Workload comparison to other HH agencies...need your opinions

[PCUSheryl]

I'm an RN who has been working in home health for more than 3 years. I started out in the field, then moved to QA, then DON. I excelled at my job in the past, was always praised for good productivity, good patient care, good relationships with coworkers, good leadership skills. I needed to changed jobs d/t a change in my husband's schedule and needing to pick my son up from school. So, I recently (in September) moved to a smaller agency after a nurse friend gave it a very high recommendation, and after interviewing with the administrator who assured me she would be flexible to allow me to pick up my son, and attend school functions or family needs when necessary. I was told the software they used was extremely easy to learn and use, and cuts down on workload.

Well, for about a month, everything was going great. I was able to finish all my work within 24 hrs without much stress. But then the DON left to have surgery on her neck. My workload suddenly got bigger, and it seems even a small change in workload meant a large difference in my ability to keep up. I got a little bit behind, then a lot behind. Here is a list of the responsibilities I have with this new agency:

1. seeing all Oasis visits for my patient caseload, which is approximately 20 pts

2. I also do approximately 95% of routine visits, and all aid sup visits--for my patient caseload

3. I do all scheduling for all patients in my caseload, rescheduling, changes in schedule, scheduling aide visits

4. I do all follow-up phone calls to physicians, DMEs, and any and all coordination of care communication for my patients

5. fax labwork to physicians for my patients

6. do chart audits on every patient every 60 days when i recert

7. send and make all referrals for my patient caseload, such as MSW, PT, OT, ST, etc

8. backup receptionist duty when in the office, and the usual receptionist doesn't arrive until after 9 am every morning, often after 10, so i am not able to catch up on documentation or focus on my own work in the morning before leaving office to see patients d/t answering the calls and following up on them

9. Attending case conference weekly, for approx an hour.

I'm sure there is more that I can't think of at the moment. But I am not used to doing all of this. At the previous agency, I only did Oasis and aide sup visits, no routine visits and did my documentation, coordination of care, referrals. And I was plenty busy of course. It just seems that all the extra duties overwhelm me since my workload increased after the DON took leave for surgery. I am getting some gentle pressure from the administrator to catch up, but was told that if I work more than 40 hrs a week, I will only be paid straight time (no OT), UNLESS I am oncall on the weekend, they only pay OT when you are oncall. I am paid hourly, not salary. So I do not want to work late every evening, not see my family, etc for straight time. It's not worth it. I don't even think it's legal. I have refused to work OT hours so far because of this, but plan to work alot over the new year's holiday weekend, because I am oncall and will be paid OT. None of the other RNs seem to be as far behind as me, but they are willing to work late for straight pay or take their work home with them.

I've said all this to ask all of you these questions:

1. Is this workload comparable to other agencies? And if so, how well are you all keeping up with it?

2. Does anyone else have similar amount of responsibilities? (scheduling, audits, etc)

3. Does anyone else work for an agency that won't pay OT when you are paid hourly? (I could understand if I was salaried, but I'm not)

I appreciate any comments, and thanks for listening.

Sheryl

[S.N. Visit, BSN, RN]

I've only been in Home Health since Oct.

I also have appx. a 20 pt caseload, which I see for Oasis, routine visits et suppervisory visits.

I only schedule my visits, not the aides. We have a scheduler for the rescheduling, changes in schedule, scheduling aide visits.

I do all follow-up phone calls to physicians, DMEs, and any and all coordination of care communication for my patients

I also fax labwork to physicians for my patients.

We have a designated office nurses that does the chart audits on every patient every 60 days.

Our assistant administrator sends and make all referrals for my patient caseload, such as MSW, PT, OT, ST, etc

I also do backup receptionist duty when in the office.

Sounds like you could you use some help!

[caliotter3]

None of the parameters you have listed apply to me except for the overtime issue regarding hourly pay. You asked about agencies refusing to pay overtime. My last three agencies where this has been an issue all refuse to pay overtime to hourly employees. Since this is new to me, all my previous employers paid overtime according to labor laws in effect, I suppose it is an attitudinal procedure to go along with the economy problems of the time. You want a job, don't complain. Complain, you won't have a job. That is how I see it.

[PCUSheryl]

Thanks for your replies! I didn't mean to whine, just really curious how my workload compares to others'.

I just remembered a few more of my responsibilities:

*intake on some patients, approx 1/3 of all new referrals, this means entering all demographic info on new referrals prior to admit/scheduling, including looking up physician addresses, phone numbers, NPI, license and UPIN numbers and entering this info into the computer.

*insurance pre-authorization prior to admit and recert or when we need more visits authorized for whatever reason(we have a lot of patients with private insurance).

*writing all orders for my patient load (this is standard for all home health nurses, tho, right>)

Thanks again--Sheryl

[S.N. Visit, BSN, RN]

Thanks for your replies! I didn't mean to whine, just really curious how my workload compares to others'.

I just remembered a few more of my responsibilities:

*intake on some patients, approx 1/3 of all new referrals, this means entering all demographic info on new referrals prior to admit/scheduling, including looking up physician addresses, phone numbers, NPI, license and UPIN numbers and entering this info into the computer.

*insurance pre-authorization prior to admit and recert or when we need more visits authorized for whatever reason(we have a lot of patients with private insurance).

*writing all orders for my patient load (this is standard for all home health nurses, tho, right>)

Thanks again--Sheryl

Luckily, I only have to deal with writing all orders for my pt load. The other responsibilities listed here are done by our administative assistant or billing clerks.