All this really depends on the agency. I never considered home health, in fact it was at the bottom (rock bottom) of my list of nursing jobs
I was interested in doing. Surprise surprise! I love home health. I am paid per visit and there is never a shortage of work for me. Sometimes I get calls begging me to take on another client because schedules are so full other nurses can't take them. I have had multiple paychecks where the take home was double, yes double, what a hospital paycheck is. Yes that does mean I'm doing plenty of visits but the stress level is much lower. Ive never, even during slow times, made a paycheck less than the job i left for home care. Yes sometimes the paperwork is daunting but it helps just to stay on top of it and not let it pile up. Organization is important, and confidence is key.
No job I've ever had has every been so rewarding. Sometimes you're all these clients have and seeing you is the highlight of their week. The home setting is very intimate and I've learned so much about people's lives and the dynamics surrounding them. Sure some places are not the cleanest of environments, you learn to say "I'm here to see you not your house" when they comment about their messes, but you're seeing a whole picture of a client and not what you see in the hospital. Maybe they need social work for community resources because they are unable to sweep that 10 year old dust bunny out from under the couch. You can help people in so many ways that they didn't even know you could help with, and there's. Itching that makes you feel more worthy than the client who says "you are such a good nurse," or "I don't know what I would do without you.". Hardest part is getting attached to these people because of the one on one care. I always say discharge is bittersweet because on one hand you know you've done the job you were sent in to do but you are going to miss seeing that person. It's just extremely rewarding.
I work for an agency that is not huge and we as clinicians are appreciated by the administration as well. It really makes a difference how you're treated as an employee.
You get difficult clients here and there but I smother them with sweetness and show them that I am attentive to their individual needs and it always breaks them down. People have a really hard time being grumpy to those that treat them with dignity and respect, and a little humor goes a long way.