Home Healthcare Vs Hospital Nursing

[Lysa71]

There are lots of talk about the hospital I work for closing their inpatient care. If this happens I will be out of a job along with many others in the area. I was offered as a visiting nurse. I have never done that but did job shadow for a day. I like it but it's obviously not hospital nursing. I've been a RN for 3 years. I worked for a year in a nursing home and then these last 2 years I've been in a hospital. I've trying to get a position at another hospital but that is so tough. I've been trying and trying to get in.

Anyway, if I take the visiting nurse job I would be working days. I work nights now. I wouldn't not be working evenings or weekends. I have to work every other weekend now and that is tough working third because you can't do anything and I miss out on anything going on. Family events and going to church on Sunday don't happened for me when I am working nights.

the pay as visiting nurse is about a dollar more than what I make now per hour. I would loose my shift differential which is quite a bit. the visiting nurse position only pays salary. I don't remember what she said they pay for mileage. I work three 12hour shifts right now and as a visiting nurse I would be working M-F 40 hours. They say even 40-45 hours at first till I get familiar with everything. concerned with wear and tear on my car as well. Not sure if what they pay for mileage will be enough to cover the cost of my gas completely either.

I'm worried that if I don't like visiting nurse that I will have a hard time to get in to a hospital even more.

I would appreciate anyone thoughts or experieince

[HouTx, BSN, MSN, EdD]

I know a LOT of nurses who have had a very successful transition from acute care to Home Care - most of them were critical care nurses. Home care is a very different practice environment and has it's own standards of practice which you will need to learn. You will need to make sure you are very aware of these. Documentation requirements are different also. The organization should provide you with adequate training & orientation.

There are some caveats. Beware the "on call coverage" requirements. Even though you have been promised a M-F schedule, you will probably be required to provide some additional coverage to ensure that patients have adequate support for prn needs - as well as "unexpected" admissions. (note: these are on the upswing as hospitals become more focused on reducing length of stay). You may find yourself working some very long hours as well as weekends. Make sure that you are reimbursed adequately for mileage. Be sure to check with your car insurance company.... you may discover that you need to adjust your coverage since you are using your car as a commercial vehicle (transportation to patient care sites & carrying supplies & equipment). I have an acquaintance (HC nurse) who was in a fender bender & her insurance denied coverage because of this...

You may want to retain a hospital/acute care PRN position just in case. If you decide Home Care isn't for you and you need to return to acute care, it will be much easier if you have evidence of continuing experience in that environment.

[Lysa71]

Thanks for the info. I'm thinking about it. From what I've gotten from some that I ran into who just happen to work there said the hours are long and because it's salary it worth it to them. They said the paperwork is crazy. I'll have to see

[Lysa71]

Is 42 cents a mile good for mileage?

[Forest2]

I think 42 cents if fair. But be sure it will be more difficult to get into acute care after working for home care, namely because the people who hire for acute care don't understand what a home care nurse does. Even though you do IV therapy, wound care, vacs, gtube, trachs , etc, cardiac patients to ortho, they still don't think you know anything. There is no appreciation for the knowledge and expertise it takes to be a good home care nurse. It is much more than task oriented work like they do in the hospital, yet, it isn't considered as important I guess.