Anyone leave ED for homecare and regret it?

[Boston-RN, RN]

Hello,

I'm and ED RN x 1.3 years. I work at a large inner city level 1 trauma center. I LOVE my career. Currently I don't really like some parts of the job (BIG PARTS). Currently we have no nurse:pt ratio in our ED and sometimes that gets hairy especially when we're short staffed which happens regularly with no offer of OT to fill the holes. I get paid pretty low compared to the area. I just got my CEN (with no raise or reimbursement for taking the test), I'm getting my BSN ($3k/yr reimbursement but no raise upon completion) work 36hrs (3x12) day/night rotation w/every 3rd weekend. There is blantent favoritism in the department. I did get a good review but our wages have been frozen for a year. We get good amount of vacation time but rarely a chance to use it. I like the MD's and most of the people I work with and I enjoy working in the ED. Right now there are no other ED jobs in the immediate area. I have been told by people that have left that they are now very happy, especially the ones that do homecare. The money is better by approx $5/hr, no nights no weekends no holidays. All my friends and hubby work M-F jobs. I am seriously considering going into homecare and keeping the ED as per diem.

Has anyone done this and truely regret it? I don't know how either environment will be effected with the healthcare reform.

Oh and my long term goal is FNP.

[tewdles, RN]

Boston-RN...

I have a friend who left ED for hospice...she is into it about 3 years and feels very positively about the experience (the clinical part anyway). She is currently considering going back to the ED and feels that her care there will be significantly changed (positively) by her hospice experiences.

Home care is a completely different animal. If you haven't already, read the pertinent threads in the "Home Health Nursing" specialty forum.

IMHO, there are some very attractive things about homecare and, just like any work, there are good/moral/proactive type employers and bad/amoral/reactive type employers with a good mix in -between. Some employers are very number focused and their expectations are VERY ambitious about how many visits MUST be completed in a day, how many OASIS must be completed in a shift, how many patients you case manage, etc. Others are more employee focused and hope that happy staff will provide excellent care and be responsive to patient AND corporate needs.

Pay can be variable, but many nurses feel they are paid adequately, if not well I think, for the service they provide. Some are paid per visit, others by salary, or by the hour...some are required to be on call or to work rotating weekend shifts.

Some homecare agencies provide cars, for a small fee. The company I worked for charged a small monthly fee, but paid for all of the gas and maintenance (fleet cards). Most provide phones and whatever digital device you require to document your care on their software.

The work can be very flexible...it can also be hectic, disjointed, and frustrating...depends upon the employer. I say, do you homework and follow your heart (and passion) in life and nursing... variety is often REQUIRED in our lives!

Good Luck!

[mamamerlee, LPN]

I don't know of any home care that is M-F, only. Most require some weekend work, and on-call. Who do you think goes out at 1 AM when Mrs Smith's foley isn't draining, and she's in pain? Or who changes those daily dressings on July 4th? Or Christmas?

Surely you knew that nurses work weekends/holidays/shifts before you chose to do this! I am not particularly sympathetic to someone who is still wet behind the ears complaining about this. Now if you said you'd been doing this 13 years, 20 years, then I might empathize. I did it over 30 years, because I never expected otherwise.

Be careful of what you wish for - get all the 'promises' in writing. I worked for an agency that had weekend staffers, limiting the weekends we worked, then in a space of 6 weeks, 3 of the 4 quit. So there we were, working every other weekend for months until new people could be hired and trained.

Best wishes!

[traumaRUs, MSN, APRN]

In my opinion, home care isn't a good option if FNP is your goal. Maybe an outpt clinic?

[Boston-RN, RN]

Trauma....do you mind if I ask why you think an outpt clinic is any better than HH for future of FNP. I can understand saying that it's better to stay in the hospital but I would think that at least w/HH you're using your assessment skills and some more than you would use them as an RN in a clinic. I don't know any clinic RN's so I really don't know what their scope is.

Thanks for your insight.