home health as new grad or wait it out?

Tenebrae, BSN, RN · Nov 1, 2014

I did district nursing (home health nursing) as a new grad and absolutely loved it. Its very much an area nurses either seem to love or not.

How do you feel about working autonomously and with perhaps not much back up?

eatsleeplove_nurse · Nov 1, 2014

@tenebrae: as a new grad nurse with my only nursing experience being just clinicals, i dont feel confidently about the autonomy part, which makes me nervous. they mentioned a 6-8 wk training/orientation (longer if i need it to be) and they wouldnt send me out to do something im not confident in.

ive been very back & forth about this! any insight?

toomuchbaloney · Nov 1, 2014

@tenebrae: as a new grad nurse with my only nursing experience being just clinicals, i dont feel confidently about the autonomy part, which makes me nervous. they mentioned a 6-8 wk training/orientation (longer if i need it to be) and they wouldnt send me out to do something im not confident in.
ive been very back & forth about this! any insight?

Ask them what types of patients they most frequently admit and care for.

Ask how many visits you will be expected to see in an 8 hour day.

How will you be paid? Salary or by the hour or by the visit? Do they pay OT?

Will you have to work weekends or provide overnight call coverage? How is that scheduled and compensated?

Will they pay you mileage or do they offer a company vehicle or a gas card as part of your wage and benefit package?

How big will your personal and professional service area be? Most agencies have territories which are fairly large, some are quite large.

Will you have your own caseload to manage or will you be given an assignment on a daily basis?

Good luck.

caliotter3 · Nov 1, 2014

Extended care, or shift work, is an easier introduction for most new nurses.

eatsleeplove_nurse · Nov 2, 2014

thanks for your help! even knowing all the answers to those questions, i guess my real question is whether i should hold out longer for a job in a hospital closer to home (which is my ideal starting place) or if i shouldn't be picky and just go with the HH job to gain experience (even though i'd have to relocate).

if you are/were a new grad who started in HHN, whats it like/what are your thoughts?

if you are/were an experienced HH nurse, what is your opinion on a new grad starting out in HH?

MissyWrite · Nov 2, 2014

if you are/were an experienced HH nurse, what is your opinion on a new grad starting out in HH?

You said you weren't to comfortable with the autonomy part. I don't blame you. But when you work in HH, you're out there on your own. You can't ask someone to come take a look and give their opinion. When I did HH, I did a lot of wound care, and also a lot of disease management (such as CHF).

From what I know, most HH companies aren't too keen on hiring new grads. If I were you, I'd be wondering why they are. Six weeks of orientation may sound good, but you can't count on that to fill in the blanks of your clinical experience.

You said you really want to work in a hospital, but it's hard to find a job near you. If you're willing to relocate for a HH job, why not relocate for a hospital job?

I would recommend at least a year of med-surg before going into HH. You will learn an incredible amount, and much of it will inform your HH practice. You want to feel confident at your job, not end up in a situation where you're anxious and floundering.

Best of luck to you with whatever you decide!

caliotter3 · Nov 2, 2014

What about hh agencies near your home? Or other job opportunities near your home? I see this as more of a question of relocating for a less than optimal first job. You want to be in a better situation should the first job not turn out. If you last three months in the new job and decide you must leave, you don't want the expense and inconvenience of moving again. If you absolutely can not find a job near home, then make the move. But I would not move unless forced to.

eatsleeplove_nurse · Nov 2, 2014

What about hh agencies near your home? Or other job opportunities near your home? I see this as more of a question of relocating for a less than optimal first job. You want to be in a better situation should the first job not turn out. If you last three months in the new job and decide you must leave, you don't want the expense and inconvenience of moving again. If you absolutely can not find a job near home, then make the move. But I would not move unless forced to.

yes, that is exactly my predicament! as MissyWrite stated, most HH places dont hire new grads due to their lack of experience and their skills set still being in the development stage. This HH place is trying to develop a new grad program, so it makes me second-guess whether I should accept the job offer (and essentially be their guinea pig) since they dont exactly have a track record of new grad nurses succeeding at their agency.

caliotter3 · Nov 2, 2014

If you know that they do not have a good track record of new grads working out at their agency, I would just let that one slide. You don't want to set yourself up for failure. Don't get discouraged. This decision is probably in your best interest.

TheCommuter, BSN, RN · Nov 2, 2014

This HH place is trying to develop a new grad program, so it makes me second-guess whether I should accept the job offer (and essentially be their guinea pig) since they dont exactly have a track record of new grad nurses succeeding at their agency.

Since you are in NYC's brutal employment market, you would be wise to accept this offer and do your best to make it work out. After all, you don't know when (or if) the next job offer is coming.

jandtforker · Nov 3, 2014

Here is my take/experience: I graduated in 1994, worked in a hospital setting 3 years then stayed home for 15 years. Went back into nursing in home health. I loved the idea but had gotten way too rusty and things had changed dramatically--many new products, hadn't messed with catheters for years, hadn't done a blood draw for 17 years etc. It was very stressful and though I had an orientation for about 5 weeks, I was not prepared for the autonomy home health demands. I have since worked in a nursing home--loved the residents, pt to nurse ratio too high/too stressful, then took a position on a step-down unit which I currently work on. I have now regained the clinical skills and would like to return to home health. The stress level in the hospital is unbelievable but the learning opportunity is priceless for both new grads and rusty old nurses like me. Many of the nurses I work with tell me they did night shift as new grads simply because the pace was a little slower. I am thinking of going to nights just so I can survive my position until April--the one year agreement will be up then. I would not recommend home health until you are comfortable with a variety of patients. A medical or surgical unit where you can do lots of wound care might be good. Seems like the majority of home health clients are s/p knee or hip surgery or have diabetic or circulation related wounds.