[NCnurse2B]

I'm currently waiting to hear from HR as to when I can start new HH position and I am soooo excited!!! But I didn't think to ask what skills I would be using. I know I will get to do a lot of teaching and lab draws and maybe some in & out caths or foleys along with wound care, but what other skills /procedures do you guys use often.

I hope that's not a silly question but I don't want to forget my med/surg skills. Any examples are greatly appreciated and thanks in advance.

[Bala Shark]

I know in my area you will have to deal with ventilators and trachs..Meaning you would have to suction the lungs and also, you will be responsilbe for the ventilators..Ventilators are life support because that makes the patient breath..If the ventilator fails, you would have to ambu bag the person through the trach..If you dont, the patient will not breath and die..

In my opinion, the skills with vents and trachs are quite complex and that is a skill that other nurses do not have..Also, you are in the home by yourself at times so no one is there to assist you if the vent fails...

[pedinurse05]

I think it depends on the type of homecare you are going to do. When I did shift work, I gained and used alot of my skills with the vents and trachs. I have recently been doing visits and found that I have learned soooooo much about woundcare, different products to treat wounds, and wound vacs. You will learn new things in this environment...however you will not be exposed to many things you do in the hospital. (example: I rarely see an Iv but do an occasional PICC dressing change, etc) I have found in my area that HH is woundcare, supervisory visits, caths, and blood draws (this is with visits). The paperwork in homecare drives me crazy! Try to get in the habit of doing it right away so it doesn't hang over you LOL I prefer the hospital so I quite the HH....it is not for everyone but you may really enjoy it! The one to one patient care is wonderful and allows for so much teaching (i loved that aspect). So to sum it up...you will learn new skills but could go rusty at some. If you are in HH for awhile most hospitals will make you take a refresher or course for nurses returning to the hospital after doing other types of nursing for awhile. I hope this helps some! Good luck!

[caliotter3]

As in any job change, you are going from one skill set to another skill set. As for your previous skills, like riding a bicycle, you will probably see that they come back quickly if you ever go into the environment again. If you are really that concerned about staying in touch with ms while you are in hh, then consider also working with the staffing side of the house (if your agency does both homecare and facility staffing) or going to a staffing agency and working shifts in ms to keep up with your skills. Someone I've met has an administrative job and works one shift per month to keep up her nursing skills. Hope you find hh to be to your liking. And there are many hh clients who are in need of nurses with good trach and vent skills so you are definitely needed there!

[Merilee]

I was in home health for many yrs, then was working from a desk for over 11 yrs (utilization review/telephonic case mgmt). When I returned to home health a few years ago, I discussed with the DON at the small agency I hired on with that I would need checked off on some procedures that I hadn't done for years. We had a nurse meet me in the home to watch me the "first" time. It was fine. It is like riding a bicycle and it does come back to you quickly. I agree that it depends on what type of home health and the size agency you are with as to what type of skills you will be using. I worked for a large city health department and another large agency many yrs ago and recall doing a fair amount of IV ATB and lots of wound care then. Now, as a visiting nurse for a small agency, I've been doing blood draws, foleys, wound care, injections (mostly s/c), med teaching, and new diabetic teaching. I also have some long-term clients that I do wkly assessments on and fill their med planners for the week. Getting your paperwork done as quickly as possible is crucial. I try to do as much as I can before I leave the home. You really have to stay on top of the paperwork. I do enjoy home visiting. I enjoy the one-on-one and being able to watch them make progress. I wish you the best and hope you enjoy it too!

[TazziRN]

Originally Posted by Bala Shark

I know in my area you will have to deal with ventilators and trachs..Meaning you would have to suction the lungs and also, you will be responsilbe for the ventilators..Ventilators are life support because that makes the patient breath..If the ventilator fails, you would have to ambu bag the person through the trach..If you dont, the patient will not breath and die..

In my opinion, the skills with vents and trachs are quite complex and that is a skill that other nurses do not have..Also, you are in the home by yourself at times so no one is there to assist you if the vent fails...

This sounds like a home care nurse who is with the pt for extended hours. I have had vented home care pts and I was not responsible for the vents. I assessed the pt's lungs and sat levels but I had nothing to do with the vents. Any problems with the vents and we call the company who supplies and maintains them.

OP, you will not lose your skills. When I started in home care I had so much to learn.....I knew nothing about home pumps and feeding pumps. I wouldn't have known a wound VAC if one had crawled over my foot and waved at me. However, my assessment skills were dead on, and I can access lines with my eyes closed. You may not start many periph IVs but home care pts have ports and PICCs and CVPs.

[NCnurse2B]

Thank you everyone for replying. I will be doing regularly scheduled visits 5-6 pts per day on the points system. Re-visits count as one and new admits as 2. It sounds like the greatest nursing job ever, except for the paperwork. But I'm up for the challenge and for the change. I'm really looking forward to taking care of each person as a whole and helping them through the healing process. I know that pts are being sent home now that are still acutely ill compared to 5-10 years ago and I will have a lot to learn. I must say if a wound vac crawled over my foot and waved, I wouldn't know what it was either but I can't wait to find out. It's going to be a huge learning curve and I'm sure I'll have many question. I just hope HH is for me.