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Posts tagged ‘Haydel Consulting Services’

COVID-19 for Visiting Nurses

How should home health and hospice visiting employees address Covid19 and protect staff and patients?

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Bad Blood


I know Elizabeth Holmes. Chances are you do, too.

I have never met her or spoken with her but I recognize her. I see some former clients in the pages of John Carreyrou’s, Bad Blood: Secrets and Lies in a Silicon Valley Startup. Holmes has the distinction of being the youngest female billionaire but fraud evens out the playing field. Right now she is worth about nothing and Theranos, her company, is but a memory.

Theranos was going to revolutionize the lab industry with a device that would run over a hundred lab tests with blood from a single fingerstick.

My first thought was who needs that much information?

It doesn’t matter who needed it because it never worked. In order to use the blood, the sample had to be diluted and that never turns out well when there are tiny variations in concentrations of very little blood causing major deviations in results.

Reading Carreyrou’s book was like reading a clinical record of a psych patient without authorization. Elizabeth Holmes had but a passing acquaintance with the truth and it’s anybody’s guess where her fantasies stopped and her lies began.

It helped that she was very well connected. Her board of directors could take down small countries before lunch just for fun. Henry Kissinger, George Schultz, Sam Nunn and more believed in her. George Schultz’s grandson, Tyler worked for Theranos for a period of time that ended with estrangement from his family and almost a half a million dollars in legal fees.

As far as employees went, she hired the best but nobody lasted. Problems brought to her attention about the product not working were met with the proverbial axe. Others had a life outside of work and that was clearly contrary to the company’s unwritten policy. They quit.

Can you imagine hiding your operations from CMS auditors?

When an employee on leave committed suicide, Theranos barely recognized the employee’s absence. When her idol, Steve Jobs, died, an Apple flag was flown at half mast outside of Theranos.

Anyone who has ever worked for a fraudulent agency will recognize Theranos. I am sure that every one of her former employees is embarrassed for having believed in her ‘vision’. All of them can see the lies in hindsight and are kicking themselves for not asking the hard questions earlier. There should be an address to send sympathy cards to former Theranos employees.

If you haven’t ever had close contact with a truly fraudulent employer, read Carreyrou’s book and maybe you never will. But don’t count on it.

Work Place Violence (and free CE’s)


workplaceviolence_bannerI must say that everyone is pretty good about conducting a home safety assessment. Throw rugs are removed, lights are bright and shiny and and much of the work done by therapists is to reach the goal of the patient being able to safely navigate in the home environment. Geaux, Team!

We’re missing something. What about employee safety in the work environment? Everyday home health and hospice nurses, aides, MSW’s and social workers go into homes where they are separated from the agency and out of view of anyone who might help them. All but the most serious incidents are overlooked.

In addition to the injuries that happen regularly such as sprains, abrasions and other musculoskeletal injuries due to moving patients, these are routinely addressed in orientation and annual inservices. A risk of workplace violence also exists and recent research shows it is more prevalent than you may think.

Homecare workers (n = 1,214) reported past-year incidents of verbal aggression (50.3% of respondents), workplace aggression (26.9%), workplace violence (23.6%), sexual harassment (25.7%), and sexual aggression (12.8%). Exposure was associated with greater stress (p < .001), depression (p < .001), sleep problems (p < .001), and burnout (p < .001). Confidence in addressing workplace aggression buffered homecare workers against negative work and health outcomes.1

The CDC along with NIOSH has published an online Continuing Education course addressing workplace violence for healthcare workers. It is not specific to visiting nurses but does offer useful advice. It also offers 2.4 continuing education credit but if you want the credit, read the ‘instructions for credit on the first page. It is provided at no cost and includes short video clips, written text and discussion questions.

In taking this course, I learned that when adhering to the strict definitions of Workplace Violence, many homecare workers have experience with verbal and physical aggression. We also under report workplace violence and ‘forgive’ our patients. It may be a fact of life that nurses eat their young but it doesn’t have to be and agencies should not tolerate bullying of their employees. Regardless of the kind of workplace violence that takes place, visiting staff may suffer stress, depression, insomnia and burnout as noted in the study cited above. Without support from management, the agency’s morale will deteriorate to the point where nothing gets done.

If you know of any other resources to reduce the risk of workplace violence in the workplace, please share in the comments. Our workplace includes most zip codes in the country and all types of people. Reducing the risk of violence and supporting visiting workers can go a long way to making sure you’re agency doesn’t lose its best employees to burnout.

  1.  Hanson, G. C., Perrin, N. A., Moss, H., Laharnar, N., & Glass, N. (2015). Workplace violence against homecare workers and its relationship with workers health outcomes: a cross-sectional study. BMC Public Health, 15, 11. http://doi.org/10.1186/s12889-014-1340-7

Novus Hospice

Novus Hospice in Frisco accused of aggressively managed length of stay numbers by overdosing patients on continuous care.

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A 36 Billion Cottage Industry

How home health and hospice visiting nurses can recognize financial exploitation of the elderly and who to call when they do.

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