Visit Equivalents

bshaw96 · Jul 4, 2008

I feel your pain on the seeing patients that aren't yours, etc. etc. (See rant below) though that is finally getting better.

As for your VE question, I am pay per visit so I set my own goal, which is 24 per week. I usually do 8 points 3 days a week. Some weeks I do 6 points in 4 days. It depends on what else I have going on. But our salary nurses have the same goal as you. 6 per day. And I don't think they get xtra for going over that. From what I've seen, they look at the pic as a whole. 6 a day is 30 per week. Some weeks you'll go over, some you'll come under. They just want to make sure you're not continuously slacking off I guess. 6 a day is very doable. On my 6 points days, I'm typically home by 2pm at the latest.

As for being "made" to do more than 6, I guess that'll depend on your agency. I know right now we are down a nurse so sometimes the salary nurses are doing more than their goal. But in the end, it's up to you. If you can't do more than 6 in a day, be honest. If they won't work with you, leave. But be careful about setting a hard and fast rule you will not do more than 6 a day. You want to be seen as a team player and someone willing to help out when needed. Good luck on your new job. I'm new to HH too and LOVE it. First time I've liked my job in 11 years of nursing!

Silverblitzen · Jul 4, 2008

Hi Anticoagulationnurse,

And welcome to the crazy world of HH nursing. I've only been in the field since April, and it's a steep learning curve. You basically have to forget what you learned about hierarchy in hospital settings and consider yourself Social worker, Nurse and Ward clerk. You do the assessing, but the family is actually the unit of care. You wear many hats as there is usually differences of opinion within the family unit as to how Dad should be treated; at home vs. in hospital, should we keep Mom informed or not, and the list goes on. Your assessment skills not only take in the physical, but all aspects; holistically, if you will, of the client's health. You are the liaison between the client and the MD and your duties may include faxing your assessment to the doc after hours to see if further orders are needed. If others are seeing your pt on your days off, you need to update them on their condition and, likewise, they'll do the same for you when they see your patients.

Now to your question. I'm now part time, as full time just sucked the life out of me and I got sick. I'm recovering from pneumonia and at home. My hours were supposed to be 8-4 but they were more like 8-8 or even later with all the paperwork involved. When you are considered 'case manager' you manage everything concerning this client. My day typically had 5-7 visits, on occasion 10 or 11 (OMG!) Then you get home and do all the paperwork. We don't have computers yet, so all is done on paper. It takes a LOT of organizational ability to keep it all, well, organized. The funny thing is, I like this kind of nursing. It's the way it should be, but there is a terrible risk of quick burnout and you must be vigilant of that. It's good that you're salaried (our organization is also looking into that, but it won't happen soon, I'm told) and have a set amount of clients to see. My bit of advice would be to keep the home office area clean and have a place for everything. I'm one that can't cook in a messy kitchen so why I expect to make sense of this mess of a desk is a big question for myself! Ask questions if you don't understand something - and communicate! Communicate to the MD, your teammates, home office and whoever else is involved in care for your clients. Whenever there is a change in condition, it should be reported to whoever else has contact with that patient. This is something I'm also struggling with - keeping everyone else informed. It can be overwhelming at times and I've been told it'll take me a year, at least, to get the hang of it. Be kind to yourself and watch the overload which will inevitably come. You have to be number one on your care list, so check all your systems before the start of the day. Stick to your guns as to the number of clients seen in a day. You'll be happier, your clients will be happier - and you won't be missing work because you're sick! :no:

Happy trails,

Sue

caliotter3 · Jul 4, 2008

As long as you are meeting your minimum requirements as put forth when you were hired or as stated in your handbook or job description, I would not get wrapped up in how to handle requests for extra work. Simply be straight with them or make up on excuse for having other commitments and a need to adhere to set hours. However, I certainly would not go out of my way to be in their face about it or be too vocal in saying no. You will probably be labeled as a non team player, but so be it. You have set your own personal guidelines. If you find that you can't meet the workplace culture and the peer pressure gets to be too much, then you can go elsewhere. Personally, I have found that individuals rarely run into any repercussions because they refuse to go above and beyond. And I'm speaking about both internal and external employees. I wouldn't get too stressed out over it. Just concentrate on doing what you do well and don't give them grounds to criticize what you do accomplish. Good luck with your new hh job. Hope you end up liking it.

DriBak · Jul 11, 2008

Good Luck and learn how to say NO, You WILL be doing hours of "paperwork" on your own dime. I have been doing HH for 13 years and been on salary the last 9. The worst part of HH and being on salary is losing windshield (driving) time and paperwork time. You must perfect your time management skills and be very independent and sure of your independent critical think skills. Many nurses jumped into HH when HH wages were almost triple hospital wages, hospital wages have since tripled and HH wages remained the same due to perspective pay etc.. pay for performance is on the horizon and will affect us all again. Hold on!!!!!!!!

bknyrn · Jul 12, 2008

I did hh for almost 6 months and then left. I was PT staff and my daily schedule was frequently changed by the office. I was given admits, and then my regular pts revisits were given to someone else, because these people did not want to open cases. I finally got fed up with it and left. while I knew that schedule would sometimes change, I liked to know what my days were like the night before. Since I also had to leave by a certain time, the change during the day would often make me late to pick up my kids! I did like visiting the pts, most of the time, it was just the changing of schedules and also the tons of paperwork when I got home. Now, I just started legal nurse consulting and so far, so good! Good luck to everyone!