Community Palliative Nursing - New Graduate

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Hi everyone,

I graduated in June, passed my NCLEX the same month, and been job hunting since. I got a formal job offer three days ago (August), for an independent home care agency (affiliated with a reputable hospital) with a strong focus on palliative care.

During the interview, they mentioned that there is paid two orientation workshops and during my initial shifts, another experienced nurse will be with me for at least two hours. No benefits as a casual, but the pay is great, no need to work STAT holidays, flexibility with schedules, and overall it seemed like a very supportive environment (mentioned they can sponsor new graduates for workshops/courses they are interested in specific to home care/palliative). They said for HH they don't typically hire new grads but there's been an influx of senior nurses retiring/less hospital beds/more acute patients needing the hospital beds etc so they need to utilize the nurses that they have and seem to want to invest in us. The Supervisor said not to worry and I won't feel "alone" when I mentioned that I've never worked independently before and told them my limitations (technical skills etc).

I also overheard them on the phone refusing to let one of their staff nurse go into one of the patient's homes due to home not being close to a subway train as they do not drive (which indicated to me they actually care about their staff!)

However...safety, to me, is the utmost importance. It almost sounds to good to be true - being a new grad and my dream job has always been to work in the community as an RN case manager and this seems like a great opportunity to see whether I'll enjoy working with patients and their families in their homes.

I was told it would be 1:1 patient care and that the shifts would range from 10-12 hours, including evenings if I wanted to work.

Can someone give me some advice on 1:1 community nursing is like? Pros/cons?

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Specializes in Public health program evaluation.

Will you be a home visit nurse or a home shift nurse? My company is hiring me (new grad) as a shift nurse to give me experience before moving on to home visit nursing. In both positions you are on your own, but the shift nurse gets an orientation to each new client with an experienced nurse, whereas a home visit nurse is expected to have the knowledge base to make assessments on "new clients". Also, the visiting nurse typically has an hour long appointment with each client, whereas the shift nurse stays for 8-10 hrs.

I'm wondering if your employer has a similar setup. I was nervous about being a home visiting nurse without having more experience in med-surg or critical care, but I understand that the pressure is on to fill job vacancies and experienced nurses don't find the community salaries to be attractive.

I have been working as a community PSW for 3 years (during nursing school) and I loved it. I think the job satisfaction comes from the management team you are working with and it sounds like yours is great. My prediction is that you will love this job and become a great case manager.

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I will be a home shift nurse as it turns out. You are spot on in terms of the scope of practices of a shift care nurse vs home health nurse and we have a strikingly similar workplace.

I do advise starting as a shift care worker to get the feel of it. I just finished my orientation and I really enjoyed the 1:1 with clients and families. Do you work with a certain client population?

My long term goal is to be a case manager in the community but since I don't have any recent and relevant medical background, I decided to work on a medical unit as well (recently got hired). I hope to keep both jobs to get my foot in the door both in the community and medical setting. I was also worried with my lack of experience and limited critical thinking/nursing judgement once I am a case manager, so I know I had to get back on the medical floor. I'm going to tough it out even though I get apprehensive at the thought of being back on a medical unit...

I don't know where you're from but I am part of a New Graduate program and I'm excited that I will have additional training/orientation and buddy shifts on the medical unit. I encourage you to do it too and take advantage of your New Graduate status (if available in your area).

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