Advice for a new grad HH nurse

[oceanblue52]

Hello everyone, I just graduated nursing school, and have accepted a job as a new home health nurse (skilled visits, not PD) and am looking for tips to succeed (e. g. Books, websites, good questions to ask my preceptor, charting tips, organization, etc.), anything that will help me get prepared for this new field. Am looking at ordering a home health care plan book, and a general home textbook as basic references:

Home Health Nursing: Assessment and Care Planning by Karen Monks 2002

Home Care Nursing Practice: Concepts and Nursing Practice 4 edition by Rice

Any experience with either of these?

I am fully aware that many nurses on this forum do not believe a new grad should start in home health, and I have spent many an angsty night thinking about those warnings. However, my geographical area is saturated, like any other metro area, and I have not had any luck in fighting for the very few acute care positions in our area, although I have tried(with good credentials and experience)! Ultimately I'm hoping to go into case management or a position with a public health department, and figured home health could be great experience with the right training. I've been annoying my family with how much time I spend on this website, just soaking up the life experience and tips!

A little background: I was referred to this job by a colleague that was also a new grad, and evidently she is doing well 6 months in. They have a good training program it seems, where I shadow a nurse for at least a month, and then they gradually let me take on my own cases, with the ability to call upon more experienced nurses if needed when I'm unfamiliar with a procedure. We have a few supervisors that can come meet me if needed for difficult cases.

Im really excited about this position, and my manager has verbally recognized that I am a new grad, will need a lot of support and wants me to succeed. I have a notebook full of questions to grill my preceptors, but do you have any other advice to make the most of my training?

[Haddoa]

I don't know if any training material. I am sure your agency will provide plenty. I believe you can succeed as a new grad just as many do in ICU and ED. It will all come down to the support you have from your agency. I went in as a nurse of 5.5 years 2 of which were in a high level ICU and I still call my clinical manger allllll the time. Because the questions I have are different and have nothing to do with hospital stuff. More with like do I send out. Should I try and get into a doc. I can't get into the doc. Can you see if you can blah blah. Trust your assessment and trust your gut. You will have times where you may have over reacted. Who cares. Better to error on the side of caution. Home health skilled nursing per visit which is what I do and sounds like what you will be doing is the best job ever!!!!! I love it and have so many of my hospital friends in line to come work here. We just aren't hiring because no one leaves. Don't feel you are missing out not being a slave on some crappy acute care unit. Those jobs are so overrated. You friend hit the jackpot. If you have good management and a good agency and fair pay you are truly the lucky one even if you don't know it yet. And trust me your friends who go the acute care route will be jealous!

[oceanblue52]

Thank you for the encouraging words! I have to say all the cautionary tales on here have made me a little worried because I'm conscientious of still having a LOT to learn. New grads seem to like it at my agency though so that is encouraging. Can't wait to delve in!

[NRSKarenRN, BSN, RN]

Book I have used in home health x several editions over 20 years is:

Handbook of Home Health Standards: Quality, Documentation, and Reimbursement, 5th edition by Tina Marrelli RN MSN

Last edition updated in 2011.

Other books you posted about> ten years old... I did buy one of Rice's book in past.

New OASIS homecare assessment form required for Medicare clients is undergoing revision; called OASIS-C2 to be released 10/1/16 for 1/1/2017 implementation so I would not purchase any OASIS book until newest release out.

Medicare Surveyor website: Outcome and Assessment Information Set (OASIS) Training - Course Menu is good website to learn how to complete OASIS form and what intent of questions and surveyors looking to find in your homecare documentation to back up OASIS answers.

Since your agency is promising 1 month buddy visits with experienced RN, use that time to soak up information and look up disease/ meds your unfamiliar with nightly.

Expect to be on information overload for first 6 months, then get better over time.

Best wishes in your nursing journey.

[ontnursec]

I started in home health as a new grad. I'm 8 months in now and I love it. I did have a placement in home health so I knew a bit about what to expect. My orientation was a month long. The specific issues you'll face may depend on the agency. I'd suggest finding the names and numbers of a few colleagues who are supportive, and calling them when you have questions. My team has been instrumental to my success as they are highly supportive.