Well, I'm on my own as a HHC nurse and it's.....

Specialties Home Health

Published

WOW!! I just can't find the adequate words to describe what I am feeling right now. I only had 6 days of orientation, which in and of itself is scary...being in the hospital, I was used to 6-12 weeks. There is so much to learn, and it's very different from a clinical setting. I like deciding who I'm going to see and when. I don't like that even though I call ahead, the pt is still not home and I have to back track. I've been on my own for 2 days now...and I feel incompetent and dumb. It even has me questioning my assessment skills. In the hospital if something didn't look or feel right, I had the advantage of calling my clinical supervisor to come take a look/listen. I'm on my own here! While I enjoy the autonomity, it scares the bejesus out of me. (At least I know to call 911 if some serious crap hits the fan lol) I guess what I'm asking is, did anyone else start hout feeling the way I do? I can't help but think I'm missing important things, even though I tend to write every little thing down so I don't forget. I feel overwhelmed. I tend to be a perfectionist when it comes to my work as a nurse. I've been a nurse now since 2004, so I'm not a "newbie" but this job is making me feel like one! How did you all get through your days without breaking down? And about how long did it take you to get into the "swing of things?" Thanks for taking the time to read and post. =)

A good way to feel better about the situation is to be proactive in taking steps to prepare for each day. Try to think of ways to get ahead of the curve, no matter how inconsequential. If it makes you feel more confident it is time and effort well spent.

What kind of patients are you taking care of? What is their level of care? I'm asking because I've been a nurse for about a year and thinking about working in home health, but not sure if I'll feel the same way as you.

Hi, I too just started home health. I've been a nurse since 2008 but only in the hospital. So far so good with home are for me but I think it's because I have a lot of support. My preceptor is awesome as is my manager. My orientation is sorta tailored to my needs so after about 4 days riding along shadowing my preceptor I felt ready to do visits on my own. Yesterday was the first day on my own and my cases were easy so I did ok. I do understand what you mean about questioning assessment skills and feeling like you don't know anything. When I did my assessment I just double checked the patients baseline to see if my assessment was way off or not. Lucky for me and the patient everything was normal. I feel like in the hospital I've become kinda lazy because if I don't know something or I'm not sure of something I just ask someone and thats that. In home care you have to know your stuff and know how to use your resources and figure things out. From what I hear it's takes almost a year to get comfy with home care.

mrsmartin, that's what I heard too. Guess I'm too impatient....I want to feel good in it NOW lol. Last Friday was supposed to be my last day of orientation, but the girl I was with had a death in her family, so I was asked to cover her people. Luckily I had seen 3 of them already with her, and I saw 6 total. I did take 2 pts of my own...did their SOC. So far they're good. I've taken over 2 from one nurse who didn't live in the area where her people were, and another one because of the same thing. They're all dressing changes...1 is daily, 1 is 2x week and 1 is 3x a week. I picked up another one that was started on Saturday...and he's a daily dressing change too. And I picked up another one today; she was already with our PT services, not for skilled nursing though...she went to the dr and he ordered nursing to go along with it. So I have a total of 6 people under my care. Doesn't seem a lot, especially when I'm used to having 6-8 at the same time in the hospital lol. There's so much paperwork involved! Caliotter...I've been planning my schedule for the day the night before...and making sure my bag is stocked....extra papers in my files....but by the end of the day my bag, files and car is such a mess...(and I drive a big van lol) I guess I'm feeling overwhelmed and like I'm not doing a good job, even though the other nurses I've talked to (well...not just talked to, but have bombarbed with endless questions) say I'm doing fine....I just don't feel like it. Emptyboxcars...so far most of my pts are wound care. I don't mind so much. I would seriously get 2 years of med surg under your belt, AT LEAST. Med surg you deal with a diversity of people, with a diverse history. The melting pot of nursing, if you will lol. I did med surg for a long time, and always told the nurses I was training that it takes a good 6 months to feel comfortable taking care of your own people. Critical thinking skills are a must in the nursing profession....I'm finding home care nursing is very independent. You are the eyes and ears of the drs. You are in the hospital as well...but there you have other nurses who can come look/listen to your pts right away if you have a question. In the home you don't. What I'm finding I'm doing is asking the person's family members if such and such behavior is normal, as well as reading past notes.

sounds like you are doing well! I haven't done SOC yet because I had nightmares about that darn oasis form the first time i seen it. lol . I again know what you mean by wanting to be proficient already. today I did 3 revisits, just teaching really and was so embarrassed to ask for my preceptor to review my goals/charting.

home care as no other nursing specialty has, most of time, been diminished and not well rewarded however as we can see, us as home care nurses face difficulties and need to sharp our skills and not only clinical because we have to know regulations, requirements and coverage, things that one don't have to worried about when working under the umbrella of a big hospital or organization. JJs don't worry you will feel better soon, the patients in the homes are not as critics are the ones in the hospital but if so as you said you can call 911, most these patients need you since sometimes you will be the only person who will visit their house and will provide an encouraging word to them give your best, love what you do and do it with all your love and you will succeed! ( always pay attention to your documentation and orders, fill ypur car, grab some snacks and start your trip) :)

I started in home health in June. I have days when I feel very incompetent. I have been a RN since 1994 but nothing has prepared me for home health. It is very easy to drowned in paperwork. I find it helpful to do charting in the home. It is too easy to forget or get caught up. One thing I am learning is to stay out if the office as much as possible. It is hard to focus and meet deadlines and the phone calls get me further behind. I go to coffee shops or the library to get caught up without people talking to me or giving me phone calls. We have LPN's that do all visits an RN doesn't need to do and an LPN in the office to make calls to the docs. This really helps! I usually do 2-4 visits a day. We have a new executive director and I hope she doesn't make any major changes! Organization is a key factor in this job. Deadlines and required paperwork regarding transfers, Sup visits, ROC's, recerts and SOC are very important and if missed cause big headaches for the company and the nurse. It's been nice to vent! Good luck! I love reading others ideas and helpful hints!

+ Add a Comment