Critical Care to Home Health?

[LovesDogs706]

Hi all!

I have a couple of questions in general. I'm a nurse with 3 years of experience mainly in CCU recovering open heart patients. So, very busy, very intense. I've been working night shift this entire time and I am really looking for a change in scenery. Home care seems to fit the bill. I just got an interview for a day shift Home care position with a local hospital. It's a good teaching hospital (Magnet) as well and closer to home than the hospital I work at.

I am just tired of 12 hr shifts, night shift, no hope for day shift (been begging for days for years now), stress, difficult patients, feeling like the WHOLE world is on your shoulders, critical patients, going home and worrying about these critical patients, you know.. the whole deal!

So anyway, generally just wondering has anyone from critical care made the switch to home care and if so, how do you like it?

If you work home care for a hospital are you usually just doing visits? I don't know, but kind of assumed that the agencies do more of the shifts and hospitals do more of the visits (Following up on their previously hospitalized patients?) Is that how it works? And do hospital home cares generally pay more, have better benefits, etc? I am mainly concerned about making about the same money, having good benefits still, etc. I am thinking I may find more stability with a hospital home care as well, but just asking in general.

I just really need to decompress and I feel like home care may be a breath of fresh air with a day shift schedule, minimal weekends, NO HOLIDAYS (hallelujah!!!), and no nights!

Thanks for any input you guys can give me! :)

[kiszi, RN]

Ok, I'll try to answer what I can. I have worked in home care for a hospital and through an agency. You are correct in that the benefits, pay, etc. are generally better with the hospital. You are also correct that home care through a hospital system generally involves intermittent visits as post-hospitalization follow up, with some long term cases for things like monthly foley changes, etc. but still intermittent visits. Agency home cares seem to have more of the shift work but some of these do intermittent visits as well. Consistency of work can vary with both.

Hospital - I worked every 3rd weekend and two holidays per year. I also case managed up to 30 patients, scheduled all their visits, and made most of them. I would be home in the early afternoon most days but then there is computer charting, follow up phone calls, making calls to pts for the next day, maintaining/inventorying supplies kept in your house/car.... The stress was worlds less than the hospital unit but you will still find yourself worrying about your patients, maybe even more so in a way because there is not another nurse that takes over for you.

Agency - I have one full time shift work case. I do my work and go home. Virtually zero stress. Work every other Saturday, no Sundays, no holidays. Pay and benefits are terrible. I am looking for PRN work in the hospital.

[HHRN81]

I worked in critical care before moving to home health. I work for a hospital. We do intermittent visits. I don't have any agency experience to compare too, but I am paid hourly with the same benefits that I received in the hospital. I am an admit nurse, I don't case manage which is awesome. I have a ton of paperwork and charting, but I don't have the stress of the constant follow up that our case managers do.

It is really hard to compare working in home health to working in ICU. Home health is not a cushy job. It requires good assessment skills and good attention to detail. Are you sure you will have holidays off? We are open 365 days a year and always have a nurse on call. I work 2-3 holidays a year and a weekend a month.

I love the flexibility I have with home health. It has been great for the health of my family. I am lucky that our department has very realistic expectations for visit amounts and since we are paid hourly we do not have to donate our time. Best of luck to you!