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Why do you like home care? What are the advantages?

Home Health   (123,055 Views | 52 Replies)
by smartandgrit smartandgrit (New) New

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enchantmentdis is a BSN, RN and specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.

521 Posts; 10,123 Profile Views

How many patients would you usually see in a day?

Imagine this: As on on call hospice nurse i work 5 weekdays, no weekends, eight hour shifts--i get paid, guaranteed, for the full eight hours though sometimes i see no patients, and other times see up to four patients per night. It is not a pay per visit scheme. I never get overtime, nor do i want it. With zero to four patients per evening--the average is only two--i have plenty of time to do my computer charting and sync it. Now, how sweet is that? With a cushy job like this, i'd be completely out of what is left of my mind to go back to back-breaking, mind-numbing hospital work.

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enchantmentdis is a BSN, RN and specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.

521 Posts; 10,123 Profile Views

I see 6-9 a day but my max was 10 in one day.

I hear you. I had the same set-up when i was a case manager in hospice--was a bit too much. Now i am doing hospice on call--much easier, and actually more rewarding and less stressful. Your job must be very hard at times, especially with two kids.

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2,139 Posts; 16,622 Profile Views

So with reimbursement being like it is are you expected to spend a minimum and/or maximum amount of time with each client? Are your mileage reimbursements on government scale which I last knew as being 41 cents?

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198 Posts; 5,410 Profile Views

I spend about 30min per pt. And I get 45cents a mile. I think IRS states 50cents a mile. I get paid per visit. And of course some times you are there for longer than 30min I have stayed with a pt for over 2 hours until she calmed down and was stable.

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NaKcl is a BSN, RN and specializes in Med-Surg.

236 Posts; 6,467 Profile Views

So,,, Is it better to get paid by visit or per hour? which one is more profitable for HH nurse?

If you get paid by hour, do they count the driving time too?

currently I am working in a busy med-surg floor, and as you all know, we do not have much time to spend with each patients. I am interested at HH because, in HH you will get to spend the time and assess the patient's health condition more in detail. So, It will be beneficial to both my growth as much as better care for the patient.

Thank you guys for posting detailed informations :):nurse:

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2,139 Posts; 16,622 Profile Views

I thought it was an hourly or salary position (depending on the employer) with mileage reimbursement. ??

It looks like 6 patients is the norm with about 30 minutes spent with each. Once you got in your groove you could probably lead a pretty laid back work-life in that role.

I wonder if the salary is commensurate with nurses in similar clinical capacities.

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Boog'sCRRN246 has 9 years experience as a RN and specializes in Utilization Management.

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I thought it was an hourly or salary position (depending on the employer) with mileage reimbursement. ??

It looks like 6 patients is the norm with about 30 minutes spent with each. Once you got in your groove you could probably lead a pretty laid back work-life in that role.

I wonder if the salary is commensurate with nurses in similar clinical capacities.

It depends on the agency. I'm paid per visit and there is a range, depending on the type of visit (admission, follow-up, IV infusions, etc.), mileage is included in my per visit pay. As far as salary similarities with clinical nurses, I've found that I'm well compensated compared to my friends working in the hospital setting

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2,139 Posts; 16,622 Profile Views

It depends on the agency. I'm paid per visit and there is a range' date=' depending on the type of visit (admission, follow-up, IV infusions, etc.), mileage is included in my per visit pay. As far as salary similarities with clinical nurses, I've found that I'm [i']well[/i] compensated compared to my friends working in the hospital setting

Well compensated depending on patient load....but I guess we're never going to run out of patients so your day is likely to be full enough.

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BrookeeLou_RN specializes in Home health was tops, 2nd was L&D.

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When I was a field nurse, I loved being able to spend time with my patients, truly focus on them and their needs without being interrupted by call lights, telephone calls, doctors, therapists, phlebotomy, etc. I liked the time in the car between patients to eat, decompress, listen to the radio, and be alone. I felt like I had the time to devote to them to help them adjust their lifestyles, rather than throw some pills at them and run on to the next one. It's not for everyone, though, and while we may gripe about our jobs, it's really true that the worst day in home health is better than the best day in the hospital.

It takes a certain kind of nurse to succeed in home health: excellent clinical skills, excellent critical thinking and decision making abilities, organization beyond all measure, flexibility to adjust to the needs of patients and the agency's staffing needs, and a sense of humility. If you are set in your ways, don't like to learn new ways to do things, always want everything done perfectly, and expect to have a set schedule, then you will fail miserably. Some days you'll beat the school bus home, some days the bus will beat you. Some days you'll be done at noon and have little paperwork to catch up on, some days you will be out past 5 to get all your visits done and still have a mountain of paperwork to do. There will be times that you are completely in over your head, and there will be days that patients or family members scream obscenities at you. There will also be times that you catch a DVT, the beginings of a CHF exacerbation, early pneumonia, and save a life. You will have hugs and threats. You will be offerred all kinds of foods, including some that you may never have seen before. (Always accept food if offered. You don't have to eat it, take it with you and tell them you'll eat it later. They are expressing their gratitude, accept it gracefully!) You will see mansions and you will see hovels. You have to accept people as they are, warts and all, and meet them where they are. You have to be humble, you are in their home. You have the ability and power to change lives, use it responsibly.

I cannot imagine doing anything else and enjoying it as much as I do home health.

I have done home health for majority of my 23 yrs as RN. This poster wrote exactly why I love being a field nurse. It is like she has written Webster's defination of home care!! I have also done home health management....some agencies were wonderful and others terrible. This is the same for the field nurse but a field nurse is in office very little, so not much politics, dealing with others etc. And almost always I have made more money in the field then the office. And I agree you either love it or hate it. Must be totally comfortable with thinking on your feet without machines, charge nurses or anyone else to ask opinion. You call the doctor and basically TELL not ask! When I started in the filed in 1991 it was the best job and I felt like I was working the best kept secret in nursing!! Patients and families basically adopted me...I only did intermittent visits not shifts in a home. Maybe then 5% of patients might not be the nicest.. now of course it is not that ratio but it is still more good than bad. Different parts of the country are totally different also. I did travel nursing doing home health and really loved that combo! and great money.

The only thing that gets to me is the road warrior traveling each day. Gets tiring..you have to love to drive , had great sense of direction, GPS helps but you still need to be able to sense you are going right, paperwork is actually documented as being more than one hr per one hr of pt care but HH nurses are so organized, they can handle if they are good at this.. if not it will bring a fantastic nurse from another specialty to tears in a heartbeat.

All I can say is try it.. like it or hate it.. then decide for yourself.

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198 Posts; 5,410 Profile Views

I see 7-9 pts a day some are 45min from home don't get home till about 5 leave around 8am. But do about 2 hours of paperwork a night and worry about all my pts nightly. But I am making the most money I have ever made. Just hope I don't burn out and I hope I get better at this. Right now my manager is not happy with me apparently my 2 hours at night is not enough. Guess I should start looking elsewhere.

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BrookeeLou_RN specializes in Home health was tops, 2nd was L&D.

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I see 7-9 pts a day some are 45min from home don't get home till about 5 leave around 8am. But do about 2 hours of paperwork a night and worry about all my pts nightly. But I am making the most money I have ever made. Just hope I don't burn out and I hope I get better at this. Right now my manager is not happy with me apparently my 2 hours at night is not enough. Guess I should start looking elsewhere.

Don't be so quick to look elsewhere..learn to document for the majority of your patients while in the home..unless you ahve an admission you should be able to chart and still talk to patient and teach and all the other things involved in a visit. Do not apologize to your patients,, MD's chart on computers in the room in their offices now!

It will be tough at first, start slow and keep at it.. Visits may take 5 mins longer but you will eliminate the 2 hrs at home.

This is how the best agencies I have been with require it to be doNe..And sometimes I just do not feel like to ding that way and wait but I am always so sorry at the end of the day!! Now there are a few homes you can not do this in..unfriendly person, unfriendly environment...You get the picture.

Practice great time management and be extremely organized and you can do it easily.

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2,139 Posts; 16,622 Profile Views

So the underlying themes here are autonomy, diversity, and versatility. Right?

Who is your boss/supervisor? An administrator, a RN, a NP...?

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