Does home health prepare a nurse to transition to NP?

Libby1987 · Mar 12, 2016

I don't have anything but my own anecdotal experience to base this on, but I don't think in your first year of nursing plus your first year of home health that you're going to be able to practice anything remotely close to preparing yourself to be a nurse practitioner. It'll be more about learning home health regulations and reimbursement criteria, and a totally different type of documentation, juggling logistics of scheduling visits and managing time in addition to developing your basic nursing skills.

Now if you had both nursing experience and home health experience you could then focus in on more advanced assessment skills and collaborating with the MDs in a way that could lend relevant experience.

elkpark · Mar 12, 2016

For what it's worth, since there are a kazillions "direct entry" MSN programs that take non-nurses and prepare them to be FNPs, and since there are plenty of "diploma mill" proprietary FNP rograms that will take any RN willing to pay their tuition, regardless of background or experience, it appears that the opinion of the larger nursing community is that no nursing experience of any kind is necessary to become an FNP. While there might be individual programs that feel that HH experience is not sufficient, there are plenty of other programs that will take anybody, regardless. (I'm not saying I think that's a good idea, but that appears to be the current state of nursing ...)

HelloWish, ADN, BSN · Mar 12, 2016

The programs I am looking at do require nursing experience. I think experience is important to become an FNP. I just want to make sure I am not shooting myself in the foot pursuing the path I am interested in by working PRN as a floor nurse and full time as a HH nurse.

RNtoACGNP · Mar 12, 2016

If you are concerned about experience, have you thought to be a nurse for a couple years before you start a program? Working two jobs with a family is stressful for anybody, adding grad school into the mix so fast out of nursing school is a whole different ball game. Your first couple years as a nurse you will be learning an overwhelmingly new amount of information and skills, maybe try focusing on that and becoming a competent nurse before pursuing grad school, just my thoughts if you are concerned. In my own experience, I feel like my 4.5 years as a floor nurse was the perfect amount of time before pursuing graduate school.

HelloWish, ADN, BSN · Mar 12, 2016

I certainly understand your point of view. I feel like I don't have time to waste though, since I will be turning 40 after I graduate. Maybe I will put off starting the program until January. I don't know yet.

I do feel like if I can handle full time nursing school and family, I will be able to handle grad school, nursing and family! :wacky:

Libby1987 · Mar 12, 2016

I certainly understand your point of view. I feel like I don't have time to waste though, since I will be turning 40 after I graduate. Maybe I will put off starting the program until January. I don't know yet.
I do feel like if I can handle full time nursing school and family, I will be able to handle grad school, nursing and family!

I haven't met a new grad yet who hasn't their eaten words about nursing school once they start their new job. There isn't a job out there these days that won't kick your butt the first year and make nursing school seem a distant breeze.

I suppose when I graduated school was more difficult but not anymore. Work conditions and expectations these days are challenging for the most experienced, in many situations anyway. 40 with kids at home and brand new, you'd be wise to prepare yourself for the reality shock. (And I'm not burned out, it's just harder now).

HelloWish, ADN, BSN · Mar 12, 2016

Yeah, I have read often enough how difficult the first year is here on AN. I expect that the first year is going to be a challenge!! No one knows what to expect until they are in the midst of it...much like when you go into nursing school. I expect my first year to be a challenge!

Libby1987 · Mar 13, 2016

Yeah, I have read often enough how difficult the first year is here on AN. I expect that the first year is going to be a challenge!! No one knows what to expect until they are in the midst of it...much like when you go into nursing school. I expect my first year to be a challenge!

It's kind of like childbirth that way, you wouldn't do it if you knew :-)

Just be sensible and prepared, I think anything difficult is better managed when prepared.

Jensmom7, BSN, RN · Mar 13, 2016

I applaud your confidence and enthusiasm. However, you haven't graduated from school yet, much less studied for and passed NCLEX.

I've said this several times in various threads: school doesn't teach you how to be a nurse. It prepares you for taking NCLEX. Period.

You're going to be studying to get your license, and learning not one, but two jobs. And then you want to jump into grad school.

I'm a former Home Health nurse. It isn't nearly as flexible or easy as some believe, especially if you're full time and doing case management.

And, in answer to your question, Home Health is not going to give you a leg up for an NP.

The care you render as a Home Health nurse is based on the nursing model, not the medical model. Yes, you report findings to the physicians, but there is nothing collaborative about it.

I personally don't agree with the feeling that one doesn't need clinical experience to be an FNP.

I've worked with FNPs who worked many years at the bedside (lots of med Surg and Critical care), and others who never set foot in a hospital unit until after they got their advanced degree.

I much preferred the former. One of the latter bragged that she chose the program she attended because there was no requirement to defend a Masters thesis. She was not the sharpest tool in the shed.

My advice would be to work part time in a hospital if you can afford it financially, study for and pass NCLEX, get some experience under your belt, then go back for your FNP.

Whatever you ultimately decide to do, I wish you the best. Just think very carefully before you potentially bite off more than you can chew and wind up not finishing at all.

JustMeRN · Mar 13, 2016

I agree with others, you are thinking too far ahead. One step at a time. Graduate and pass nclex first. Next, no, IMO, home health is not a good place for a new grad. You really need some time in acute care or long term care before jumping into the independence of home care. Secondly, 40 is young. If you want the most bang for your buck take 6 months or a year to gain some real life experience before you start going for your ultimate goal. Many online programs rely on your experience to help you pass classes. You are going to do much better if you actually have a little experience.

Also, you will develope more as a nurse if you work full time immediately out of school, as opposed to several per diem positions. In your shoes I would do full time for a year (32 or 36 hours is considered full time in many cases) in acute care if you can find a position. After a year enroll in a masters program, if you don't love acute care find a per diem or per visit home care job and work part time while completing a masters. Most RN yo msn programs are 12-18 months. You are still only 42-43 when you are ready to enroll in np, and have some experience and direction. Good luck.

anh06005, MSN, APRN, NP · Mar 13, 2016

So right after graduation I worked cardiac step down for about 16 months then went to home health for 3 years until I graduated with my MSN. I have now been a FNP for about 13 months.

First off HOME HEALTH isn't good for a new graduate RN. Right out of school you're nervous (if you're not then you may get in trouble for being too overly confident), you don't know much about meds, side effects, and interactions (it's impossible to learn that plus everything else in nursing school), and, most of all, RIGHT OUT OF NURSING SCHOOL YOU'RE A NOVICE AND NOT MEAN TO BE INDEPENDENT. That's why orientation is often 2-3+ months and there are so many residency programs that can last a year. Nursing school does NOT prepare you to be an independent RN. It prepares you to be an entry level RN. It prepares you just to not kill people. Not necessarily know what you are doing.

Home health is a whole different ball game. YOU are there. YOU are reconciling medications when the patient is fragile because they just got released from the hospital. YOU are the one there when the bed bound patient who can't communicate has a pulse of of 80%. YOU are the one trying to draw the lab work to see if the patients potassium is normal or starting an IV so you can give Lasix to your CHF patient. If you think as a new grad you can handle all of these situations with ease I think you think too highly of yourself.

My home health agency once hired a new grad who wound up being a great nurse but it took a looooong while so they no longer hire new grads. Some agencies may be so desperate they don't care.

I'd recommend trying to find a job where you have SUPPORT as a new grad RN. Where when something goes wrong you have coworkers to help. Where you can get a second opinion. After that I think home health is great! Many don't understand it but I think it was beneficial to my NP practice. After working home health I know more about the struggles some of these elderly people have at home. The time it takes the caregivers to help their mom/dad. I can simplify most problems so that patients can understand. I know more about the outpatient services available for assistance in the home. And, yes, as you mentioned being confident in assessment is a big part of home health and I gained confidence there as well. Not to mention the knowledge I gained about pharm because, well, a lot of patients don't know why they are on their medications. They say "my doctor told me to take it."

Home health isn't for the faint of heart (think about roaches, animals, urine, poop, sketchy areas) and, I think, is NOT for new grads.

Just my 2 cents.