Published Mar 13, 2014
Is FULL TIME in Home Health really 40 hrs/week? Or is it like the hospital that where a 12 hr shift can easily turn in to 14 hrs?
Home health agencies don't typically pay overtime for an extended care shift, you are expected to leave on time. If there is an emergency situation at the end of the shift, you are expected to call the agency. They will tell you whether to stay or not and pay accordingly.For intermittent visit work, you are required to set up your schedule so that your work gets done. If paid per visit, the pay is the same, no matter how long you spend with the patient.
So it is understood that you can see your patients and complete required documentation in 40hrs/week? Do you find yourself "working" (to include documentation) more than 40/week?
What is extended care shift?
What is intermittent care?
There are two main types of home health care. Extended care, also called continuous care, or shift work, is basically routine care for stable patients on a long term basis, think of vent dependent patients, that takes place in the home, instead of in a facility. Intermittent visits, occur for a time limited period, usually following a hospitilization, such as wound care following surgery. Nurses that do shift care, complete their documentation while on shift, often visit nurses spend time on followup activities and completing documentation at home, depending on how their work day goes.
The elephant in the room is that home care nurses are supposed to get six-8 patient visits, documentation and travel done in forty hours per week with few exceptions. Some agencies pay a salary to avoid OT. In my personal experience, observation and discussions with other home care nurses , anyone who can do that is cutting corners or working hours daily for free. The one scenario which is unrealistic is having stable patients who need only a basic assessment and easily understand basic teaching. They also need to live within a few miles of each other!
And this is the most honest and accurate answer you'll get. I work overtime every week, but my facility does not care. I think they would rather pay us overtime instead of hiring for more staff. Which is bittersweet to us of course. I can see 4 to 6 pts a day and it be a full day. or I can see 8 to 9 and be a full day. depends on the pt and issues they have that week. But I case manage, so that makes it worse. If it was just making visits only, its a tiny bit better but not much.
If you do a thorough assessment and really address their issues its hard to get all your charting done in the home, not counting dr calls and med issues. you can make a quick in and out for some, and some nurses will do as little as they can get by with, but you'll find that in every nursing field. As a RNCM I have to answer for all the issues, so I have to spend more time that just a prn nursing visit.
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