New to Nursing, New to Home Health!

[Aniroc]

Hi Everyone,

There is a ton of information and suggestions to sort thorugh on this site, but I was wondering if anyone would like to share any pearls of wisdom as I venture into my career as an almost graduated RN who seeks the community as her practice environment.

I'm working as an ESN (employed student nurse) with the local health authrority in a community office for Home Health Commmunity Nursing. The philosophy of this context of care melds with what I think nursing should be. I'm hoping to be hired after I graduate and write my exam in January. I start tomorrow, but I am so nervous and not exactly sure what to expect except from the 6 wk clinical I had last year, and from reading my texts of "ideals".

For the orientation, I wrote up a brief into letter for the staff outlining my goals while I worked as an ESN (i've only been given 167 hours) which included:

• Learning to competently assess client determinants of health while helping them define and find ways to meet their health goals
  
• Developing a greater proficiency in the complex world of wound care always keeping the whole client in mind, not just the hole in the client
  
• Becoming familiar with therapies offered in the community such as infusions, medication pumps and the challenges of managing them in non-acute settings
  
• learning how palliative care differs in the community compared to those of hospice and hospital facilities in order to develop a base of knowledge and experience in this area

What would you offer as advise to a new nurse who wants to make this area her area of specialty? Any suggestions on some actions I can partake in to meet these goals?

Thanks in advance!

Corina

[jnette, ASN, EMT-I]

Lofty goals, but worthwhile ones. :)

My advioce would be to shadow a seasoned HH nurse in your community for some time and expose yourself to as many varied HH care situations as possible. See how things are done out there.. how you contact the docs, how you go about ordering supplies, how you improvise when you have little to work with. Many challenges, indeed... but I still say HH is nursing's best kept secret !!!

You will love your patients, and they will certainly love you back !!!

Wish you the very best !

[nurseby07]

I wish school had taught us more about wound care. HH nurses deal with wounds daily and we are expected to know what to do. I have read, studied, shadowed WOCNs but I still have no idea. I would recommend getting as much info as possible about this as you can.

Good luck!

[ame222]

In reference to the following note, this might help. I purchased the book called "Wound Care Essentials" by Sharon Baranoski and Elizabeth Ayello. It is a great reference book and has helped me alot.

I wish school had taught us more about wound care. HH nurses deal with wounds daily and we are expected to know what to do. I have read, studied, shadowed WOCNs but I still have no idea. I would recommend getting as much info as possible about this as you can.

Good luck!

[Aniroc]

Great advice everyone. Yes the goals are lofty, but if you're gonna shoot, aim high with a steady eye -wink-! I've had a few shifts and I've been working in the clinic providing wound care to ambulatory clients. I've been lucky to have had some great previous wound care experience and taken in a few conferences one as recent as last week. So so far so good.

I'll be shadowing a home care nurse on her route hopefully next week have have accompanied the CRN to do a VAC dressing already. I love working with the clients in this context, its so different and much more rewarding in my opinion. I'm still worried about making sure I do thourogh assessments, making appropriate referrals and interventions but I realize all this will come with time. Keep the great suggestions and ideas coming! Thanks again!

[jnette, ASN, EMT-I]

You'll do FINE ! I can tell by your attitude and your passion. :)

Don't worry.. the docs give the orders for whatever woundcare you will need. And if it's one you're not familiar with, your agency will tell/show/teach you how it's done. Never do something you're not comfortable with, something you haven't done on your own before, something you don't yet quite comprehend. Ask to have another nurse go with you for these situations as they come up.

Just take your time watching and learning, and don't go out on your own before you feel competent. Better to buddy up with another nurse for an extra few weeks to be on the safe side.

The most crucial thing is finding a great agency.. one which is supportive and willing to teach you the ropes.. and gives you plenty of time to do so.

Keep it up.. you're going to be a good'n !

[nurseby07]

You'll do FINE ! I can tell by your attitude and your passion. :)

Don't worry.. the docs give the orders for whatever woundcare you will need. And if it's one you're not familiar with, your agency will tell/show/teach you how it's done. Never do something you're not comfortable with, something you haven't done on your own before, something you don't yet quite comprehend. Ask to have another nurse go with you for these situations as they come up.

Just take your time watching and learning, and don't go out on your own before you feel competent. Better to buddy up with another nurse for an extra few weeks to be on the safe side.

The most crucial thing is finding a great agency.. one which is supportive and willing to teach you the ropes.. and gives you plenty of time to do so.

Keep it up.. you're going to be a good'n !

I agree with you, but what about when the order is for the nurse to go assess and determine wound care? The docs seem to all write wet to dry orders and we seem to know which magical new wound care supplies will be appropriate. That is what I get stuck on and that's when I call, all the time. They're probably sick of me calling for the 900th time, but better to ask.