HH GN Internship

Cmyst · Feb 17, 2005

. This is my question...Does a 6 month internship program change your opinion any on whether or not HH is a good idea after school?
Any opinions are greatly appreciated. Thanks.
Cindy

I would guess it would depend on just how structured and supportive such a program really was. If it's a good one, then -- yeah.

I know where you're coming from. I wanted to do *anything* to stay away from floor nursing, and I did, for nearly 12 years. But I also spent 3 years as an LVN in the Urgent Care unit of the ER, and six months as an RN in the regular ER. And when HHC became hard to work in due to instability shortly after OASIS, I did Telephone Triage and clinic nursing and finally -- I ended up on a Med/Surg floor in a really big, busy urban hospital. I just ended a three year run as a Med/Surg nurse, and it was every bit as grueling as you think at first -- but I adapted. The money was certainly a lot better than I can get doing HHC, I'll tell you that. IMHO, I learned much more about assessment and teaching, and holistic nursing care, from being a home health nurse. If this program is a good one, and if you get good basic assessment skills training, then it will work -- but remember, the less stressful nursing jobs often don't require the sheer numbers of nurses, which means that it can be hard to find another HHC job if something happens to yours. Without the experience of working a hospital floor, it can be hard to then get a job in the hospital, if need be. It isn't fair, and it isn't accurate, but many hospitals do not view HHC nursing experience as "real". That was another reason I went into Med/Surg floor nursing; I wanted to travel, and no travel agency thought that I had the necessary experience to hire me, despite nearly 10 years of full-time work as an RN!

So, if you're sure this is what you want, then go for it. But if you find that you need to go into Med/Surg, look towards the positives of the experience and not just the negatives.

renerian, BSN, RN · Feb 18, 2005

Part of the experience on a busy med surg or other busy floor is the development of your assessment skills. You just cannot do that as quickly without a high degree of exposure to many illness states. Just my thoughts. I have done home health since 91 and without a solida assessment base I would have been sunk for the times I walked in a patients home and said, Wow you need to go to ER for blah blah blah. You can just look at people and alot of times know what is wrong.............

renerian

alintanurse · Feb 18, 2005

I completely agree with renerian,I am so glad to have had my years on the med/surg and ortho floor. You need alot of nursing experiences to make a successful transition to home health (in my opinion) because of the autonomy issues,it will add to your confidence in handling some of the difficult situations you will deal with. I find that the pts. and familiy can be very critical of a nurse they feel lacks experience.

CardioTrans, BSN, RN · Feb 26, 2005

Depending on the amount of true structure of the internship, then it might be ok. As many of the others have said, you need excellent assessment skills in home care. You are the eyes of the physician. You must know the ins and outs of many diseases. In the hospital a patient may only be being treated for one problem. In home care, you may deal with a patient who has CHF, COPD, HTN is a diabetic with a wound. You treat the whole person, not just one thing. You teach symptom control, diet, exercise, wound care, medications etc. You become familiar with the patients, their families, their home. Just yesterday, I went into a patients home who I have been seeing for months. She was still in the bed at 1030 and was covered in urine, and had been in the bed for 2 days. Her BP, HR were elevated, her temp was 102, and she was unable to move. First thing that struck me as odd with her was her still being in bed at 1030, she usually greets me at the door. After I completed my assessment and got her vitals, I called the physicians office and asked if I could send her to the ER. She was sent by ambulance and admitted to the hospital. The nurse in the MD office at first said "tell her to take Tylenol for fever and wait til Monday". Not an option for me, because I knew that something else was wrong, couldnt quite put my finger on it, but just knew. I did everything that I could to get her clean and dry before sending her to the hosp, but she weighs 260 lbs, and couldnt move, and I only weigh 115. I called my office to have our social worker contact the hospital to speak with them about the condition I found her in. If the house would have caught on fire, she would not have made it out. When her son and daughter were called to let them know she was being sent to the ER. Their comment was "call me when she comes home"

Anyway, back to the main subject. In home care you do have to have excellent assessment skills, with medical problems, as well as social or family problems. If the internship gives you all of that, plus having a resource person, then its a good thing. Make sure that it has lots of documentation and Medicare guideline issues in it as well.

Good luck to you!