Advise for clinic RN thinking of working prn for HH

[ayorenee]

So I was approached by the daughter of one of the midwives that I work with at the health department to see if I was interested in HH nursing. I have a background in maternal/child nursing, outpatient dialysis, and outpatient women's health. I told her that I would at least come in to interview, she told me that it was "basic nursing" and that the patient's were stable not sick. I told her I had no med/surg experience, the majority of my job as a nurse at the clinic now consists doing histories, BP, T, R, and P, dispensing meds and lots of patient education. Could some experienced HH nurses give me more of a clue on what a stable HH patient is as well as give me tips and questions that I need to ask when I meet with them in two weeks to discuss this possible per diem position. Thank you I greatly appreciate it! I have been interested in HH for some time, but with my lack of med/surg experience I did not want to put my patients or my self at risk. Thanks!

Ayo

[caliotter3]

First you have to decide what type of hh you want to do. Extended care cases consist of doing routine care for stable patients on a shift basis for the long haul. Usually an 8 hour shift, but may vary from four to 12 hours. In addition to skilled nursing tasks such as assessment and med admin, you do the ADLs that would normally be done by a CNA at a facility, bathing, dressing, toileting, etc. Anything and everything pertaining to the patient's daily care for your shift. Intermittent visit work is just that, visits that normally last about 45 minutes to do such things as education, monitoring, blood draws, wound care, etc. More of an episodal type care for a shorter period of time. You can do anywhere from one to 7 or 8 (or more) visits in one day, driving from one to the other. Of course, the easier gig is the shift work type work. Sounds as if this is what is being described to you. Basic assessment at the beginning of the shift, all skilled care requested by the plan of care during your shift, notifications as necessary, emergency care as necessary, ADLs as I described above. One patient for one shift, with one nursing note documentation. Pretty straightforward. Most of these long term cases are rated at the LPN level of care, so be prepared to be lowballed on the rate of pay if you are an RN. A good agency will pay their RN doing extended care more than they pay their LPNs, but not all do. Do some reading in the hh forum and you will find a lot of posts that go into this in pretty good detail.

[NPvampire, MSN, RN, APRN]

My advice is to see if you can "ride along" with a current employee to actual pt houses, not ALF, and see if you like working in those conditions. Patient's houses can be NASTY--I mean health department violation gross and may be nothing you can do about it.