Time For A Change...Need Advice

Hi All!

I am looking for advice...I am working on a very busy sub-acute nursing floor. I no longer want to do this. The patients we get are so sick, with so many co-morbidities with many of them not sub-acute/rehab material. Assignments are not based on acuity, they are based on number of patients.

Here is my dilemma... should I take a prn position in a hospital on their sub-acute/rehab floor or go in to home health? I shadowed at the hospital and didn't get that "gut" feeling that this is "the" place. Everyone was very nice, place is clean but again it was hurry up pass meds before the patient goes to therapy. I liked it because the people were professional and friendly and the fact that I would have less patients.

Positives of this choice: less patients, pick days I want to work, not have to work every other weekend, get to pick the holidays I want to work

Negatives: $5.00 dollars less an hour, pay for parking, taking care of same type of patient (but no as sick as nursing home patients),, not guaranteed hours due to prn status. I did tell the manager I was interested in part-time and she told me to stick with prn....and I don't know why...When I hear "you're getting an admission" my stomach sinks

Home Care Positives: as many patients as I want, one-on-one with patient, if it's a tough case your only in home for approx.. an hour, make my own schedule (good since I have children) people I met were really nice, work one weekend a month, work one summer and winter holiday, they provide you with a computer for charting

Negatives: all the driving, paper work - I hear it is A LOT, long days, dirty houses, rough neighborhoods, doing paper work at home and not getting paid for it.....Also, I tried home care for a very brief time and didn't like it and I don't know why OR was I just not ready at that time for a change??