Should I consider a career in home care as a new graduate nurse, bsn?

Nurses New Nurse

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I have been looking for work for almost 7 months since graduation, never worked as an rn before and have applied everywhere. I have also been to several interviews and I have been looking actively for that "hospital" job without success. I speak a few languages and have some healthcare experience but not in nursing. I live in new york city. Finally a company is contemplating hiring me full-time to work as a community health nurse in home care. I will be oriented and shadowing an experienced nurse until I feel comfortable on my own. The cases would range from sub-acute to acute. This is so unplanned because I have been trying to get into a hospital and never even considered this non hospital possibility until now. My question is, is it becoming more common for new graduates to do community nursing/home care? Also, would hospitals consider my experience in the event I decide to pursue a career in a hospital setting later on?

Frantic baby nurse aka skyheaven477

What would you do as a community health home nurse? What kind of patients?

I would assess the patient's environment for safety concerns, educate the patient, nurse aids, immunizations, dressings, trachs, vitals, etc... The patients are mostly geriatrics and disabled.

Some of those things would be fine, where others would be very difficult without experience. Would you have a resource person to help you if you are at a home and need a second look at a wound? If it is the only job you can get, you will have to take it. But without experience you are going to have a hard time with some of the skills and assessment stuff. A lot f what I learned is from the people I work with. When you are new you have to call another nurse or an opinion a lot. Maybe they could keep you on the straught forward stuff until you get your feet wet.

I agree with you a tons. They actually are providing me with an orientation (not sure how long yet) and I will be working with a nurse or two for a while until I feel comfortable on my own. Also, there is always an RN on call at the office should I need help or have any questions.

I don't think it is a good idea to take any job in which you will be on your own until you have a year of experience. Nurses have so much to learn when you start out. Sorry, it's nothing against you personally, I am sure you will be wonderful. You seem to be concerned which shows you are thinking! But in the beginning you need experienced nurses to learn from. Calling someone for advice is not as effective as having a second pair of eyeballs.

I don't think it is a good idea to take any job in which you will be on your own until you have a year of experience. Nurses have so much to learn when you start out. Sorry, it's nothing against you personally, I am sure you will be wonderful. You seem to be concerned which shows you are thinking! But in the beginning you need experienced nurses to learn from. Calling someone for advice is not as effective as having a second pair of eyeballs.

I understand your point. However, I am in a predicament here where I depend on no one but myself, bills are pilling up and loans are starting to kick in and I have been actively looking for several months for a hospital job without any success. I have to take this job because I have to start somewhere and need to start working as soon as possible. It is not my dream job but I feel I have no choice.

Specializes in PACU, presurgical testing.

I'm always intrigued with the different requirements for similar jobs across different employers. Around here, you can't work home care without 3-5 years of experience, period.

Wow, as a recent grad (9 months in my first job), I have to say that home care would not be my first suggestion for a newbie. Autonomy is nice, and it does force you to learn quickly, but home care goes beyond autonomy to plain old isolation. And we don't see what we don't know. Does this agency perhaps have a clinic where you could work with other nurses for a year or so, or at least part of the time?

Specializes in geriatrics.
I have been looking for work for almost 7 months since graduation, never worked as an rn before and have applied everywhere. I have also been to several interviews and I have been looking actively for that "hospital" job without success. I speak a few languages and have some healthcare experience but not in nursing. I live in new york city. Finally a company is contemplating hiring me full-time to work as a community health nurse in home care. I will be oriented and shadowing an experienced nurse until I feel comfortable on my own. The cases would range from sub-acute to acute. This is so unplanned because I have been trying to get into a hospital and never even considered this non hospital possibility until now. My question is, is it becoming more common for new graduates to do community nursing/home care? Also, would hospitals consider my experience in the event I decide to pursue a career in a hospital setting later on?

Frantic baby nurse aka skyheaven477

While you may have access to a resource nurse, home care is rarely a good idea for new grads. You need to be properly mentored, and more importantly, new grads lack experience and assessment skills which come with time.

After 16 to 18 months of full time work on a floor somewhere (minimum) would many agree that homecare is wise. Too much can go wrong without adequate supports in place.

Specializes in Pediatrics, Emergency, Trauma.

I am going to disagree with the rest of the posters, for now.

Many moons ago, I started out in home care as a new grad. I was trained, and if anything, home care helped me have that space to get comfortable making assessments, patient teaching, nursing judgement, and advocacy. I performed all the skills that you are going to do. A lot of agencies send you to classes to become competent in those skills and rationales before you receive those cases, so if anything, ASK if you are going to get competency on trachs, wound care, etc, and get those cases so you can hit the ground running. In the area and companies I worked, there was ALWAYS support and constant classes and training and practice time to keep me comfortable in my skills. One agency has a skills lab that list is ALWAYS full because the nurses take advantage of keeping the basics and the complexities up.

To me, home care was NOT isolating. I always visited my nurse managers, schedulers, etc. I knew the office, networked and contacted nurses after engaging with them during classes, so to say home care is isolating, I wonder whether that is dependent on the area, because its not, ESPECIALLY if you are working in a high population metro area...you get to meet a ton of nurses. I STILL run into other nurses I use to work with that are happy to see me and speak highly of me, and I can do the same.

Each people's experience is also dependent on the individual.

I suggest you try this one out...you are getting VERY valuable experience. What you explained is a very supportive home care environment. Advocate for yourself...ask questions, prepare for skills, and see how it goes. I stayed in home are for 7 years and was able to get facility jobs during my journey and hit the ground running because of the positive development of my practice in home care. Good luck in whatever you decide! :)

When you are new, you don't know what you don't know. So it is far more likely to miss something critical and never even know you missed it until it is too late.

Specializes in Pediatrics, Emergency, Trauma.
When you are new you don't know what you don't know. So it is far more likely to miss something critical and never even know you missed it until it is too late.[/quote']

I beg to differ on this too.

When a successful, excellent home care company educates their employees, these issues are heavily covered; as well as one to be cognizant to LISTEN to their patient, whether it be verbal or non-verbal communication...assess vitals signs, look at trends documented for the patient...that is all a part of the process as a home care nurse. A huge part of assessment for me is including my assessment, then looking at the trends for this patient. I have practiced a questioning attitude and have advocated in contacting the physician's office and my managers as soon as I sense something wrong, and that was because my agency had a process in place. I engage my care managers and involvement in the pt's POC is a priority and encouraged. If the agency can do that enough for the OP, then she is in a good place...if the OP can't then the OP has the option to say this is not a good fit for them.

I'm speaking from the experience as a new grad who started in home care. I entered the nursing profession as a LPN when they phased out LPNs in the hospital in my area, so a TON of doors were closed for me, like a ton of new grads today. I am a new grad RN myself, but have that conundrum, but still marketable. Back then, I was in the same boat as the OP and countless others, but I did what I needed to do to make sure my nursing career would not be at an impasse, and make sure I was prudent in my practice, and if I needed to call 911, I did it if I needed to. Most of the time in ALL the home care cases I had in my 8-year career, It came down to my foundation: assessment, assessment, assessment, and investigating trends, communication with the patient/family, agency and physicians, using SBAR and advocating, things I had to learn as a new grad, but did them pretty effectively...obviously much better as I got experience. The attitude I had as a new grad was, "let's investigate this together." That helped when a pt's trends looked off to me, and helped the pt's get interventions that they needed. Some interventions needed an urgent care visit and an admission into the hospital, but the "critical" potential was delayed due to being diligent in being an advocate, regardless of one's experience. And even after my years experience I STILL have the attitude of "let's investigate."

I also understand that people may not feel comfortable early in one's career. This happens in hospitals and facilities too, ignoring of critical issues REGARDLESS of level. I had a very experienced nurse not realize a kid in our faculty had a broken leg, even though he could walk on it. Upon further intervention, a new grad spoke up after her examination, we agreed, and he had a broken leg. So again, I beg to differ about "not knowing," I find it to be when one doesn't "investigate."

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