Now you all are making me scared! - page 2

by RipeTomato 3,124 Views | 10 Comments

I'm in the last quarter of my first year of nursing and have been working in the ICU. I've been thinking of switching jobs, and have been researching home health care. It appeals to me for it's more family-friendly hours and the... Read More


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    I agree with getting more hospital experience, I would aim for at least 2-3 years acute care experience. People who do homecare without that experience will tell you they do fine, but they do not know how they would perform differently if they had the experience, because they never got it. In short, you don't know what you don't know. As for the suggestions to do HH per diem to "try it out", that really doesn't work well in practice. The reason is, you need to work consistently and often to properly learn OASIS documentation. It depends on the agency of course, but per diems typically work sporadically and often on weekends. Our agency will not hire per diems without OASIS experience because they just do not work often enough to learn to do it well. They will hire case managers and part time staff without OASIS experience because they will be working often enough, and during regular business hours so they can get regular guidance from supervisors and QI on how to properly do it. At first glance, OASIS seems like a no brainer, but it actually takes a couple of years IME to be proficient at it. If you gather OASIS info incorrectly, your agencies outcomes will be screwed up. Learning to do OASIS honestly and accurately is the key to an agency making money. Medicare fraud is rampant in homecare, and nurses that can collect OASIS info correctly and accurately to reflect the good outcomes at an agency are worth their weight in gold. Additionally, there is always more to learn about it, changes in interpretation etc. occur at least monthly with the Moos....you have to keep up to stay good at your job. What shocked me about homecare when I first started was that *all* my charting was reviewed with a fine tooth comb....not just OASIS. A good agency will do that, because that is what the state, the feds, and JCAHO will do. Ultimately, if I were you I would stick it out in acute care for another year or so, and start doing reasearch on finding a really good HH agency to apply to. Then go for it, get a part or full time position and give it a shot. Trust me, you will be glad you paid your dues in the hospital and you will be more confident and really enjoy all that a good agency has to offer it's nurses, and you will be on a new learning journey.....the world of medicare and reimbursment.....it can be a bit daunting at first, but you can fully concentrate on it because your clinical skills will be finely tuned already. Good luck!


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