Home Health

Specialties Private Duty

Published

I am a new LPN. I just got my licensure back in May and started my first nursing job in June. I am working for home health. I have worked with one patient only the whole time and stay at that home 12 hours a day. I love the schedule I have here and is a big reason I have settled for just one patient. It is convenient for my family and me. My question here is do you all think that home health can stunt a new nurse's career as far as experience and skills go? I feel it may bc I do the same thing every day. It never changes. I feel it may not change much even so if I tended to 2-4 different patients in a weeks time. I am currently expecting a baby right now and am debating if I should just try to move on to an actually facility or doctors office (for more structured schedule) afterwards. What is you alls thoughts on home health nursing? I would love to hear the opinions of other nurses! Thank you!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

If you are spending entire 12-hour shifts with the same client, it sounds as if you are working private duty cases, not home health nursing. There is a distinct difference between home health and private duty.

If you were driving to five different clients' homes each shift, that's true home health.

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Specializes in Complex pedi to LTC/SA & now a manager.

Do physicians offices even hire LPNs? Many hire APN & medical assistants

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Do physicians offices even hire LPNs? Many hire APN & medical assistants
A handful of physicians and hospital-affiliated clinics in my area hire LPNs, albeit at lower rates of pay than they would earn in LTC, home health, private duty, or psych.
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Haha well you can tell I am a newbie I didn't realize there was a difference! Thank you for clarifying that part for me. Either way private duty or home health do u think it is a set back for a new nurse?

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Yes all the doc offices where I live do hire LPNs as well as medical assistants. Yes rate of pay is lower.

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Specializes in Private Duty Pediatrics.

I do private duty pediatrics. Since 1986, I've had one client on peritoneal dialysis, and several with severe cardiac problems, but almost all of my clients have some type of respiratory problem. That can range from someone who chokes easily to full ventilator support. Some have degenerative muscle diseases, some have cystic fibrosis, some have central apnea, and some are quadriplegic. I've had at least five with a hemangioma inside the trachea requiring a tracheostomy, along with several who had malformed tracheas. I've had a few who were on long-term TPN or frequent IV antibiotics, requiring IV Ports.

Many of these kids have cerebral palsy, seizures, or are developmentally delayed. They need nursing because of their problems with breathing, but these are common comorbidities.

You'll work with vents, BiPAP, and CPAP. Tasks/skills include dealing with the vent, trach care/changing trach ties/changing trachs, suctioning, percussion/CoughAssist, nebulized medications, GT care/changing GTs, GJ care, tube feedings, straight caths, range of motion, splints and braces.

You'll get very good at assessing lung sounds and doing pulmonary hygiene. Private duty pediatrics will give you a LOT of respiratory experience. The question is whether a new grad should specialize so soon.

I would caution against having only one client at a time. If that client goes into the hospital, you suddenly have no income. Ditto if the client moves or dies. It can take a week or more to obtain another client, and even longer to get your hours back to what they were. Also, it isn't good for the client to have only one nurse: what happens when the nurse is sick? They need to have other nurses who are oriented to their care.

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Well I'm not the only absolute nurse. He is 24 hour care. And there are other nurses that are oriented to him just in case we need fill ins. He is a pediatric patient. I plan on venturing out to other work eventually. Something I can aquire more experience. I feel I am stunting my career and my experience where I am at. I don't want to look like an idiot out in a more diverse facility. I will get there one day.

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I'm in the same boat as you, but RN. Some will probably disagree but, yes, I do believe it stunts career growth as a first job. I think private duty is better suited for nurses with experience, but I had no other options. I don't feel that private duty nurses get as much educational support, as facilities do. That's important as a new nurse. Even offices and LTC facilities train more than private duty agencies.

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The nurse who feels they are experiencing career stagnation because they are working in extended care home health should be proactive in seeking other nursing opportunities to "shake it up" at regular intervals, just as with any nursing specialty. The more variety in your jobs, the more variety in your skill set. I have always come across nurses who made the move from extended care to other nursing areas without much problem.

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