Truth or Dare, how many hours do you really work a day?

wonderbee, BSN, RN · Nov 1, 2007

This is a serious question, not just a curiosity. I'm wondering if I'm getting gipped working 10 to 14 hours a day (without lunch) because the agency is poorly managed or if this is just the way it is out there. Is there anyone out there at all who can comment on this?

cookie102 · Nov 1, 2007

most days i can finish up in 9 hrs, that's no real lunch "eating and driving",,,bigger question is how many hrs are you working on your day off????? i was off yesterday,,,and literally spent 2 hrs taking care of things, office calling with soc for next day

i have worked places where i am done in 8 hrs, and it is mostly because the office is not calling me all day....sure we need updates etc from the office,,but when they call looking for info that is in the pts records that is a waste of my time....i think all HH takes a little longer than the usual 8 hr day,,,but i do think it can be kept very close to it

how many visits are you having to do in a day?

hang in there!

NurseFeelGood2005 · Nov 4, 2007

Hi there,

We are paid salary at our company and its based on a 37.5 hr wk week. We are given a productivity number based on the areas we will cover. Mine is 55, that means I need to see 5.5 contact hours per day to get paid my salary. Keep in mind an admission is worth 2.5, offhold 1.5, and revisit is 1. So I see anywhere from 3-6 pts in a day considering their need. But I live and see pts in the country and some pts homes are 30-40 miles apart. I start my day about 830am and am done seeing pts about 3pm, but then need to finish up paperwork. most days I am officially done by 5pm, but still need to make calls for next days visits. some days I have to see pts later d/t their specific needs (chemo hook up, iv antibx) or earlier d/t stat labs. All depends. We have to take call 1x/wk and on 1 day of our weekend on (we work every 3rd weekend) call for the weekend day is 24 hrs. So thats our co, its not horrible unless someone is out then I'm seeing a lot more pts in a day and that can be very stressful.

I'd be interested in what everyone else says about this.

Chrissy

TazziRN, RN · Nov 4, 2007

I usually literally work about 10-12 hours including paperwork time, but I rarely bill for all of that. If I work 10 hours one day and bill for 8-9, then on a later day I can leave early and bill for 8. That's not cheating the agency, BTW, admin is aware that we do that and would rather we do that than bill all the OT. We are encouraged to actually take a lunch break but my desk partner and I often work through lunch.

Sabby_NC · Nov 4, 2007

We work 8 hour days with 2- 15 breaks and either 30-60 mins lunch our choice which.

Notes done in the home of each patient before I leave their home.

If done early I am out of the office and on my pager.

Sometimes when I do not have my full compliment of staff I may have done extra but I always get the time back by leaving early the next day.

This system is very fair and works well for me :)

RPN_2006 · Nov 5, 2007

I saw thirteen patients today. I drove nearly one hundred kilometers (some days much more than that). I have been home for 2.5 hours and aside from stopping for 20 minutes to eat the dinner my son cooked for me, I have just finished doing today's paperwork. After a small break here I will go online and retrieve tomorrow's work order and prepare for that.

NurseFeelGood2005 · Nov 5, 2007

13 patients? thats ridiculous!

wonderbee, BSN, RN · Nov 9, 2007

Thank you for all your replies. At this time I have gone casual for HH and hospice because it just seemed like a never ending tread mill. It gives me time to think of options. My time management is what got me into trouble. They'd want me to start off at the office and often not see the first patient until 10:30. By the time I got home with my paperwork, there was just no way I could deal with it. I was already done in for the day. I'd find myself getting up as early as 4am to complete admissions, go to the office and do it all over again. It's so easy to get behind that way and that's just what happened. It all got so out of control.

Some things I learned. Don't start off at the office. It's ok to end there but not to start there. For some reason, my DOCS has a hard time with that concept. Don't bring paperwork home. I'm reclaiming my kitchen table and my home as a place of rest and relaxation. For me, this is a necessity. Get a job with a company that uses computerized technology. It will save trips to the office and time spent copying, setting up work files and generally looking for stuff.

jnette, ASN, EMT-I · Nov 9, 2007

Wow... thirteen patients... that surely IS way too many !!! :eek:

As for the above.. I do start at the office BUT... I get there by 0700 before any of the others get in except a few admin here and there. This way I can pull my charts, get what teaching materials I need, have the copy machine all to myself to make what ever copies I need for the day, etc.

Can glance over my notes one last time before turning them in, and make changes in the MARs as needed from the day before.No one else there to talk to or distract me.

I can get out of there in half hour and be on the road. I try to be at my first patient's home no later than 0800... often quite a bit earlier, depending on the patient and what time they will let me show up.

I do have several who let me come as early as I want. I see one regularly at 0645.

Catch her on my way IN to the office.. same as my lab draws if they are enroute to the agency.

We get our schedules on intranet the noc before, so I already know whom I must see the next day, and can call them from home that evening already to let them know. Also know what labs I will have to draw and where, so that helps, too.

I average 6-7 pts./day and my area of travel averages about 25-30 miles/day. Often less than that.

So on average, I get home by one pm .. sometimes later if I have 7 pts. and several of those being tedious wound care. Rarely get home later than two, and often have been home by noon. All depends on the patient, and the care needed.

I, too, try to get my notes done IN the home before leaving, as they are chit chatting with you. Helps a lot, that way the remainder of the day is MINE. (except we ARE still considered "on the clock" until 4:30 pm.. meaning if they need you to do a PRN visit somewhere or somthing like that, they can still call you back out.) Happens only once in a blue moon, though.

Sometimes I just can't get my notes done in the home if I have a heavy load or things are crazy that day. I do as many as I can, sometimes I have done none and will have to do them later at home, which I don't like. But... gotta take each day as it comes and do the best with each one.

We're still hoping to get up to date with laptops or PDAs in the future.. wish it was sooner than later. *sigh* That would be a HUGE help and timesaver!

I don't understand why your agency doesn't want you to see patients before 1030 am. ???? :confused: ????

Ours requires us to be on the road and on the way to our first patient no later than 0830-0900 at the LATEST. Most of the nurses come in to the office by 0800- 0830. I'm already long gone by then.

caliotter3 · Nov 24, 2007

As a hh employee, I've only ever done shift work, patient care. I would not consider doing intermittent visits. It's not worth it as far as I'm concerned. Just going to one (or two when I work multiple jobs) patient a day has caused me to go through a car with the mileage and hard use. One of the pitfalls of hh. Right now, though, the advantages outweigh the disadvantages. So I'm staying with hh, at least for now.

caliotter3 · Nov 24, 2007

I forgot to add to my post, 13 visits in one day is insane. When I precepted while in nursing school, my preceptor never saw more than 6 or 7 patients in one day. That is considered the norm as far as I know.