I've been at it nearly 4 years now. If I walk away from it, it will be due to sometimes working 8 hours, and only being paid for 5. That can happen on a bad day, because we only get paid per visit, and our travel time isn't paid either (we do get mileage, though.)
There's a lot of paperwork, and you spend a lot of time on the phone, talking to case managers, doctors, ordering supplies, etc., etc.
The upside is I love being independent, and it's great to be able to develop a relationship with a patient, see them in their own environment, get to know who they really are. And, of course, see them get better. Or, in the case of palliative care, help them accomplish the final tasks of their life, and, if they desire it, help them to die in their own home.
I find I generally have a better relationship with the doctors than hospital nurses do. You are their eyes and ears, and they have to listen to you. Most of them do, and it's really nice to have your opinion valued. I can think of only a few time in the past 3 years when I've encountered a doc. who was a real idiot. The worst was a GP whose pt. had had hip replacement surgery, fainted, and dislocated the hip. She was on total bed rest, and having really bad headaches. She was on Fragmin (Low molecular wt. heparin) which meant there was the possibility of an intracranial bleed, but she also had a history of migranes. SOOOO....I figured the GP was the best person to ask.
His reaction? "What are you calling me for? I've never even heard of this medication (fragmin). You should be calling the surgeon..."
"He's in surgery all day. I can't get ahold of him..."
"Well, don't bother me just because I'm easier to get ahold of. I didn't even know she'd HAD surgery!"
Sheesh. Wound up taking to the hematologist who'd seen her for all of 5 minutes before prescribing the Fragmin. He told me to send her to the ER.
Patient refused to go. I agreed, it wasn't necessary, unless she started to have neuro symptoms.
Then, I went home, and had guilt pangs all night, because I hadn't done what the doctor said, and WHAT IF???
By the end of the week, the headaches were gone, and she had found herself a new G.P. (surprise,suprise!)
That was one of the bad times. The good times are the times you know you've made a difference. I've saved a few lives over the years when I've found a few people lying on the floor, too weak to get up. One was a diabetic, who definitely wouldn't have lived much longer if I hadn't visited that day. Other times, the rewards come from simple stuff, like being able to offer reassurance, for instance, to say, "I've seen dozens of cases just like this (cellulitis) and most times, the infection is better in 3 days." Or..."The vast majority of people sail through chemo with maybe some mild nausea, fatigue and malaise. It's nothing to be scared of." And when things DO go wrong, community nursing allows a lot more opportunity to do some hand-holding and provide a shoulder to cry on than hospital nursing does.