career change: ICU to home health

mpccrn, BSN, RN · Jul 31, 2008

i did icu in a trauma unit for about 20 years then moved to a dialysis unit for 5 years. waited for god to strike me down for leaving my skills behind for about the first year or 2. i did it because i was so very tired of being mandated. everytime i heard the helicopter land, i knew i wasn't going home. dialysis was a means to spend time with my family, share their lives, see the kids' games. i did do dialysis in the icu and ccu's....those were the good days, the rest were like a factory assembly line....get them in their chairs, hook them up, move on to the next one. i won't say there weren't some good things about the job, but i left and went back to the icu in another hospital, a smaller hospital. now i'm pretty sure i go home at the end of the shift, i can mold the younger nurses into giving icu standard care by example and there are even a few days now when i get someone really really sick. it's not the same as the trauma unit, but hey, been there, done that. i don't need the epi rush anymore, and i get to use my skills again. it was a good compromise.

rnnursesandy · Jul 31, 2008

everyone has their "nitch" in nursing....sounds like you like the direct care....give home health a try, if you dont like it you can always come back. also you could work part-time at acute care and part-time at home health...see which you like.

wonderbee, BSN, RN · Jul 31, 2008

Yes, I went straight from neuro trauma ICU to home health with a short detour into hospice in between. I was thrilled with the autonomy of home health. I felt very well prepared by my critical care experience. I was in charge of my own schedule of visits. Half my visit time was spent on the road which suited me just fine as I had a nice mix of rural and urban patients. Just enjoy the countryside. Most patients were hospitable and offered beverages. They had gotten over the acute stage and were just happy to be home.

There were downsides though. In ICU your shift is over and you go home. You can let it all go till your next shift. Not so with HH. There's the paperwork and there's TONS of it. A full set of admission paperwork can take 2 hours if not computerized. So if you've done a couple of admissions and four visits, you're looking at a long day and you're getting paid a set salary that doesn't take your additional hours into account. There's a lot of work from home. Phone calls, paper work, faxes. Home for me was no longer the place I counted on for rest and relaxation. The waters were muddied between what was my time and what was company time. It was a very big deal for me so I went back to the bedside on a psych unit. A lot of people leave HH for this reason.

If you do decide to go to HH, go to a company where they give you a laptop. It will save you time in travel and nonproductive office time.

pazrn0704 · Aug 7, 2008

I went from being an ICU nurse for 25 years to try some other things-did telephonic disease management,longterm care-as charge nurse then ADON,DON-now Hospice-have been away from critical care now for 4 years and I want to go back to the ICU direct care situation.

I find that having been so used to dealing with one or two patients and having to know so much about them-I always tried to do the same in the other nursing areas and just found myself getting frustrated-although with my clinical background I was frequently called on as a resource which can be good for feelings of self worth.

The other challenges,such as being on call,clinically and as an administrator,visiting people's homes and not knowing what you will find-are ones which I have never felt comfortable with and which have caused me far more stress than having my patient code as I walked in the door of the unit to start a shift-

I prefer the knowledge that at the end of a 12 hr shift you can feel that you have tangible proof that you have accomplished something or at least you can take away one thing that you did that made a diffenence-the other areas-no such satisfaction

This is just one tired nurse's opinionbut I'm pretty sure I have company in this belief

GrumpyRN63, ADN, RN · Aug 7, 2008

I had worked for 20 yrs inpt, mostly gyn/onc, was getting burned out, decided to give HH specifically onc/palliative/hospice team and I absolutely love it. I do W/E baylor for the benies and still work perdiem in the hospital. At this stage of my life I can't see doing any 'one' job 5 days a week or so. The psychological break between the two is perfect. HH will utilize all your skills, my pts are pretty sick, there's so much autonomy and you really get to know your patients-- it is truly primary nursing at its best. One on one care for an hour or so, completely meeting your goals and feeling you did a completed job, addressing all of your pts needs, physical, emotional and spiritual. I say go for it, you never know :wink2: