WWYD?

I've been working for a small HHA, poorly run, no proper equipment or real supplies, not paid mileage or an hourly rate for office time. No orientation to speak of. Sounds terrible, right? In some ways, yes. But I have incredible autonomy, can manage my patients as they need to be managed without interference, am completely on my own for teaching (which I love, so is good for me), and can make my schedule however it suits me (and my patients, of course). The per visit pay rate is best in the area, but census is down and no benefits.

Recently, I've been offered a full time position as a field nurse with a new HHA moving to town. They have excellent orientation, aggressive marketing staff that will pull up the census quickly, and several long-term staff members in their home office (out of state). When I originally interviewed, I was very excited about the possibility of getting in on the ground floor, but that was over two months ago and I'm still waiting to hear from them about visit rates, etc. (I know that it won't be what I'm making now, more likely around half the rate after hearing what they've discussed.) I had another interview with the owners last week and was at first denied the position, then offered it a few hours later. Issues with this company are that they are micromanaged to the nth degree with not much flexibility. They expect (demand?) a productivity of 7 visits a day, and I don't know how that can be done in an eight-hour workday. There is no wiggle room for scheduling, it's all done by schedulers and case managers in the office. They say I would get a printout each morning of which patients to see (and presumably in what order), that supplies would be packaged up and ready to take with me (no "shopping" the supply closet), and that teaching materials would be provided.

I intially said yes to the offer from new HHA, but am still waiting for them to announce visit rates (which may well be a sticking point). No info yet regarding when to start. No info at all, actually. Lack of communication is a big issue for me. At least at the agency I'm at now, I can call my supervisor anytime and get the info that I need, whatever it is. I've been having nightmares every night since I pseudo-accepted the new position and am now wondering what I should do. Is full-time and benefits worth the loss of my autonomy and flexibility? Is it worth killing myself with an expected productivity of seven visits a day? Or would I be better off trying to find another PRN position to supplement my original employer and forget about health insurance until healthcare reform pushes its ugly head through the door (not holding my breath!)? Help me think "out loud." What would you do and why?