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. 
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.
BuckyBadgerRN, ASN, RN
3,520 Posts
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 =(