Just finished a weekend working as a visiting community nurse. Snowed ALL DAY Sunday, but since traffic was so light, it wasn't a problem. Saturday night, on the other hand!!! Black ice all the way home, plus traffic, plus idiots in SUV's who though they could speed in conditions like that....
If you don't like driving, DON'T go in for community nursing. You will spend most of the day behind the wheel of your car. Here in York Region, we sometimes have as many as 14 patients a day, and you will easily put over 100 k. a day on your car.
Types of patients...very heavy on the palliative. A lot of people who want to die at home. It's very draining sometimes, but when someone passes away peacefully in their own home, and you know that you were largely responsible for them being able to do that, it's a really satisfying feeling.
We do a LOT of wound care. The first thing you will need to do will be to start taking upgrading courses in wound care skills. You will see awful stuff...fulmigating tumours, gangrene, leg ulcers, lots and lots of butt abcesses (pilionidal cysts, rectal abcesses, childbirth tears.) Last week I admitted a patient with cancer of the mouth, with mets to the outside of the jaw and neck. Large nodules, draining copious amouts of foul, purulent fluid. It's starting to affect his breathing, as well as his eating (he's on liquids only) plus he's got mets to both lungs. Ugly, ugly, ugly. I'm very glad he's decided not to die at home. I think someone's told him what might happen when the Ca. starts to eat into the major blood vessels in that area. We did have a patient awhile back who had several major bleeds at home, yet continued to stay there until she finally passed away. Fortunately, her death was peaceful, and was not from a hemhorrage, as the nurses had feared.
We do see a lot of patients with IV's in the community, both peripheral and central lines. Most of our nurses are IV certified, and some can insert midlines too. We also see home dialysis patients, teach parents to do breathing treatments on asthmatic kids, do VAC therapy for wounds, high compression bandaging, insulin and diabetic teaching, teach patients to manage catheters drain tubes and ostomy care. In short, we are jacks-of-all trades, and there is ALWAYS something new to learn!
The downside? We get paid much less than hospital nurses, PLUS we put in a lot of unpaid time doing paperwork and making phone calls. If you've got an 8 hour day on paper, you've probably spent 10 hours on the road, then have paperwork to look forward to when you get home. It can get really, really annoying, and a lot of nurses quit because of it. Needless to say, we are shortstaffed most of the time. Why do this sort of a job when you can make much more money in the hospital, and get paid for your breaks?? (Most days I eat lunch while driving, and on a really insane day, I may not get lunch until late afternoon.)