Friday, February 7, 2014

Adventures in Home Care

After almost a week off from homecare , I returned today. My day went exactly as planned which is highly unusual in homecare. My son had his first day of preschool so I was very nervous to work as I expected I would have to pick him up early if he couldn't handle the whole day. I planned on telling my agency I would only take 3 patients as this would give me enough time to see everyone, drive, and chart. My DON told me I'd be receiving 3 patients from our case manager and I was pleased with that. That is until the case manager tried to give me 4 patients, I kindly told her I was only taking 3 and her reply was "well the DON said you'd do 4 let me go check with her" she returns and says exactly what I told her in the first place. Lol anyways I was very proud of myself for sticking up and speaking my mind because the old me would have just took that 4th patient and stressed myself out the whole day worrying that I wouldn't make it home in time to meet my daughter at the bus stop.

On to the field work, my first case was about 16 miles from the office. I arrived there on time as planned. The visit went well, the patient and family were very pleasant and thankful for my care. I did a little education on the patients disease and a new med she was prescribed. I also had to make my first call to an MD and this went smoothly as well, the MD got right back to me, so I was able to let the patient know the update plan of care within hours of seeing her :) I was pretty much done the visit within 20 minutes but a very concerned family member happened to call and wanted to speak with me just as I was about to leave. I spoke with the family and the vist ended up being 50 minutes! But I was still on time to see my next patient. This visit was just an observation/follow up. I just had to go and literally check on the patient. I was in and out in about 20 minutes :) thankfully the patient was doing well.  After seeing my second patient I had a whole hr before I was due to see my last patient. I thought about calling and asking if I could come early, but decided that wasn't necessary. Instead I drove to a parking lot and charted on my first 2 patients, I made it to patient number 3 ten minutes early. This visit went smoothly as well, no issues. This was a teaching visit and the patient seemed to be doing well at home. I did my assessment and teaching and finished within about 20 minutes. My charting wasn't completed in the home because I could tell this lady just wanted me out of her house lol. 

I arrived back to the office around 1330 and finished all my charts, chatted with my DON and got all my questions asked. finally my email acct was live so I was able to email report to the case manager to let her know all was well with the patients I seen today.

I must say I was pleasantly surprised with how well my day went. I still worry that I didn't do a good enough job, even though I'm pretty sure I did ok. I'm not feeling all that confident in documenting goals and writing out why the patient is still home bound, I really love the one on one patient care and I feel like I am really doing nursing care as opposed to the hustle and bustle of hospital nursing. I have time to sit and chat about anything the patient may be concerned about, I get to educate my patients, meet lovely families, see beautiful homes, eat when I want and enjoy the beautiful sunshine. My work day started at 9 am and I was home by 3! I know this isn't typical of home care especially full time, but knowing as a per diem nurse I can pretty much have everyday like this is very enticing. As I get more comfortable I will of course take more patients. I think I can defitenly do 4 now as I am much better with the charting. The hardest part for me so far was planning out my day.

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