What are some thing RN's do when they work Home Health Nursing

jessluvsbama03 · Feb 22, 2012

I have been an RN case manager for 7 months now. Yes we do dressing changes, PICCs, wound vacs, foleys, etc. We have LPN and Aide supervisory visits that we have to make (most of the time in conjunction with a regular visit or recert). I see 8 patients a day most weeks. The only time I am in the office is in the mornings to turn in paperwork and prepare for day, and occasionally in the afternoon if I get done early.

AMN74 · Feb 23, 2012

Get up and get ready early in the morning, finish up last minute notes from the day before, transfer laptop, pick up new patients start calling them to set up your day. Transfer again to make sure your schedule is set for the day, out the door I go. Grab a diet coke for the long day and need of some hydration. Drive 20 minutes to first patient house. PICC line care, Wound care and documentation, OASIS for re-certification, get labs. Total time about 2 hours after care, teaching and documentation, drive 30 minutes to the lab and drop off labs. Get a call patient in distress with blocked foley, make prn visit to change out foley, do teaching and documentation. Get back in the car and start calling patients to tell them you're running late. Drive 20 minutes to do a wound vac dressing change, photo and document wounds and teaching. Get back in the car to drive 20 minutes, get behind a slow farm tractor and some cows in the road and get behind again... get to next patient house, new out of hospital resumption of care. major med changes, oasis documentation, medication and disease management teaching, realize he only has 3 of the 4 new meds in his home no rx for 4th med. Call md to get rx called into pharmacy, patient can't afford med, call social worker. Make med calendar, visit, follow ups, documentation, new orders 1.5 hours. Get in car listen to voice mail a mother is in panic over her son's condition, call her and get details, calm her down, teach what needs to be done over the phone schedule visit for the next day to see him, pull over on side of road to document the situation. No time or place to pee. Keep going, to next patient house just got home from doctor with new med changes and severe drug interactions, call MD to clarify meds, he orders labs, get labs via venipuncture, document the whole visit, update meds and drive blood to the lab again. Stop at office to pick up some paperwork and transfer laptop. Can't locate next patient on the phone. Call next of kin, no answer, call hosptial, he's hospitalized. Do transfer oasis, necessary paperwork, notify hospital liasons. Finally get to next patient, she is anxious and confused. She is not safe to be at home by herself, she has not taken meds from pill box in 3 days, bp elevated. CAll md, he says get social worker involved and notify family. Spend 20 minutes on phone making arrangements with family and social worker for a family meeting that will be held later. Next patient routine wound care, photos and documentation, mentions that he is having trouble and burning with urination, and blood sugars have been elevated, call md get order for ua and cx. Have pt pee in cup, drive 45 minutes back to the lab and call last patient to see them they are mad that it's 5pm and you have not shown up yet. Follow up visit and teaching, routine documentation, prepare them for discharge at next visit. Get home around 630 pm, finally rush to pee, finish up notes, make important phone calls, follow up with social worker about plans for visits on patients with no meds or patient not safe to be at home and what we can do for them. 730 pm put laptop down for the night and pray all is quiet because you are on call tonight. Several calls about crazy stuff after hours, laptop back out to document and alert necessary personel about the on call issues. Try to get some sleep by 11pm because it starts all over tomorrow and you have more crazy stuff going on....

I'm burnt out!!! :)