Unhappy with HH

Kaisu · Jun 7, 2018

In the first two weeks of working home health, I was overwhelmed. I contacted my DON and she cleared my schedule for the next day to allow me to catch my breath. Two things here - 1 - I was definitely overwhelmed and 2 - my agency backed me.

I am now in my 5th month. Yesterday I did 2 starts of care and 2 supervisory visits and a discharge. This is about average for me. I love this job. What has made all the difference is the support I received from my agency. It sounds to me like you have not made your feelings known, or you have and they are not listening.

deefizzle · Jun 7, 2018

Probably a little of both. I am and have always been a people pleaser and don't like to be a bother. I sent out an email earlier to my team and asked for tips for scheduling patients and manipulating the schedule as needed. Everyone has been nice. I'm just not used to being so independent and not having coworkers around to bounce things off of. I feel like I am emailing and calling my manager constantly.she always says that it's no bother but I feel like her tone says otherwise. Then again I am sure that she is completely swamped with work and just trying to get a quick answer to me.thank you for the feedback, I really appreciate it.

caliotter3 · Jun 7, 2018

Consider changing to extended care, either with your agency or another. If you find that you still dislike hh, then consider finding a new nursing area to try.

Kaisu · Jun 8, 2018

I felt like I was being a bother too. My DON always told me that she expected questions and would be very nervous and worried about me if I didn't ask. I think your DON is busy, but she does want you to ask.

As I gained confidence and experience I asked fewer questions. I had a big advantage in that I was a paramedic for years before I became a nurse. That made me comfortable being autonomous. Now that I think about it, I was scared out of my mind for the first 6 months of EMS.

I think coworkers for the most part will be happy to help if you have questions. Everybody remembers what it was like to be new and I am always honored if someone picks me to ask a question of.

You seem really intelligent and organized and your idea of a emailing your team is a really good one.

I think a month is still very early days but I have a question. Are you happy to be going to work? Do you enjoy any parts of your day? Are you excited nervous or dreading it?

deefizzle · Jun 8, 2018

At this point I am dreading it. I'm in a very rural area so my patients are 30 minutes apart. Half the time they don't call me back or agree to the time I suggest, so I'm spending a lot of time driving aimlessly. Today for instance I have a SOC and 2 revisits. I called all 3 last night, with plans to start at 9am. No one has confirmed. I live 40 min away from the first visit. Then the next one is 30 minutes further. Close to an hour from me. Then the next is 40 minutes away. They are so spread out its making it really hard to plan my day. I'm sitting here in my kitchen now just waiting to hear from someone. When I send the visits back to the office due to non response they will send me someone else in the opposite direction! I agreed to this position but I did not realize they would be sending me all over a large county where the patients are so spread out. I assumed I'd have some kind of territory. IF I see all 3 today, IF they call me back, I will have driven a total of 2.5 hours.

Allanka · Jun 8, 2018

Dee, the best part about HH is that you're your own boss and get to make your own schedule!

Agencies only care about their visits being verified and documented, so they can get paid. Your inconveniences matter none.

You are the one that needs to take charge and accept patients you are comfortable with. If I get asked to take a patient that's too far, I decline. If I get asked to take a pt. that needs care I am uncomfortable with, I decline.

Don't be emotional about it; it's just business. Most of all, don't let yourself get treated like a doormat, you're not a hospital nurse.

Good luck!

kbrn2002, ADN, RN · Jun 9, 2018

My biggest question for you is about that 2 1/2 hour drive time. I don't work HH so honestly not sure how that works. Do you get paid for that drive time or are you only paid for the actual visits? Unless you are paid plus a mileage reimbursement that's a lot of down time. Depending on the climate where you live it could also be anywhere from inconvenient to downright dangerous during inclement weather.

Libby1987 · Jun 9, 2018

One of three underlying problems is that you are "independent", more like tossed out there without a rope, at 1-2 weeks, nearly at full productivity and already doing SOCs. At this point you should just be doing approx 3 revisits or 1 SOC per day and ramp up over the next 2 months.

The other things you're struggling with, that's a skill set that's built with time, along with a whole lot of other knowledge and learning how to navigate.

Not all agencies will throw you out there like that.

Kaisu · Jun 10, 2018

What Libby1987 said.

It does not sound like a good agency.

Have Nurse, ADN, RN · Jun 11, 2018

Dee, the best part about HH is that you're your own boss and get to make your own schedule!
Agencies only care about their visits being verified and documented, so they can get paid. Your inconveniences matter none.
You are the one that needs to take charge and accept patients you are comfortable with. If I get asked to take a patient that's too far, I decline. If I get asked to take a pt. that needs care I am uncomfortable with, I decline.
Don't be emotional about it; it's just business. Most of all, don't let yourself get treated like a doormat, you're not a hospital nurse.
Good luck!

Be careful. That's easier said than done in many HH offices. Refusing to see a patient can get you fired if you aren't careful. I agree though she does need to make her needs and concerns known.

It might be possible to switch to being a Visit Nurse as oppose to Case Manager. It's less documentation and you just keep your Case mgr informed of any changes in addition to what you've documented.

Regarding your clients who don't confirm: You can politely state in your voice message that if you do not hear from them by such and such an hour, that you will assume that they are not available. You'd be surprised who responds quickly then!

Sit down with your D.O.N. and share your concerns.