Acute care to home health

[Tiffanymarie28]

For the past year I have done cardiac tele/IMCU nursing. I am used to managing drips and patients with acute cardiac problems, a lot of ACLS. I am staying in the hospital setting full time, but I am taking on a second job in home health. I have been an RN for a year now, and for the most part I feel like I am as comfortable with my autonomy as I could be for my level of experience. I am not implying I am 100% comfortable yet.

I am looking for some advice managing my home health assignments. I will be doing mostly visits and flu/wellness clinics and shifts on occasion. Patient ages range from new born to elderly. Mostly children with chronic conditions, stable vent patients, tube feedings.... I have experience with pretty much everything I will be exposed to in the field with the exception of vents. We are not to do anything with the vents. The settings are to remain as is, unless we obtain an order to change them.

I think the two things I am most nervous about, is being alone in someones home... and handling an emergency in the home. I know what to do, but I am so used to having a crash cart... and now I will be at the mercy of waiting on EMS.

Any advice or personal equipment recommendations would be appreciated.

[caliotter3]

The important thing my supervisors have told me about emergencies in the home is recognizing an inability to breathe properly, contacting EMS immediately, and 'bagging' the patient until they get there if necessary. Anything short of a respiratory emergency would require conveying the assessment findings to the doctor and following their order, which still might mean moving the patient to the ER. In that case, emergent: call the EMS. nonemergent: the parents may be able to transport depending upon the circumstances. You stay on duty until you turn over care to the EMS. By this time you have notified the clinical supervisor and they will tell you whether or not they want you to go to the hospital with the patient. That is about it. All situations are handled according to whatever is going on. With your background, you are better equipped to handle emergencies than most nurses starting out in home care, many of whom are just coming out of school.