Gaining experience/knowledge in HH

I greatly empathize with you. I've been a RN longer than most of you have been alive. My primary experience in years gone by was in some high level and complex ICU/trauma units, ER's with a short stint on Med-Surg (those are some hard working people!!). Personally, I think I'm a darned good nurse. However, working in those areas I never had to deal with wound vacs. I'm not well-versed in wound assessments/treatments. Those are things I'm having to learn now and part of what I like about home health - the new challenges.

As for the family member saying you don't know enough. True. You are not a walking encyclopedia of nursing knowledge and good luck to him on finding that person. We nurses tend to try to set ourselves up as "specialists" of sorts when in reality most of us are "generalists" and especially in the HH arena. Jack of all trades, as you said. And you know what, 99.9% of the time that is the perfect thing for HH.

We are in the home for a very short period of time. We can't address and/or undo years of bad habits, bad health. We can only do our best for the 45 minutes a week we are there. And yes, just like in the hospital or SNF, you will occasionally "miss" something in the flurry of activity. Your're fine. Hang in there and know that you will always do your best.

Thank you for your feedback and perspective. You are absolutely right about setting ourselves up as specialists when we're very much generalists. It'd be impossible to be experts in everything we encounter: wound care, cancer pain, palliative care, nutrition, diabetes educator, cardiology, pharmacology.... That reminds me of another thing I was recently asked in the home. The pts family member asked me to read a copy of their EKG strip. I literally have not done that since nursing school. Maybe it's the demographic I serve because I do feel like I get put on the spot quite often and am expected to be a little doctor. Thank you, thank you for the reminder that we won't be able to fix it all in 45 minutes once a week (or even daily for 9 weeks).

I concur with the other poster that of course you cannot know everything and should not feel bad about that. You can and should use whatever resources are available and fill in the rest with educational Youtube videos, internet ed etc. Also the wound vac , PCA pump companies etc should provide their own ed materials, maybe you can call them directly if unable to troubleshoot and they can walk you through it, i have done that before. Also, be careful what you are telling pts becuase they do ask many questions and some should be referred to the MD, you can try to call while in the home to have questions answered, i have done that also but it is usually hard to get the MD on the phone. You will pick up tips yourself and figure those things out (troubleshooting etc), it will get easier with time. Sounds like you are doing OK and probably premature to make the jump to TJ's lol. Best wishes!

Thanks Daisy4RN!

Sometimes I get suckered into thinking I should have all the answers when they really should be going to their MD's. I like calling the MD in the home, then the patient can see my effort to help them. Even if it's just leaving a message with the medical assistant.

Thanks Caliotter3!

That's a great idea. I'll ask my supervisor about getting some reps in after our case conference meetings once a month. I was just pondering the fact that we have all these inservices on Oasis and billing but literally nothing on improving patient care.