Working Prn/per Diem Home Health

Cattitude · Jan 13, 2007

hi,
any hh nurses out there that are working prn or per diem and would care to share any tips or offer any advice...i read about so many of the hh full time nurses experiencing a very heavy case-load and putting hundreds of miles on their cars and this is a big problem...does working prn or per diem avoid some of those problems?:idea:

well, i worked per diem before i did ft and the tip is to say no when you feel you've reached th max amount of pt's you can handle. my supvr. would usually ask me at the end of each week how many cases i could see for the following week i would tell her and it was never a problem.

i also occasionally do fee for service (same as overtime) now on saturdays for our acute service which is the main branch. they too ask how many i can see. if i say 6, they may give me anywhere from 6-8 but there is always someone who is not home. it works out fine.. i have a pretty good agency and from reading the stories here, i know i am lucky!!!!

Wgbem · Jan 14, 2007

When working per diem, it is OK but as a per diem nurse I also did some case management. That way I made sure I always had several clients. Per diem alone can be up and down.

pattycake · Jan 14, 2007

there are many agency and travel nurses who register with more than one company, in order to have work...i imagine the same can also b[color=yellowgreen]e done in home health, wouldn't you say?

caliotter3 · Jan 19, 2007

I do continuous care (usu 8 hr shifts) and have technically been w/4 employers at one time in order to stay w/pts and to stay gainfully employed. Oftentimes, when a case closes, there will be very little or no lead time to you the nurse. It can be very shocking to get told good bye at the end of your shift when rent day is 3 days away and you have been relying on this one case to pay your rent. Sometimes your agency can fix you up w/minimal days off and sometimes they just can't find a case for you. That is when you start calling your other agencies. When none of them can keep you employed, its time to figure out a different way to pay your landlord, as this is stressful in the long run. And heaven forbid, do not get seriously ill, w/time off work. Your case(s) will be given to other nurses, and you can almost bet that no matter what kind of positive relationship you thought you had w/your agency, they will not put the replacement nurses off for you. That is why some hh agencies find themselves being "attacked" by attempts at unionization, so that there is a forced fair way of placing employees. Just some input on my experiences. Yet, I wouldn't give up the one to one contact with pts for anything (except steady employment).

Wgbem · Jan 21, 2007

I worked per diem with 3 agencies at one time. I agree with Caliotter3 regarding the inconsistencies. It is great as you have the freedom to take clients or not. I never had a problem with being overloaded. I would take as many patients as I could. I could select the area so all my patients from each agency would be in relatively the same area. It made it easier.

It is rough, though, when you go on vacation (one of the few you may have had) or get sick and need to build up your patient load again. It all depends on the agency client load. I have had times when all 3 agencies were slow. I finally had to go full time. That was when the agency closed. There really is no security anywhere. The biggest benefit for full time is vacation and sick time. Otherwise, all have their ups and downs.

I still feel that whether per diem or full time, you should be able to direct your own course. You should not overload or allow an agency to give you more patients than you can handle. It is not safe and does not do the patients any good. You have to push back.