|
|
QUESTION: Hi! I've been in home health only the past four months, prior to that I worked
Med/Surg/Telemetry in an acute care setting. I got really frustrated with all
of the changes going on with staffing for RNs in hospitals. It was an
increasingly unsafe environment as RNs were asked to supervise unlicensed
personnel who were responsible for direct pt. care, etc. Anyway, I thought
home health was a wonderful place to be a Real Nurse again--when I initially
started working in the hospital, we were doing primary nursing (not too common
anymore, I know).
Now, with all of the Medicare changes, my job in home health is in jeopardy. I
live and work in a rural setting, so many of the homebound pt. we see for
venipuncture will have an extremely difficult time getting to the Dr. office or
hospital lab for this service. Also, they will not be assessed/monitored so
frequently by an RN and no longer qualify for assistance with personal care.
Many of these pt. will no longer have the choice to stay home and will end up
in the hospital more frequently or a nursing home.
In our rural area, many independent home health agencies will be forced to
close because of these and other Medicare changes (ie Interim Payment System).
This will really hurt those pt. that don't live close to a large city with home
health agencies that are associated w/hospitals to help them get through this
transition time. I don't think the abuse and fraud of a few agencies should so
gravely impact so many people.
I hope all home health nurses are writing to your legislatures about the effect
of the Balanced Budget Act of 1997 on Medicare pt. and demanding they support
reinstating these things that will allow us to continue serving homebound pt.
Our population is getting older. We cannot continue to allow or support the
removal of health care services for the elderly. WRITE OR CALL YOUR
CONGRESSMEN AND THE PRESIDENT TODAY!!
ANSWER: I predict that at least half the current home health agencies will
be out of business within 2 years. The ones to survive will be the ones
actively pursuing and winning managed care contracts. If you can find
a job with one of those, you should be safe for another few years.
I saw the end coming for home health back in 1994 and decided to pursue
becoming a family nurse practitioner. After finishing up my BSN, I am
now in an FNP program and figure I'll be able to find a small town to
practice in for the rest of my nursing career. I have sadly urged other
nurses to find other areas to ensure their professional futures,
hospital nursing and home health nursing both look too professionally
dangerous to me. Clinic nursing might still have a future ...
MR> I don't think the abuse and fraud of a few agencies should
MR> gravely impact so many people.
The joy of our wonderful Congress ... penalize the honest folks, the
dishonest folks will just reopen or buy someone else's shop, they have
plenty of bucks to show how well-financed they are.
Sylvia (dot) Steiger (at) lunatic (dot) com (change characters as needed,
I'm posting it this way to keep junk E-mailers from capturing my address).
|
|
|
|
