Coming into Home Health

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Here's something I've been reading about here and seeing on the job..

Home health often seems to be the escape someone is looking for, or the lure of more time with patients or a flexible schedule. It's nearly always something more promising than what someone is currently doing. It's rarely anyone who went to school to get into home health.

What I don't see is many having done any indepth research prior to hire. I don't think I've ever had a new orientee who had prepared by with a CEU course on HH. And my ride alongs don't come into it with much information. It seems they are looking to us, potential employer and coworkers, to give them a glance before choosing and starting in this completely different field.

I entered HH back when it was simple and easy, remember BID dressing changes? I came into it in the same way and for the same reasons as listed above.

I think anyone here who is asking about HH is starting to do the research but how unprepared I think we tend to be versus going into another field. Most places expect new hires to be productive relative early, but trying to be productive while still learning the basics is so over whelming.

Anyone agree? Did you or have you noticed the underestimation by nurses new to home health? Do you think there is anything that could better prepare someone considering HH?

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Specializes in FNP- BC, Med-Tele, PCU, Home Health Case Manager.

I think because there is a lack of emphasis/education on HH in nursing school. My school barely touched on it and there were definitely no clinicals to give us an idea about what it is. It is too bad too, because it's a field in need of RNs and only growing. I have always been in love with the concept of HH and the schedule and autonomy is what peaked my interest. So I networked and asked around to people I know who work in the industry, also have been looming on AN HH board for at least 6 + months before I decided to start applying to jobs. I know HH will be challenging...I know in the beginning, I may question my choice of transition, but I am very unhappy at my current job and know that acute care hospital nursing is not for me. I only hope that this change in specialty, will bring me the happiness that I've been searching for in nursing and allow me to be a good momma to my young boy. :)

As far as being under prepared for the switch in specialty, I think the HH company's should be investing time in new hires to train. Is it possibly the census being so high, that is causing them to not be able to give new hires more training? I requested at least 6 weeks of training before going out on my own and this HH company granted it to me. I know in the hospital, usually when you switch specialties they require a residency (12 weeks with a preceptor) if no prior experience, but lately are taking experienced floor nurses and only giving them 2 weeks of orientation to a new specialty due to high censuses and the need for more staff. I think overall, nurses are under prepared when going from nursing school to the real world of nursing, and then when switching specialties. It's unfortunate because in order to keep great nurses and stress levels down, they should be investing time into training them. That's just my observation. ;)

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I think because there is a lack of emphasis/education on HH in nursing school. My school barely touched on it and there were definitely no clinicals to give us an idea about what it is. It is too bad too, because it's a field in need of RNs and only growing. I have always been in love with the concept of HH and the schedule and autonomy is what peaked my interest. So I networked and asked around to people I know who work in the industry, also have been looming on AN HH board for at least 6 + months before I decided to start applying to jobs. I know HH will be challenging...I know in the beginning, I may question my choice of transition, but I am very unhappy at my current job and know that acute care hospital nursing is not for me. I only hope that this change in specialty, will bring me the happiness that I've been searching for in nursing and allow me to be a good momma to my young boy. :)

As far as being under prepared for the switch in specialty, I think the HH company's should be investing time in new hires to train. Is it possibly the census being so high, that is causing them to not be able to give new hires more training? I requested at least 6 weeks of training before going out on my own and this HH company granted it to me. I know in the hospital, usually when you switch specialties they require a residency (12 weeks with a preceptor) if no prior experience, but lately are taking experienced floor nurses and only giving them 2 weeks of orientation to a new specialty due to high censuses and the need for more staff. I think overall, nurses are under prepared when going from nursing school to the real world of nursing, and then when switching specialties. It's unfortunate because in order to keep great nurses and stress levels down, they should be investing time into training them. That's just my observation. ;)

Even with a reasonable orientation there are unique responsibilities that take awhile to sink in with clarity. Home health I believe is the only field where the field staff are directly responsible for reimbursement, we have to know what are reimbursable services and how to document to that in addition to very strict compliance requirements, in addition to learning how to be a nurse in a completely different setting with resources you must learn. The varied amount of info needed to function smoothly is enormous. Getting a jump start on understanding the Medicare regulations and state compliance policies so that you can focus your orientation on learning the SN role, how to schedule your day, how to obtain orders, where are the labs and their protocols etc etc will make your experience much easier and get you rolling without being so overwhelmed. IOW, doing the textbook work pre-emptively on your own will pay off for either a better understanding of the job or an eye opening that HH isn't for you, though honestly most hold tight to the idea that it's the employers' responsibility. Of course it is, but that mindset will likely add months to your transition.

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Specializes in FNP- BC, Med-Tele, PCU, Home Health Case Manager.

Do you have suggestions for information on regulations etc to prepare myself? That is a great idea to get a jump start! :) any helpful advice would be greatly appreciated!

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My school actually had home health clinical days where you got to be with a nurse (who does visits) and you got a small taste of what it's like. I think more schools should prepare you for the home health field.

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This is a brief explanation of the Medicare home health benefit, all insurances follow Medicare guidelines with the exception of requiring pre auth and not being as generous with the number of visits.

http://www.medicare.gov/Pubs/pdf/10969.pdf

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For a preview of Oasis, the basis of home Health documentation, you can search the Medicare site, forums, CE. The more you are familiarized going in the quicker you will grasp it and move onto other aspects of orientation. And the less corrections that will come back to you.

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Specializes in FNP- BC, Med-Tele, PCU, Home Health Case Manager.
For a preview of Oasis, the basis of home Health documentation, you can search the Medicare site, forums, CE. The more you are familiarized going in the quicker you will grasp it and move onto other aspects of orientation. And the less corrections that will come back to you.

Thank you Libby!!! Very much appreciated :)

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Specializes in Rehab, Psych, Acute care, LTC, HH.

Thanks Libby187. I downloaded Oasis manual, scanned the CMS website, and networked with someone who has done HH for years as a resource before I even start my new job April 6th. This was good advice on your part. Think I am going to love the autotomy of HH and learn the business end of learning what is going to be reimbursted by insurances. HH is valuable and a good background for case management.

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