Visits vs. Shift work?

I just read a lot of the posts under the "sticky" about your typical HH day...but still wondering if the shifts are better than the visits?

i have done HH for 20 years, i have always done "visits" so i have no imput on shift visits, i like what i do , seeing a variety of patients, following them until they are "all better" is rewarding for me. the paperwork is just a necessary evil, do it every day , do not carry it over to the next day or you will bury yourself.

I do shift work 8 or 12hr with one patient. We start a nurse's note form when we get on shift. It has spaces for VS, diet, assessments, etc. There is a space for a narrative note. We usually document chronologically such as received report, checked vent, assessed, etc. The nurse's note is 1-2 pages depending on how complicated the patient is. One page is usually fine, but with wounds I can use two. Then we sign the MAR and narcotic sheet after giving meds. Some patients have a flow sheet with I&O, VS, chest percussion, etc. and a checklist for their equipment.

I usually finish my note when I'm feeding the patient at the end of my shift (he eats slowly & surfs the web while I feed him, doesn't want me to talk to him). We turn in the top copy with our time sheet and file the copy. We also have a communication book for the nurses. The charting is not bad at all.

Hope this helps you.

I am a little confused about HH I guess. I am thinking about checking into it, but was wondering this: Do some nurses do visits like I am reading about here, and some do 8 or 12 hour shifts with one patient?

I'm assuming RN's do one or the other, right?

After reading about these visits, I would much rather do a whole shift with one patient! Do you still have a lot of paperwork if your assignment is just one patient?

Also, what kind of pt.s are you seeing on these visits?

Thanks

Hi, I am a Home Health RN and our agency only does visits. We typically see 7 pts a day if we don't have an Oasis to do. We do have an agency in our town that does both. They call the full shifts private duty nursing. They use RNs for the Home Care visits and LPNs for the private duty. I am in Tennessee and TennCare will pay for private duty if the patient qualifies and the MD orders it. Medicare on the other hand doesn't as far as I know. I prefer doing visits myself but I am one who doesn't like to be still. I was an LPN before I went to RN school and I did private duty for a short period. It paid well but most of the time it was extremely boring. This is just my preference, it may not be what you prefer. Hope this has helped a little.

i have done HH for 20 years, i have always done "visits" so i have no imput on shift visits, i like what i do , seeing a variety of patients, following them until they are "all better" is rewarding for me. the paperwork is just a necessary evil, do it every day , do not carry it over to the next day or you will bury yourself.

So true about the paperwork. Putting it off is a very bad habit to get in and once you start it is hard to break. If you put it off for one day you will be trying to play catch up all week. It took me awhile but I did break the habit and I was much less stressed. Paperwork is definitely one of the negatives of HomeCare but there are worse things.