some tough love is under 200 lbs and frequently stops in the office to bring us all goodies - she calls me her angel....that keeps me going!!!)

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This is a tough question to answer. Having done home care for over 20 years, and still loving it I think I would say;

1. Never think you are suppose to have all the answers. There is always something to learn. Don't be afraid to say I don't

know and then seek the answer.

2. Feel confident regarding your clinical skills. Good assessment skills and critical thinking is a must.

3. Do know your mission is not to cure all.....but rather remember home care is a bridge. Some injury or illness caused

an interruption in your patient's life. Your goal is to provide them with the knowledge of how to get back to where t

they were before the injury or illness occurred....or as close to it. With some you succeed....with others you don't.

4. There is no place in home care to be judgemental. Not everyone rushes to be the first to move into the low housing

development that is infested with roaches and rats. Not everyone can put in the ramp, stair lift, modify bathrooms etc.

to make them safer in their homes. We are fortunate that we do not have to make the decision regarding buying my

medicine or paying the rent. Be empathetic to where the patient is now....and accepting. KNow we are ministering to

them on THEIR turf now.....not the sterile rooms of the hospital.

5. Do know your days will be a roller coaster of emotions.....frustration, excitement, sadness, joy, irritation,

fatigue....much like in any other area within health care. The key is to be able to put your head to the pillow each night

thinking you have made a difference in at least one person's life.

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Specializes in Geriatrics, Developmental Disablities.

1. Always tell someone where you are going especially when you are going into the not so great neighborhoods. 2. Keep at least half of tank of gas in car3. Get a GPS( but always look of up directions) gotten lost cause of GPS a few times4. Buy a cell phone charger5. Invest in blue tooth ear piece for phone.6. Always keep your work ID on you. ( Been stopped before by police coming out of shady neighborhood and they wanted to know why I had all the syringes and tubing etc etc)

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