Help for Interview in home health!!!

hopeandresilience · Nov 16, 2012

Which home health is this? Just wondering as I'm in LA too and a new grad. Thanks

Home Health Columnist / Guide · Nov 16, 2012

Hospice nurses , especially those who do home visits, should have some expertise behind them in order to provide effective symptom and case management. Same is true for Home Health unless it is a large agency who have sufficient low tech patients or shift work that you can learn how to become proficient in care.

Our agency has given up on hiring new grads as 95% resigned within first 2-3 months as unable to master all the intricacies of paperwork, computer charting, independent judgement, case management and juggling various insurance payers need for authorization-we provide a 10 wk orientation! Too many agencies provide no support for learning nursing procedures/complex wound care, yet alone IV therapy. Learning curve is 3-6 months to get over the newbie jitters. Don't want to see anyone thrown to the wolves.

Zazak · Nov 16, 2012

Hospice nurses , especially those who do home visits, should have some expertise behind them in order to provide effective symptom and case management. Same is true for Home Health unless it is a large agency who have sufficient low tech patients or shift work that you can learn how to become proficient in care.
Our agency has given up on hiring new grads as 95% resigned within first 2-3 months as unable to master all the intricacies of paperwork, computer charting, independent judgement, case management and juggling various insurance payers need for authorization-we provide a 10 wk orientation! Too many agencies provide no support for learning nursing procedures/complex wound care, yet alone IV therapy. Learning curve is 3-6 months to get over the newbie jitters. Don't want to see anyone thrown to the wolves.

Thank you! Wish me luck )))

hopeandresilience · Nov 17, 2012

NRSKarenRN,

I worked in home health as as admin assistant for about 2-1/2 years and was involved in all aspects of paperwork, regulations, went through CHAP, Medicare, Medi-Cal, and Kaiser surveys etc. I am very well versed in all aspects of the required documentation.

I'm now a new grad RN and would very much like to work in home health. I do understand your statement about physical assessment. I have a few points to make regarding seasoned nurses' physical assessment skills. Both in my clinical experiences, as well as home health, seasoned nurses seem to have lost the art of comprehensive assessment. During my clinicals many of the assessments by the staff RNs were a BIG JOKE. Nurses never even listened to lung sounds, for instance, and charted it anyways. I understand why this happens. They are simply too busy to really assess. They may then end up losing their assessment skills. Just FYI I did my clinicals in very well known and highly reputable hospitals. My former boss, an Administrator/DPCS who has been in home health for 20 years, also calls me and tells me how awful the assessment skills are with some seasoned nurses.

At least when a new grad comes out of school, she is fresh with the latest knowledge re: how to assess well. Some nurses I had observed don't even know the latest guidelines. Having said that, it is certainly true that a new grad RN needs MUCH guidance and a great mentor and they will do just fine.

And another issue I have not gotten clarification for in the board. In CA at least, an RN should have at least a year of acute care experience to work in home health or the home health company may get cited at the time of survey. The only way I've learned that the companies get around this, is if a home health has a new grad program. Is that what you had, assuming you are in California? And Zazak, this is why I am very curious as to which home health would take you in as I have not found one with a training program in Los Angeles.

Thank you very much.

rancin98 · Nov 17, 2012

CoP's mandate the nurse must have 1 years professional experience

Ntheboat2 · Nov 17, 2012

I've always heard that home health is a big no no for a first job. I have a friend who took a job in home health for her first job and still says even years later that it was a horrible idea. I didn't think most home health agencies would even hire a new grad. I definitely would be too nervous to take on that job!

Zazak · Nov 17, 2012

NRSKarenRN,
I worked in home health as as admin assistant for about 2-1/2 years and was involved in all aspects of paperwork, regulations, went through CHAP, Medicare, Medi-Cal, and Kaiser surveys etc. I am very well versed in all aspects of the required documentation.
I'm now a new grad RN and would very much like to work in home health. I do understand your statement about physical assessment. I have a few points to make regarding seasoned nurses' physical assessment skills. Both in my clinical experiences, as well as home health, seasoned nurses seem to have lost the art of comprehensive assessment. During my clinicals many of the assessments by the staff RNs were a BIG JOKE. Nurses never even listened to lung sounds, for instance, and charted it anyways. I understand why this happens. They are simply too busy to really assess. They may then end up losing their assessment skills. Just FYI I did my clinicals in very well known and highly reputable hospitals. My former boss, an Administrator/DPCS who has been in home health for 20 years, also calls me and tells me how awful the assessment skills are with some seasoned nurses.
At least when a new grad comes out of school, she is fresh with the latest knowledge re: how to assess well. Some nurses I had observed don't even know the latest guidelines. Having said that, it is certainly true that a new grad RN needs MUCH guidance and a great mentor and they will do just fine.
And another issue I have not gotten clarification for in the board. In CA at least, an RN should have at least a year of acute care experience to work in home health or the home health company may get cited at the time of survey. The only way I've learned that the companies get around this, is if a home health has a new grad program. Is that what you had, assuming you are in California? And Zazak, this is why I am very curious as to which home health would take you in as I have not found one with a training program in Los Angeles.
Thank you very much.

Honestly the owner of the home health is my husband's friend, and they just invite me to interview, and it was surprise that's why I don't know the name, i will tell u later when I find out, a lot of my friends they sad that in La there is a lots of opening in home health for Rn !

greyL · Nov 19, 2012

I know we're all desperate for jobs, but in the state of California it is illegal for home healths to hire new grad nurses under Title 22. The only way around this is for the home health to apply for a waiver of the required 1 year nursing experience, but that is extremely difficult and takes time for the Licensing and Certification office to approve it. The waiver is usually only granted in more rural areas of California.

So I guess you've gotta ask yourself if you really want to be working for an agency that does not follow State regulations.

hopeandresilience · Nov 21, 2012

I always wonder what these home healths do come the time of survey. Someone posted at a another thread that one company didn't pay the new grad for the home visits. Maybe they used a seasoned nurse to refill all the paperwork instead. The paperwork is very involved and the home health company can tell whatever it wants to a new grad, as she won't know any better. There is a lot of scam going on in home health. I'm sure they're figured out how to use new grads, too, and for cheaper, and to hide it from surveyors.

Regardless, I would certainly love to do home visits but I guess it has to wait since I'm a new grad.