[SillyStudent]

I am a recent grad, and I currently work in SICU. I have been there for 4 months.

I saw an ad for HH PRN nurses and called. I spoke with their Director of Home Care and explained my desire to try something other than ICU. Don't get me wrong, I LOVE ICU!! I just want to see other parts of the profession, and perhaps get some new experience.

He said that they generally do not hire nurses with less than a year of experience, but we did chat for awhile. He asked me what else I had done before nursing. I listed my experience as a US Navy Hospital Corpsman, a tech in a PICU, and a manager for Low-income housing communities. I was also the ED (executive director...not emergency department! ) of a non-profit that put kids in free after school programs on Low income housing communities and did food banking, free clothes closets on the communities, etc. Sort of a social service kind of thing... lol BTW, I am 36

He said, "You know, you are pretty well-rounded Why don't you come in and talk to our Director of Nursing and let her pick your brain a little. You don't have a ton of experience, but let's let *name* talk to you and see if your nursing knowledge is up to par, we might be able to use you."

So....is that the right way for him to think about it? I guess I never expected them to even talk to me! HH is a pretty darn tough job, and you are so 'by yourself'. I am getting pretty comfortable with my assessment skills, but I am not sure I know enough to do something like this. To tell you a little about me, I am really into patient education. I read a lot and generally take a critical care book to bed with me at night so I have new questions to ask at work.

So, experienced Home Health Nurses, Help me out here! Do you think this is a really bad idea?

[caliotter3]

Most hh agencies are so in need of workers that some will even hire those with no experience. Your lack of extensive experience does not change the fact that your orientation to the job and to your individual patient(s) will be more important to your ability to succeed. Do you feel comfortable with the idea of being in a home, responsible for the well being of a patient with no one nearby to help? You have help a phone call away, however, you can't always depend on that. There are judgement calls that you need to be capable of making and you just can't depend on a supervisor or another nurse to be there to assist you. Sometimes you don't get a return phone call right away, or more often than not, you get told something like "do what you believe is best". Talk to this person. See what she says about orientation. If you believe that you wil get sufficient orientation and support, then try it. Otherwise, you should get more experience under your belt and try to go with another agency. Can't emphasize enough, the importance of good orientation in hh. Even for the very experienced.

[bloomicy]

I'm almost in the same boat, except that I don't even have the 4months' experience! I know I really want to do HH, and I've been an aide with an agency that is now interested in hiring me as a "visit nurse" -- as opposed to a case manager, I guess. I have a great rapport with the staff and with several of the patients, so they're willing to train me for HH.

I'm very excited, but also nervous... is it a career-killer to not work in the hospital a while first??? I don't like floor nursing at all -- I'm ADHD and easily distracted, so I get stressed when I have to juggle call bells and the myriad of things competing for my attention. I'm SO much better one-on-one... but I worry whether or not it's a bad idea to not have hospital experience (other than as an aide or student).

What do you folks think? Can I make a good career of HH without ever having worked as a floor nurse?

[Silverblitzen]

Man, oh man, oh man.........! No advice to give, per se, but I'll relate my own experience. I'm 58, have had 21 years of hospital and clinic nursing in a lot of specialties such as OR, ICU, Telemetry, Med/surg, rehab, LTC, and palliative. I thought that I'd be able to sail into HH with no problems but I'm finding it's a whole different kettle of fish! In hospital I found that sometimes if I offered suggestions to certain docs, I was put down for even having an opinion, much less offering one. You get to the point that you wait for instructions from the MD and follow the orders. Yes, I know, we're supposed to have autonomy, BUT......in institutional situations docs are still God. I'm coming on 3 months in the field after what seemed like a decent orientation and I find that I'm second guessing myself constantly. In HH you are the unofficial doc, nurse, ward clerk, social worker. In other words, the family and patient look to you for all the answers, whether you know them or not. You learn to develop a good poker face, and search your brain like crazy until you can come up with something like an intelligent response to the constant questions while you're trying to chart. It takes an extraordinary ability to organize, and wear many hats at the same time. Even 21 years of experience is being taxed with this HH newbie! Best of luck in your decision, wherever it may lead!

Sue
Just me and Nuvi (GPS) beating the country roads of the Niagara peninsula!

[TazziRN]

If you were "just" a new grad with so little experience I would not even look at you twice. In home health you need autonomy and the ability to think on your feet, because you literally have NO immediate back up.

With your past experience, however, my supervisor would be willing to see if there's a way around the state policy that says nurses have to have one year before being able to work home health.

[jpunky]

I believe HH is a very challenging job, but if you have the confidence needed, someone will be willing to hire you and patients will be willing to listen to you. I just had an interview today and am fairly confident I got the job...I am starting out part time as I have NO experience in HH and was a medical floor staff nurse for only seven months. I know HH is what I've always wanted to do and if you exude that in your interview, you will do great!

[sherrytzu]

In Texas you are supposed to have one year of experience in med/surg or comparable. I was hired 3 months out of school because of my LVN experience in HH. I hired a new RN (6 months experience NICU) because we read the regulations and it states they can work they just can't supervise until they get the HH experience. So she can't do supervisory visits for HHA or LVN's until she gets more experience. There are ways around it but you really need a solid medical background to recognize when a patient is going bad.