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What do you think? Cause I know it's not right..

Really long just cause I want you to have the whole picture. No experience whatsoever in HH. The company is very small, nurse wise. At the time, there were 3 field nurses, LPN in office, and DON.They say there are PRN nurses but IDK anymore.

I've only done a school rotation for 4 hrs in it years ago and never laid eyes on an OASIS form. (Because of this I did ALOT of correcting. They gave me a sample that was "right", but I still had to correct my forms 2-3 times.)I joined, "signed the papers", this HHA February 14th this year.

I did not get my first patient until March 9th. I even did the admit all alone even though they told me someone was going with me. I never got an orientation, a ride along, or anything really. I got a run down of the company and what kind of patient load i was to expect.

At first I was getting a supplement, I still dont understand, as long as i did a private duty case once a week (12HRS). Did that. The supplement and PDN didnt add up to nothing.

I was pulling weekends with another agency paying over $1000 for that weekend to pay for bills. They actually got ***** at me because I wasn't available Monday am. I told them why too. Hell my lights were cut off and facing foreclosure. I'm sorry!

Closer to the end of April, one field nurse was resigning at the end of May. I was told her case load would be split up between the other nurse and I. In the midst of this another nurse was hired. This one got ride alongs. i know this casue she was to ride with me one day. She even backed out on that. This one also got the resigning nurse's entire patient load. I asked 2 weeks after I figured this out, "why did RN get RN's cse load? I thought it would be split up?". The answer..."Oh I thought because you had enough patients at that time". Well I didn't. I had 9 total and was to d/c 5 within that next week.

We do a case conference every week. IDK.....; About 3 or 4 weeks ago new RN gave a weeks notice to do traveling RN but still wanted to stay on for PRN work. :o

What now??? We have to split the case load as originally planned. Most of which are PDN cases. I only have 2 right now. Most of mie are IV infusions. I have a few teaching and wound care.

I don't like the ""teaching" case b/c it seems pointless to me. I need to "get my hands nursey" when I go to a home.

The other field nurse loves these and says that's where I should make money. I disagree. The "teaching" cases take up too much time. I have to call dr's, pharmacies, etc. Just be on my phone all the time. I STOP every time I have to make one of these calls. TOO MANY near misses b/c of calls and looking up numbers etc.

The infusions and wound cares warrant extra visits sometimes. I feel like; nurse doing these teachings and assessments of wounds and infusions.

We get $30 reg visit,$45 recert, $60 medicare SOC and any ROC, and $75 private ins SOC.

Right now it's $0.50 per mile reimbursement. Tomorrow it's goin down to $0.42 per mile due to medicare reimb. Typically, I will drive 100 miles a day on average.

We aren't given patients based on anything. A referral comes over and they just text. not a mass text but individually. So I don't know squat until i get back to the office to see the whiteboard.

Next, the hub office was shut down about a month ago i guess and moved back to main office. So instead of a 30 minute drive to the office, it's an HOUR. so i don't go unless i have to or i am in the neighborhood, which i'm not, EVER.

I never turn a patient down, until just recently. Personal crisis at home and they were starting to resent me being gone. 12 hr days seeing at the most 9-10 a day.

Trying many different ways to handle all this, it still hasnt panned out. All paperwork done at that time of visit including oasis, mapquest's route planner, paperwork at home after work and weekends, pre-filling out forms before hand with info already given to me, calls while driving, stopping to make calls, taking notes, writing case conference notes, MD change orders, ... if you think of it i have probably tried it.

So up to date now. I'm getting nervous here. I'm not on call this weekend. I have taken call up to a week at a time. Hell it was 2 months before I had a day off from seeing patients just 2 months ago.

I understand the business, the more you see in the least amount of time the more pay.

I try to spend at max 45 min in a home. 15 minutes being the least amount of time in a home and 3 hrs MAX d/t IVIG infusion. That day I still saw 9 pts.

I made plans today because, no call. I had to hold a parent meeting for my little girls cheer squad cause I'm her coach. I agreed to see 2 pts, one dsg change on a PICC and to pull another.

Well the dsg change was done yesterday by other RN and cant get the other on the phone. Calls and texts about that one go unresponded today.

Friday I spent 5 hrs on ONE pt because we couldnt find her. (another long story) It was life or death pretty much and 2 seconds from the fire department being called to break the door down.

I picked up an extra pt, drove all over hell's acre. As far as I know, there is no replacement in the works for RN that recently left, only referrals that are being taken are PDN (d/t recerts not completed but HALF on the list are d/c'd already),DON and LPN are taking call, blah blah blah.

There are many more things wrong here so I'll spare you. Right now my patient list is somewhere around 20 or less. I saw 30 people last week. 3x week and 2x week visits plus new pts.

I start later on my own accord some days because of when lbs are due. i refuse to spend 13 hrs a day in that truck. Some days, just recently, I will come home (which is out of the way)and do what I need to do until next patient.

Here's the point blank. I am trying to mend my family, keep my house with lights, maintain my vehicle, and work all while keeping my own sanity. I LOVE LOVE LOVE my job.

Don't get me wrong. I would rather love my job that be shoved around by corporate hand jobs trying to make their image "prettier" by kissing tail. I just want this job to co-exist with a happy family. I haven't had a job i love like this in 10 years.

And please don't think I'm bashing the people i mainly deal with here because I'm AM NOT. The sweetest, caring, compassionate group since 2003. Like I said, I'm new to this and just trying to carve my 3D Mona Lisa, ya hear? ; Any insight?????

Please exclude sarcastic remarks towards me or derrogetory tid bits. I can get by fine without it.

I will take experience, corners to turn, time savers, etc. By the by,I am a stickler for documentation and patient care. I DO NOT skip any corners here. I have too many burn scars from things. MY RN LICENSE, i say.

Thanks for reading this introlude to my autobiography LOL and Thanks in advance for tips or even your shoulder.

Extremely sorry for length but this is the first and only place I've released this. This is still just icing on the cake.

Edited by sirI

Sorry I am not sure what your looking for. Do you want more cases or do you feel you have too many? I am leaving HH for the reasons you stated. I have not had a full weekend off in a month and I am tired of it. No other nurses I work with sees as many Pts a week as I do.

I do not have any answers for you. And with all the Medicare cuts companies are going to expect more from us to make up the difference. Good luck

Sounds like a huge mess,I am in the same mess as well and getting out of it. My company is a bit more organized with orientation and ride alongs though. It is so time consuming I'd honestly rather at this point go back to do the 12 hr hospital shifts and get my 4 days off. Time is always spend locating patients,answering the phone and the office is always calling when I am in the middle of something. It is rough with a family,and pay is NOT that great if you count it dollar per hour that is wasted and you can't get paid.Hope you find something better soon.

Also It is a huge heartache trying to balance my family with this job. Some of my other friends do homecare and schedule themselves 7-3 but I'm in infusion and I end up seeing patients in the mornings,afternoons then get called for more in the evenings..I love the job,love the patients just hate the fact that I barely see my family.

itsmejuli

Specializes in Home Care.

So, if you don't like the job, quit and find something more suitable.

Edited by sirI
off-topic comment/unnecessary

Its not the job. I love the job and the people. I was just wondering if this is just me or what?

I have my people i see. Most of the time the call with a SOC middle of the day and ask me to go. If I don't... missed out on monies. If I do, potentially its a mess. Its the trade right. I think it short staff.

Edited by sirI
reformatted OP

The post did not sound like someone who loves all of that.

Well alright. Some get it and some dont. and it seems I get the same type of answer for most of my FEW posts. so I'll refrain from now on.

I feel the same way as the poster. I LOVE the job and patients but when I get a SOC if I dont take it I miss out on money and if I do take it it NEVER goes as planned and stretches your entire day from 8 hrs to 12. It gets crazy when you have to pick up your kids or call home and tell them whatever plans are canceled. I've missed out recitals,been late for parent-teacher meetings,canceled many appointments..its heartbreaking each time to disapoint your kids so its either struggle without money or disapoint your family. It's a better position for singles I guess.

I feel the same way. My Mom guilt is soo bad I am leaving HH. Tired of working 6-7 days a week for weeks at a time. I hope my new job is truly a Mon-fri type job. I don't mind a weekend here or there but not every weekend.

WannaBNursey, ADN, ASN, RN

Specializes in ER, Med-surg.

Find a different facility? I've worked at agencies where there are many RN's and they barely get work and are forced (or guilted) into working days that they explicitly said they wanted off, and I've worked at agencies where there are only 2 or 3 RN's and you work pretty much every day. That's the nature of home healthcare. It is truly per diem.

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical.

What is it you love about this job? I was frankly surprised to see the ending to your post where you proclaimed your love for this position, because I wasn't feeling that reading what you wrote.

I'm not sure what you're asking of us, advice, kudos?

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical.

I'm not sure why you're getting upset with the responses you've gotten. Enjoy the ones that agreed with you, disregard those posts you didn't care for. I for one am still confused by what it is your searching for =(

iluvivt, BSN, RN

Specializes in Infusion Nursing, Home Health Infusion.

What is bothering you the most? let me ask you this rksgray....are you able to turn down a SOC in the middle of the day if you have a full day planned out..or are you expected to do it? That is why I do not do IV home health full time. I like to be in control as much as possible so I can say "NO" when I do not need or want the work. many times I do say "yes" even when I may not want to to be a good team player and if you say no to much..they stop calling you..so its fine balance you have to strike. What is great for me about HH is that I enjoy the relative FREEDOM I have. I enjoy driving..do not mind going into other peoples homes...love that it is not as stressful as the hospital..plus many more things. Its a trade-off..with more good things than bad.

I'm sorry it's confusing. I thought I was giving enough information to get insight. Just "what do you think?" I have no experience in home health. It was offered and I took it. Is this unusual for home health or not? Is it just the company is small and that's what happens?

The company is welcoming and willing in any way to help. I wanted outside opinion on the situation. If there is one.

I can turn down patients at any time. But with the 2 nurses leaving so close together, I try to help everywhere I can. 2 field nurses for over 130 patients. The 2 office nurses help where ever they need to respectively.

What upsets me is a response that makes me feel like an idiot. If I didn't love this position, I would have quit. The home health forum was the best place to come for suggestions since I know so little. I did put in the title what i was looking for along with more specific in the post.

It's not big deal really. If its confusing, u have nothing to offer besides the obvious, or just plain can't relate, just don't comment. I appreciate the informative posts though, Thank you. Its hard to assess feeling or even write feeling for me so maybe i gave too much info in the post. I apologize for that. Its really not a big deal anymore, i think I just need to tell some one to get out my confusions.

nursel56

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Do you feel your agency is disorganized so you lose cases you need due to not being able to drop your life on a dime and zip over to see them?

Time management tips to help you deal with the avalanche of paperwork?

A substandard to non-existent orientation that was less than the other new hires?

I'm sure there are answers to your concerns here, and home health is the appropriate forum, so no worries there.

If you can break it down into bite size pieces you can begin to address them separately.

You could also write a narrative stating what you expect from your employer. How do you envision your workday going to allow you to function to your fullest potential? You don't need to give it to them, but that might bring things into clearer focus when and if you communicate with your management. I'm sorry you are in such dire straits financially. That has to be terrifying in and of itself. Hope things get better for you. :)

Thank you!! Nail on head. That's something i was looking for exactly. I have been cutting my day short to spend some kind of daylight with my family. The company has PDN and home health and due to the lack of recerts turned in on time or them just not aware of the status, they have cut off the infusion referrals right now until it's straight.

I think it all just built up and i released it here. I have tried different thing since i posted this. I have cut my visits down and spread them out. I have also grasped the concept of see the farthest out and work my way towards my house. I was not wanting to even come home after that last visit because it was such a long drive. I live at least 30 minutes from the city. So getting back home is a long drive. Its working out better.

As far as the company goes, I cover my tail. Thank you all so much for replies. I'm sorry I snapped. I was also having some issues with a bill that had me on edge already. Truely I am sorry!

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