Published Jul 29, 2012
emptyboxcars
191 Posts
I see opinions split on whether a new grad should go straight to home health. I can definitely see a point to both sides of the argument. However, out of curiosity, who out there started in HH as a new grad and is still doing it after a year and feeling a certain level of confidence about it. Those of you who have done well, can you tell me what, if anything, the company did to train you/equip you to succeed?
caliotter3
38,333 Posts
Started in home health while still in school. Company did nothing to prepare me. I was scared as all get out and did what I could to prepare myself for each assignment. When I knew I was going to a peds patient, I whipped out all of my peds references. Crossed my fingers that no one would ask me anything important. Muddled through and learned as I went. Started a LTC job some time before this and took the same approach. Looked up this and looked up that. Asked all the questions I could think of. Learned as I went.
bubblejet50
230 Posts
i started out in home health as an rn grad. i had a year of ltc experience as an lpn however and had been exposed to a lot of the same aspects as i was exposed to in my current position. I currently work with one ped client who has a ventilator and that is a different set up than a lot of home health nurses. i had a week of training with this one client and then was left on my own. the first few shifts were scary of course since it had been almost a year since i learned peds and had never worked with a vent. i felt comfortable around the trach and that made things a little less scary. I had worked with a few trach patients in my past. i think the scariest thing to overcome is the assessment. it's like is this normal? it's okay to talk to the patient or parent to see what things have been trending in the past. i constantly ask the parents questions and they do not think any less of me for doing so. it's information i need to make an informed nursing decision. now with going to multiple homes when i followed my preceptor during clinicals (we did do rotation in hospice) and most assignments were at snf. there are others around. lean on your other staff which if you work in HH that rotates sites then other staff have worked with this individual. lean on your case manager. if something seems a little off give the CM a call and talk about options (always have some ideas in mind). it's not as fast paced as the hospital and you can really learn some skills without being overwhelmed. some HH will work with IV's, some won't. so you may still get all the same experiences at a much slower pace with more time to critically think on your own which will be an asset in the future.
prettygirllpn
30 Posts
I went straight to HH as a new LPN and worked there for four years. It was scary but i had a good mentor who was willing to help, and she was a friend before i went to work there. As far as the company itself, There was training, after I had been there almost six months and had taken call twice, but that is just the way they were. How I learned was from asking questions and reading everything I could about procedures, diseases, meds, etc. on my own time.
MintCondition
15 Posts
i have been a nurse for 15 yrs and started in home health 3 years ago as a case manager. i am by no means saying that you cannot succeed but I think you will be extremely overwhelmed. my work requires you to have 2 yrs nursing experience before they will even consider hiring you. the reason is as a home health nurse you are expected to work pretty much on your own. you have to admit, discharge, peer review, decide number of therapy visits, resumption of care and all documentation along with knowledge in education each patient on specific disease process, iv home therapy infusion, access mediports, understand medicare and medicaid knowledge, insurance payer sources and many other things that you are responsible for . your case load can average around 30 patients at a time. if you are not a well rounded, experienced, organized, knowledgable and multi tasking nurse this job will be difficult for you. i was told from the beginning of my nursing career by a very old military nurse lol she was stearn too. she told me to start my nursng out in a med surg hospital where i would get knowledge on just about every type of disease in nursing. i took her advice and it has helped my nursing over the years. just about every thing i know now i learned from med surg and while i was learning, i had help, mentors and advice as a new grad. i strongly believe you should do this also as it will help mold you to what you really want to do as a nurse. good luck to you
L8RRN
188 Posts
I am new to home health but not new to nursing. I graduated 3 years ago and got about 1 1/2 years of experience in med/surg before I moved to a new state. My first patient that I saw alone last week had a PICC line dressing change and lab draw. No big deal...done them many times in the hospital, but the PICC line would NOT give up any blood at all. I ended up flushing again, changing arm positions, having her deep breathe and change positions and FINALLY got blood. As I was doing all this, I was praying for blood. :) It made me think about how alone I am in these situations. On the floor, if I was having any problems, I had 5-8 other nurses to give me advice and show me "tricks". I only have myself and my own tricks now. Just something to consider...
Nurse ABC
437 Posts
No and I wouldn't recommend it! When I first graduated nursing school I worked in home health with just 4 months experience. I had one day of training with another nurse and was on my own. There were so many things I didn't know and I was so alone and didn't have anyone I could grab to help me like you do in a hospital setting. I only lasted 3 months before I went back to the hospital to gain more experience.
Tori11
16 Posts
I can t say I would recommend it but I started in HH as a new grad. I have worked as a CM and it is very demanding. You will be overwhelmed and there will be situations in which you will wish you had more experience. I was unsuccessful as a case manager but plan to return after I get some acute care experience. I also have a pediatric pt on a vent with a trach, who is total care. I have worked with her for most of my nursing career at this point. It s boring but I gained new skills. I am pretty good with vents and trachs.
bigtownRN
I started as a new grad in home care. I did 2 visits with my DON and she set me loose. I do not recommend her method! After 2-3 months of doing visits I became a FT case manager. I have been doing it now for 2 1/2 years, and feel really pretty confident in the types of cares we are doing. We have been getting more infusion clients and have been learning more about that. We also do wound care, and alot of chronic diseases management. Some post-ops, cancer tx, etc. What saved me on many occasions was having a natural ability to make clients THINK I know what I'm doing, even when I don't! :) But, I know when to ask questions, and I do every time. I would say something like " well, that's beyond my training, so lets give so-and-so a call to see what they would advise". As long as the client can look to you to either know the answer or attain the answer, it all works out in the end. I enjoy the flexibility in my schedule, driving around the countryside on nice days, and being 1:1 with clients. You really get to know people well.
Debm46
4 Posts
I started in HH as a new grad four years ago. I think the first year was stressful, but I wouldn't trade the independence, flexibility, autonomy that you have for any hospital nursing position. The time you get to spend with the patient is a real plus. I was older and more mature and already had an advanced degree, so by no means was I green and inexperienced. I think my past education and professional positions definitely made it easier to adjust. I have an assertive personality anyway and do not have a problem making decisions. For home health, you definitely need to be able to make decisions on your own and feel confident about them. You also need to be resourceful and know where to obtain information or help if you need it. Being organized and being able to manage your time are also key. I think if you have a good nursing team and mentor, it is definitely doable. I have been lucky because my mother has been a RN for over 50 years. She is a Diploma nurse who worked in the trenches and did hospital med-surg for many years so she knows just about everything and has a lot of helpful tricks up her sleeve. So I have been lucky, too.