New Grad - Is HH nursing difficult to get out of?

Specialties Home Health

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Hello AN,

I graduated in May and passed my boards at the end of June. I have been applying online to multiple job postings with no progress. This past Sunday, in passing, I mentioned to a few of BFs friends that I was looking for a job. Turns out, someone in the group, that I met that day worked for a HH agency.

I had my resume/cover letter ready by Tuesday, walked in on Wednesday and practically got the job offered on the spot. Turns out that Spanish speaking HH nurses are in high demand in the Boston area.

Now this is my dilemma. Throughout nursing school, I had a feeling that HH was the way I wanted to go. Until I had my rotation at the CHildren's Hospital and I absolutely loved it, I also worked at an elementary school which I enjoyed very much. Then I new I wanted to work with kids. I don't care if it's in a bedside or community setting.

My question is, How hard would it be to get out of HH/Community nursing if I wanted to broaden my horizons?

To be honest, I believe that I will enjoy the HH very much. I always wanted to work with my patient within the community, but I don't want that to be my only option or loose my bedside skills which I really haven't learned since this would be my first job.

Well, offhand, it should be easier to get out of the hh field, than to get out of the 'old, unemployed grad' category. Don't be afraid to take a job offer and give it your best while you continue to look for your niche. Experience is welcome everywhere.

Well, offhand, it should be easier to get out of the hh field, than to get out of the 'old, unemployed grad' category. Don't be afraid to take a job offer and give it your best while you continue to look for your niche. Experience is welcome everywhere.

Great Advice. Thank you!

A nurse friend of mine told me not to take the offer because its better for me to get my bedside skills first.

My mentor told me something along the lines as what you told me. "HH experience is better that no experience".

Don't get me wrong, I like the idea off HH nursing. I just want to keep my options open.

In my area it is so bad that even long term care facilities do not have available work. That is a bad sign because not many are willing to work in long term care, as I am certain you are aware. People were always told that "you can always get a job in LTC". That venue doesn't look so bad any longer, now that jobs are scarce everywhere.

In HH you will most likely be the Primary, so you have a patient for an entire Episode of 2 months.

The revolving door at the Agency I work at has RNs leaving by

A: Not taking on any new patients

B: Any patients that they oversee as "Case managers" (where the patient is seen by an LPN) are transferred to another RN

C: Another RN does the Re-Cert/Discharge at the end of the episode and then takes over that patient from that point moving forward.

You gradually phase yourself out over 2 months.

You could just up and quit, but then your DON has to scramble to find RNs to take on your patient load that you just dumped in their lap.

Specializes in Home Health, SNF,Psychiatric, Prison,.

Our agency doesn't accept new grads. RNs and LPNs must have a years experience in hospital bedside nursing or LTC experience.

Specializes in Pediatrics, Emergency, Trauma.
Great Advice. Thank you!

A nurse friend of mine told me not to take the offer because its better for me to get my bedside skills first.

My mentor told me something along the lines as what you told me. "HH experience is better that no experience".

Don't get me wrong, I like the idea off HH nursing. I just want to keep my options open.

HH IS bedside skills; you will find you have more exposure to many different medical conditions that the average bedside nurse, and know how to effectively manage their treatment as well; those skills transfer everywhere, even to acute care. :yes:

HH IS bedside skills; you will find you have more exposure to many different medical conditions that the average bedside nurse, and know how to effectively manage their treatment as well; those skills transfer everywhere, even to acute care. :yes:

Thank you!!

Home health is for the experienced nurse!!!

Our agency doesn't accept new grads. RNs and LPNs must have a years experience in hospital bedside nursing or LTC experience.

And if you were to LEAVE your Agency and move to another area of Nursing, what would be the process for you, as a Home Health Nurse?

Specializes in Home Health, Med-Surg, Telemetry.

I'm curious which bedside skills you are worried about losing? I didn't do any trach care (no vents at my agency) or any NG placement/removal in home health, but I got to use pretty much everything else I learned in school. There were regular foley changes, wound care (pressure ulcers, venous stasis ulcers, surgical incisions, dehisced incisions needing negative pressure therapy), IV antibiotics (through either a PICC or peripheral line, occasionaly with a pump but more often an infusion ball or simply counting drops), lab draws, IM/Sub-q med administration, ostomy care, and central line dressing changes. Anybody can be taught those skills (which for most you are hopefully doing for competent family/caregivers).

All of that said, the most important bedside skill (that you will use every day) is the head to toe assessment. Don't get lazy and think because people are at home it isn't necessary. You are in a position to catch any number of possible complications and hopefully prevent readmission or ER visits.

I'm starting on a telemetry unit here in a few weeks and the process for me leaving home health was to be offered a new position, give notice, stop taking admits, and move people over to other nurses. I was able to answer almost all of the interview questions with examples from my past 18 months of home health experience.

I second this excellent insight. Also some HHC agencies have more pediatric clients than others. It would be great if you let the agency know of your interest in these cases for future experience value. It is true some HHC look for acute or LTC experience, but your clinicals and knowledge are fresh! Best wishes!

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