Acute care to home health. Stories welcome!

[anh06005, MSN, APRN, NP]

So I have been working on a cardiac/step-down unit for almost 2 years. While I enjoy what I do the atmosphere has gone downhill (FAST) the last few months. Ratios were increased, we have sicker patients, our floor merged with a med-surg floor so there have been times I'm the only original cardiac nurse so I wind up with drips, post-thoracic surgeries, etc. with a 1:5 ratio. Plus to top it off earlier this year we did not get raises due to "financial issues" within the hospital. So I'm going on 2 years experience now and making new grad pay (plus to top it off the annual bonus checks have been stopped). Basically, everything good I signed up for is gone at this point. Plus about 75% of the time I am rushed at lunch time (with no other breaks) and still wind up staying over to chart.

SOOOOOO I'm looking into getting into home health. I have talked to a few people who were previously on my floor and made the move and they love it. I'm just wanting to hear some stories from those with similar situations. I have read multiple posts here (I especially enjoy the "typical day" thread) and just want some more opinions.

I'm realistic and understand there are good days and bad days everywhere so I'd like the good, the bad, and the ugly!

Also I have applied for a position with Intrepid USA. If any of you have any experience with them please let me know how it is! One of the nurses I spoke with is with them and says the offices in this region are awesome and she doesn't regret her decision in the least!

Thanks in advance for any replies! :)

[tachynut]

Hello!! I found this post and while I know it was from years back, I am in the same situation and am wondering what your result was? I currently work in a cardiac ICU and am looking to move into home health (for my own sanity and health!). I was also looking at Intrepid as a company. Any information would be sooooo greatly appreciated!!!

Thanks! :)

[nutella, MSN, RN]

Do not be fooled. Working in home care is also hard work. Even more so, it is not easy to get all work done without unpaid overtime because it takes some while until nurses are so skilled in time management that they get notes and visits done within the allotted time. Plus multitasking is a MUST to get everything done.

Economy is still not as good and companies also do not pay as much as a hospital.

Best advice I can give you is to shadow a home health nurse for a couple of hours, not just for one visit and see what you think.

Ask about productivity (how many visits a day the nurse has to do), on call responsibilities, weekend rotations, number of cases on the case load if it is a case manager position, turnover rate (most likely high...).

Not everybody is cut our for home care and while some like it and do well a lot of others leave after some months because they can't arrange.

[HHRN81]

I was a cardiac ICU nurse and transitioned to Home Health. I wouldn't say it is less stressful, but a different kind of stress. I think it all depends on the agency, so like the previous poster suggested, I would research agency expectations and follow a HH nurse if possible. I work for a hospital based agency and I'm paid hourly. This means that I am paid for my documentation time and get paid overtime if I go over my allotted 10 hour day.

It is a completely different kind of nursing than hospital nursing. ICU provided me with a good background and good assessment skills which are huge assets in home health as the job is very autonomous.

I can honestly say that I have found my niche in Home Health. It's definitely not for everyone, but for me it was the best transition I've ever made.

[tachynut]

Ok, I just tried to leave a comment but I seems to have disappeared . I was wanting to ask the above poster about what challenges you faced in making the transition from ICU to HH? What should I look for in a company? I have several interviews lined up, and I really want to make the right decision! Any info would be helpful! Thanks!

[HHRN81]

I think time management and learning how to work autonomously were my biggest challenges. Those and learning a new kind of nursing. I had to overcome a sense of loss of control. In an ICU setting you are in control of every aspect of patient care. You give them their meds, make sure that they are bathed, are routinely turning them and providing skin and oral care, etc. In the home health environment you are educating. Sure you provide wound care and other interventions, but once you walk out of their door you have no control over what they do (or don't do) to promote their own health.

You have to be creative in figuring out what style and tools are going to best reach a patient. Your communication and interpersonal skills are vital to be able to make a genuine impact on helping people make lifestyle changes.

When choosing an agency, I would look carefully at their productivity expectations, orientation time and if possible, shadow a nurse or get some employee feed back. Best of luck with your interviews!