Is Home care a good choice for New Grad?

tokmom, BSN, RN · Nov 25, 2011

I guess it depends on where you want to go, but if this is all you can find and you need to put food on the table, I guess you take it, you know?

IMO it looks better than no experience.

Meriwhen, ASN, BSN, MSN, RN · Nov 25, 2011

IMO...no.

Home health means that you will have little training and little to no supervision when you're on the job, so if anything happens it's on you 100%. You've got to make the decisions and judgement calls on your own. There's no backup staff down the hall for you to call for help. There's no supervisor to come in to take over for you and make things right if they've gone wrong or if the patient's unhappy. Plus the fact that you have no experience would paint a big red target on your back as far as lawsuits go should (God forbid) something goes wrong. And should something happen, your BON won't be as sympathetic as you think: their primary concern is protecting the public, not new grads who got themselves in over their head.

IMO new grads don't have that clinical judgement skill set yet, unless they were prior LPNs/LVNs who worked for several years prior to becoming a RN. I'm sorry you're having a hard time finding a job, but I don't think home health is the best choice for a new grad. I don't think it's worth the potential risk to your license.

If you insist on doing it, go through an agency so you get some training and support.

Your mileage may vary with this advice. Good luck whatever you decide!

Infermero · Nov 25, 2011

Thank you very much for your instant openions.

Cuddleswithpuddles · Nov 25, 2011

IMO...no.
Home health means that you will have little training and little to no supervision when you're on the job, so if anything happens it's on you 100%. You've got to make the decisions and judgement calls on your own. There's no backup staff down the hall for you to call for help. There's no supervisor to come in to take over for you and make things right if they've gone wrong or if the patient's unhappy. Plus the fact that you have no experience would paint a big red target on your back as far as lawsuits go should (God forbid) something goes wrong. And should something happen, your BON won't be as sympathetic as you think: their primary concern is protecting the public, not new grads who got themselves in over their head.
IMO new grads don't have that clinical judgement skill set yet, unless they were prior LPNs/LVNs who worked for several years prior to becoming a RN. I'm sorry you're having a hard time finding a job, but I don't think home health is the best choice for a new grad. I don't think it's worth the potential risk to your license.
If you insist on doing it, go through an agency so you get some training and support.
Your mileage may vary with this advice. Good luck whatever you decide!

I definitely agree with everything you have said.

I entered home health care as a new grad LVN. I went through an agency, started with clients who were relatively easy and had adequate orientation with another LVN. I always had supervisor RNs available through the phone. These factors are incredibly crucial that, even now as a more experienced RN, I would not go without them.

In addition to the points Meriwhen has raised, I would like to add another: Patients and their families are often unfamiliar with what is reasonable to expect from a nurse who is providing care in their home. I have been asked to do things that could jeopardize my license such as administer OTC meds that were not prescribed, drive clients to doctor's appointments and provide them foods or beverages that are no-no's according to the doctor or dietician. Some situations were a lot more hazy than the aforementioned examples, and I definitely needed my supervisors' input before proceeding. Infermero, in the home care job you described, you may be asked to do iffy things but have no one to turn to readily. You can ask more experienced RNs online and offline but you may have to share so much information that you risk breaking HIPAA.

06CaliforniaRN · Nov 25, 2011

I'm a new grad myself, but one of the nurses I worked with said she started out in home health and found it to be very valuable. In her own words..."Let's just say by the time I got a hospital RN job I was able to put in an NG tube with one hand on a toddler"

And if you think about it, it's true, you can become great at a lot of fundamental skills in home health, which will make hospital nursing an easier transition. It obviously doesn't amount to starting in hospital nursing with a variety of patients; HOWEVER, you could always get the home health job, and if you are able to get a hospital job down the road, you can still pick up a shift a week of home health (you wouldn't have to bail on them), I know a couple fellow classmates that have gone this route

Good luck!

LoveMyBugs, BSN, CNA, RN · Nov 26, 2011

I started out doing peds home health, I was with a terrible agency and recived no training and there was no RN on-call, one of the assingments I was told "just read the nurses notes to figure out what to do":eek: I was taking care of medically fragile kids with no back-up.....very scary

I see now that it was not okay, as a new grad desperiate for a job needing expereince I went with it.

Sometimes you don't know what you didn't know untill you know it. :clown:

I would not recomend a new grad doing home health, apply to SNFs, LTC then go back to home health. I know LTC/SNFs are not everyones dream, but they are enough to get your feet wet before stepping out on your own in home healt.

IMO; any home health agency who is willing to send out a new grad without exentsive training is not an agency that you want to be working with

MN-Nurse, ASN, RN · Nov 26, 2011

IMO...no.
Home health means that you will have little training and little to no supervision when you're on the job, so if anything happens it's on you 100%. You've got to make the decisions and judgement calls on your own. There's no backup staff down the hall for you to call for help. There's no supervisor to come in to take over for you and make things right if they've gone wrong or if the patient's unhappy. Plus the fact that you have no experience would paint a big red target on your back as far as lawsuits go should (God forbid) something goes wrong. And should something happen, your BON won't be as sympathetic as you think: their primary concern is protecting the public, not new grads who got themselves in over their head.

I used to work in home care as an aide and I have many classmates who work in home care as RNs now.

Nothing I experienced nor anything they are experiencing is anything like what the above poster describes. At all. They all received training and are precepted on the job with clients.

If I didn't get the job I have, I would definitely be working in home care and I would be doing fine.

Meriwhen, ASN, BSN, MSN, RN · Nov 26, 2011

I used to work in home care as an aide and I have many classmates who work in home care as RNs now.
Nothing I experienced nor anything they are experiencing is anything like what the above poster describes. At all. They all received training and are precepted on the job with clients.
If I didn't get the job I have, I would definitely be working in home care and I would be doing fine.

And that's great, but not every home health job is like that. That's why I recommended that if he insist he do it, he should go through an agency so he gets some training instead of answering an ad on his own...and even then it's a matter of finding an agency that will provide good training and percepting. Even so, I still don't think it's a good move for a new grad though.

tcvnurse, BSN, RN · Nov 26, 2011

Every home health agency I have ever worked at has required at least a year experience at a hospital. They do that for a good reason. I can't even imagine a brand new grad as a home health nurse. Because there is just too much that can go wrong, and end up over their head and the grad might not even realize.

Also, new grads sometimes can't tell OMG YOU NEED 911 NOW from LETS WAIT AND SEE.

Not worth the risk, IMO.

Blackheartednurse · Nov 26, 2011

I have been working as a home health nurse for the almost two years now and although it is rough I'm making it. Going from having a few patients now I'm the nurse with the heaviest case load and yes I started out as a new nurse with no experience, I got lucky because my boss is very understanding and he carefully plans my assignments. My boss tells me all the time I'm doing great which boost my confidence and this job gave me an opportunity to get a second part time job also in a home health nursing, thanks to this job a almost year ago I almost got an opportunity to work in a prestigious hospital (they wanted more home health experience, I only had 6 months back then) So I say home health job is better than no job, at this point I dont even know if I would like to work in a hospital, I make a decent pay (just like in a hospital), make my own schedule and have no boss spying on me all the time, I dont have to rush like a maniac and I dont stress out so much although it is a physically and mentally demanding specialty, but I understand what the opponents say, basically in the field you are on your own,carry your own weight and risk like I said I got lucky, I just regret I didnt started out in home health sooner, like right after graduation, I was afraid to work in such independent field and I wasted one year of doing basically nothing.

KateRN1 · Nov 26, 2011

Check out the home health forum for more information on what home health care nursing is really like. It is almost NEVER a good choice for a new grad.