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

Home Health   (123,052 Views | 52 Replies)
by smartandgrit smartandgrit (New) New

1,088 Profile Views; 2 Posts

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hawkfdc has 9 years experience.

157 Posts; 4,346 Profile Views

It wasn't the small batteries I was talking about, it was the dead car battery ;) . Oh well issue resolved $140 later-ouch!

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2,139 Posts; 16,622 Profile Views

It wasn't the small batteries I was talking about, it was the dead car battery ;) . Oh well issue resolved $140 later-ouch!

What the **** do you think I was talking about?! Read the fourth sentence again.

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2 Posts; 624 Profile Views

Are you still doing home health? I am considering this. Totally agree with your description of a typical "shift" in acute care setting. If your still on this site, can I ask your advice?

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272 Posts; 9,133 Profile Views

I like the fact that I'm not around all the confusion that goes on in a facility setting.

Get a can of fix-a-flat, that stuff is great.

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vinsonmm has 25 years experience.

15 Posts; 2,208 Profile Views

I have been in Home Health nursing for appox. 18mths now, after having done 10 plus years of clinic and other nursing. I love home health. It has its stresses and one is that it is definitely NOT a eight hour shift job you walk away from and forget. I see on average 4 to 6 patients a day. DUE TO MEDICARE, I get paid by patient. This is not the in home care some nurses are talking about. That is more long term. I have seen 7 patients in one day but, it was very stressful. I always end up on computer time at home for at least 2 more hours documenting. I love it due to my empty nest. It is not a job for a single mom.

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vinsonmm has 25 years experience.

15 Posts; 2,208 Profile Views

No its not "more profitable" but it is more enjoyable. Also, it depends on the agency you work for. I get 55 cents a mile and pay per patient due to MEDICARE. I hear Oregan has different laws. You can also use all your personal items as tax deductions: Car, phone, computer, gas costs, etc.

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2 Posts; 760 Profile Views

Is HH ideal for newly grad like me, who has limited clinical knowledge and skill and less expertise? what happened if my patient has a complicated problem during my visit and then I would not know what to do esp if it is an emergency case?

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3 Followers; 37,152 Posts; 98,945 Profile Views

Is HH ideal for newly grad like me, who has limited clinical knowledge and skill and less expertise? what happened if my patient has a complicated problem during my visit and then I would not know what to do esp if it is an emergency case?

People survive it and others, even the experienced, lose their license. It just depends on the circumstances. In general, you have to know when to call 911 and what to do in the mean time while waiting for them to get to the home. You can give yourself dry runs as often as necessary. Go through emergency procedures with the family members as part of their education program. They will be your second pair of hands in an emergency and it is your responsibility to get them on board. It boils down to being proactive, or "prepared", as the Boy Scouts say.

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2 Posts; 616 Profile Views

I've been an LPN for 3yrs and worked for home health here in Oklahoma for 2yrs. I absolutely love my job, the great pay and the hours, plus I have a company car with free gas and maintenance. It does have its stressors, for me it's last minute patients that call and need a visit but all in all, I feel like my job is easy. I love that I can be independent and I use so many more of my skills in the home setting than in other settings. You def need to be confident of your knowledge and skills as a nurse.

-Amanda LPN, sent from my iPhone

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camoflower specializes in Ortho/Peds/MedSURG/LTC.

70 Posts; 3,622 Profile Views

I work, finally, with management that shows appreciation every single chance they possibly can. I work with a really good group of nurses in home health...the sweet nurses. There is not a Debbie Downer in the entire bunch...and I love, love, love that. I joined HH in March 2012..from day one they looked me in the eyes, and smiled, when they talked with me. My bosses used to be HH Rns...they understand the sweating like a laundry woman by 11 am, the lethargy that arrives around quitting time, or saving some charting to do at home. Kudos to my bosses. Their Best advise..finish in the home..just make yourself finish. They say 45 minutes you should be done with your assessment, visit and charting D O N E. I have been HH two months, its still taking me over an hour to get it done, then the mileage/lunch/Medicare mileage rules from home blah blah messes me up a little now. The rushing ...is more stressful than driving. But I think I can do it. Rural roads - long drives - forget it. I make prob a 100.00 per day (ARKANSAS)...so being paid hourly is like $20 per visit. 5 patients 200-300 miles daily.

I got to sit down and figure out..new VW..or run my vehicle into the ground at 20 mph...till the wheels fall off? or a used VW? hmm? Anyone got it figured out? If they provided a company car - I'd never leave.

My boss called me to her desk this month...my heart sunk thinking the worst (thanks to my first boss I always think THE WORSE)...she said to me softly so others could NOT hear her.... "Hey, you are kickin.._ss" You get out get the visits done faster than others that have been here for years, fantastic charting, c y a cya..but call them doctors more and chart it if you do.. - you go girl...doing grrrrrrreat" (now I have heard from other nurses "you are not doing us any favors on not putting in for overtime"..so I have started putting in some overtime, which may bring my first growl from my managers. I think where is the incentive to go faster? (mine is to get it done and get home without work to do- to cool down in the shower!!) I have received two "star" awards from compliments from patients to my management. There is more feedback in HH from patients to management. So it seems like management talks with us more. One of our nurses quit after 5 years she got a 2 hour stop by if you can party, which most did not get to drop in for, of course, but the effort was made, and we got a text to go and join in at a Mexican Rest for a good bye lunch, on our 30 minute lunch)...top notch management. Here is what else I love, I love the music on the radio between patients. I love charting in the rain in my vehicle. I love seeing animals and farms. I love overhangs at Sonic and the half price icy cold drinks. I love people, the horders, the animals and after the 3rd visit they love me and offer me food (no thank you I am fine- so sweet for offering). However, I am not fond of lunch on the road. I am not big on take out foods...so, hospital lunchroom I grab and go sometimes when I take Labs to the Hospital, or make spring rolls with plum peanut sauce, I take along lots of ice water. Bowls of oatmeal and raisins with maple syrup is my thing...when sunflowers or fruit..I can eat it til 2 pm. This is not a job for Moms with children my son is just about grown and thinks I work all the time. I don't cook like I used to when I get home the heat drains. ..I am up at 5 am, taking report from my computer..accessing all info on my patients prior to hitting the pavement, getting prepared for anything, jotting down handy phone numbers. I write an itinerary for the day - giving a little over an hour in-between patients. It never works out the way I planned..but I keep trying. The worse is the 47 cents per mile, hearing "no overtime..no overtime". Hate roaches...fell sorry for pts w/wound care..ohh the germs. Hate heavy smokers worse than 30 kitties. I feel guilty heading out the door of a patient's home and hearing "just one more story, I really hate taking up your time, but you're so nice to talk with, my heart hurts for them", or a nurse putting in wrong directions along with a wrong phone number..lost in the heat of the day, or a snippy nurse returning your call at closing time and because you were lost and in a hurry and left that cell phone in your car because it slipped out of your pocket, silently out of site, inbetween seats, as you grabbed your nursing bag and computer and dashed across the dirt road to hurry to try to get your last PT/INR of the day prior to doctor's offices closing early on Fridays, knowing you were NOT going to beat the time, realizing your phone is NOT in your pocket, having to dash back across the dusty road, and search around in a 100 degree car for a slippery phone. You look down at your phone as your running back across the dusty road..and see you have a message..its The snippy nurse returning a call did not answer the question you left, prob because the receptionista did not bother to ask the nurse your question. Ms Snippy saying 'Well, it looks like YOU'll have to call back on Monday because YOU did not answer your PHONE!"(My brain says ..why not just answer the question!!).and being/feeling responsible you will go home and research for hours if it is normal for a pt with a new illiostomy bag to have a little stool come out of rectum, my thoughts = snippy nurses have snippy bosses..better know before you let this go. (YIPES..my imagination sets in again) The last pts PT/INR was 3.1..and of course the doc's office was closed when I called.....could I live with this all weekend, without any orders, I do believe that patients should NOT have had PT/INRs on Fridays, after noon, of all days, or we should not have 5 PT/INRs do do in a day (you have to call the physician's office and WAIT for an order..which will come as you are driving 60 miles an hour down the hwy 2 miles from home, your brain is fried, you have to pull over for each phone call and KEEP them very straight by being organized)..all weekend my head will have thoughts..will my license be safe?, or will my boss change her perception of me within 24 hours when Murphy's law rears its ugly head and cranking nurse with cranky physician calls our office with complaints?.... sorry, so long. I just love Home Health, love the diversity, most patients are awesome, its just another part of the nursing beast that takes 50,000 things to remember ...so different from floor nursing!

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camoflower specializes in Ortho/Peds/MedSURG/LTC.

70 Posts; 3,622 Profile Views

Although nurses have = precious Limited time. You must address, by calling physicians, any red flags, or issues. Good doctors never let home health nurses wait for answers. I have one that I know who tells his staff to NOT to let us hang up without orders or answers. An hour later we are possibly 25 miles away and in another patients home...in the middle of a wound change or drawing blood when we get the return phone call.

Instructions....clear and precise are given to the family. Our facility has the big magnet with our office number with instructions call and ask for a nurse for any questions. (Most patients have just come home from the hospital..and we know all too well some should have been able to stay a couple of more days) Whatever you tell them can and will be repeated several times. Even my age...I look younger than I am by 8-10 years....told a patient my age, told her NOT to tell anyone..she was so surprised..well guess what?..everyone knows now (and she pinky promised never to tell anyone) lol

Ask physicians for perimeters ex: for blood pressures that are too low..even when a patient states "ohh all the nurses call and ask the physician the same question" It takes 15 minutes to call, 15 more to document (takes time) I was surprised to dig into the chart and see NOT every nurse will do it, or address it in the charts, but the State Inspectors will. Even if the patient is asymptomatic C.Y.A. put it in writing 80/60 acceptable with the medications patient is currently prescribed stated Dr. Knowit. Gotta paint that picture..every note must stand alone.

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2 Posts; 599 Profile Views

I've been a home health LPN for almost 9 months and I will never go back to facility nursing. Everyone has already stated most of the pros and cons. I was thinking today about the time break down at the LTC facility I worked prior to Homecare. 12 hour shift, 24 patients, 10 minutes per patient means 4 hour medpass. Which is how long it would take me for one medpass, however, add in blood sugars, resp treatments, gtube feedings, gtubes falling out (granted not often), catheter replacements, patient questions, family questions, dealing with CNA issues, meal issues, bathroom issues, pain management, and in our case, wound care/treatments, falls, hospital send outs, admissions, hunting for supplies (yes we had to do that!) deciphering and entering dr orders, blood draws/labs, and any extra thing we were required to do PLUS second and third medpass! I don't know how or why I did it but I did. We did everything but interact with patients and give truly good care. Now I have basically however long it takes to devote to one person (usually anywhere from 20 min to one hour), no rushing, no staff drama, and I'm using more skills that I can be proud of. And sometimes I get goodies from patients! Like today I got a bag of sweet potatoes :) Best nursing job ever.

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