Unrealistic schedules. Unrealistic productivity expectations per week. Scheduled to see patients not in your zone. When you are expected to see one patient out in boon docks then drive 45 + minutes to next patient when another nurse is in that area. Locked minimum time requirement when a long term patient does not need 30 minutes to discuss diabetes that they've had for 40 years and can recite verbatim what they need to do and they are well controlled. Field nurses are over ruled by office staff, who have no clue about the patient, on discharges needed or non admits because they want to keep the patient on the books to make their numbers look good. The new computers/tablets were not designed by nurses for nurses but some geek programmer who has no idea about medical documentation. Information in one area does not carry over to the next when the same question is asked. Meetings that last 1-3 hours that do not accomplish anything or that could have been covered in a email. The training is not sufficient for new hires and then they send them out to a full schedule or overscheduled with 8-12, sometimes 15 patients and expected to get it all done in 8 hours. This action makes the patient quality of care suffer because we are expected to see X amount regardless of situations or emergency care of the patient. Being penalized because you can't see a patient who is in the hospital, admitted to hospice, or refuses care at the door once you arrive to the home after patient agrees to be seen. Keeping non homebound patients on the books after numerous documented notes of chasing them to pad their numbers. They can't keep staff in the field due to all of the above. Burn out is a high risk! Nurse turn over is one week to three months once they are in the field. If you voice complaints, or concerns you are disrespected, written up or terminated. I've seen awesome nurses terminated because they rocked the boat on how the field nurses are treated or if they refuse to see a non emergent patient because it would be the 12th one that day.
