Would home health care be a bad decision

hello101 · Sep 16, 2008

I personally do not think it is a bad thing...but I do think sticking with hospital patients/environment you'll get more experience and see more stuff than doing home visit. I am not a FNP but I do internal medicine/infectious disease and after I got my degree, I did some homehealth type of work as an NP. In homehealth, they are more stable and I was just managing their hypertension, diabetes, etc.. Now I am more in the hospital and let me tell ya...I am seeing and learning a lot thru the other NPs and Doctors and of course, the nurses. Hope this help:nurse:

SuzGreenRN · Sep 17, 2008

I did most of my 15 years of nursing on tele, so I am biased in saying the experience you get on that kind of unit is invaluable. However, I have been doing home health while in school for FNP, and I really have enjoyed the flexibility of scheduling while I'm in school. Definitely think about home health when you decide to start NP school!

squinky12 · Sep 17, 2008

If you are interested in home health care as a career as a NP then by all means get some experience doing it before entering a NP program.

My very first job after graduation as a PNP was the Director of Nursing for a pediatric home health agency. We did both skilled nursing visits (IV therapy, phototherapy, early post partum discharge visits) as well as long term staffed cases (vents, central lines, etc.). In addition to the "nursing" part of the position (doing intake assessments, attending discharge conferences, etc.) This was actually my goal as I was going through NP school.

I also was involved in negotiating contracts with insurance companies, contracting with DME, lab and pharmacy companies, hiring and training nurses, writing policies and procedures, etc.

I think this field is wide open for nurse practitioners but it does have it's own set of problems (long hours, on call, family "situations" being less than optimal, ENDLESS paperwork)--maybe try it out and see what you think.

ANPFNPGNP · Sep 18, 2008

I'm curious to know how much you made for each visit as a NP in home health. A doctor offered me $25 per visit plus gas and I refused because it just didn't sound right. Well, a LVN I know gets $35 per visit plus gas. I wish that doctor would call me again, I would like to tell him what he can do with that $25 per visit!

JDCitizen · Sep 18, 2008

if my goal is to go for NP (either FNP or ANP)?
I'm a new nurse (on tele), and want to go back in 1-2 yrs for my NP. Recently, i started thinking about going into home care after i do my year in tele- it really appeals to me, but i'm wondering if that might really work against me becoming an NP?
In some ways, i thought the autonomy/experience might be a good thing, but then i also think that missing out on the bedside nursing experience might be bad.
Any advice or insight? I know i just started on tele, but i'm always trying to think about the next step.

Not a bad idea. I know a few NPs that went similar route....

All the home health care nurses I know:

- independent thinkers

- great assessment skills

- well versed in community health offerings

- well versed in the health care/insurance paper work shuffle

- their knowledge of medication by sight has always amazed me

In the hospital one can get accustomed to instant answers: labs, EKG, respiratory therapy, pharmacy or a doctor almost instantly at the push of a button.....

In the field it's you, the patient and the situation (maybe a call into the doctor or 911).... The point is you are more dependent on yourself / your own skills. With the days long gone of all stable patients being just in the hospital your knowledge / skills could very well be taxed.

In the home sitting you not only get to know the patient but their family. You also may be able to address needs they may not even know they have by completing an in home assessment.

Just my .02

squinky12 · Sep 19, 2008

I'm curious to know how much you made for each visit as a NP in home health. A doctor offered me $25 per visit plus gas and I refused because it just didn't sound right. Well, a LVN I know gets $35 per visit plus gas. I wish that doctor would call me again, I would like to tell him what he can do with that $25 per visit!

Now, you have to remember that this was in 1990-1992 but it seems that we paid a minimum of $40 per visit back then (more for infusion visits) and the nurse was expected to do the visit and deliver the blood sample (if needed) to the lab as part of the deal. Mileage was paid extra using a per mile amount. I did quite a few early post partum visits and literally drove around with a portable infant scale, a sharps box and PKU slips in the trunk of my car for a year. We were willing to pay $60 per visit but most nurses were either afraid of the baby or afraid of the mom. :rolleyes: I LOVED doing these but it can be a LOT of driving.

Don't know what type of a visit the doctor was expecting you to make for $25 but that seem awfully low. I have heard that some ANP/GNPs do nursing home rounds/visits and that $25 might be a little better if you could do a number of visits in the same setting.