Home care psych RN job offer...input please!!

[jamkpb]

I have my 2 years of hospital nursing in (I graduated in 2007) and I am looking for non-hospital based jobs. Prior to my BSN I worked for over 5 years w/addicts/HIV..so that's my "behavioral health" experience as most of the clients had dual-diagnoses. I've facilitated groups and have done case management/addictions counseling. I've experienced the addictive personality...manipulative, liars, staff splitters, victims of trauma, etc.

There is a position I interviewed for and they are interested and they are offering close to a $7/hr pay increase from my current position. So here's my dilemma..

1) am I really qualified?

2) they require home visits, whether they be in an independent setting (i.e. apartment) and community based settings. I did ask about safety, as that is a concern of mine. They assured me that initial assessments are done w/a mental health clinician and if I feel unsafe to call 911. Unfortunately, the area is very "shady",a lot of crime and drugs.

This is a newly created position, so there are no other RN's to get feedback from.

[Itshamrtym]

Sounds like a fabulous job, except for the unsafe areas that you would have to go to..!!!!! Don't know about this one... $$$$$$$$$$$ NOT worth your safety!!!!!! Good luck... keep us posted!!!!!! (P.S. It sounds like you are very qualified otherwise)

[Whispera, MSN, RN]

It seems to me that a good percentage of home visits would be to clients who have schizophrenia. People who have schizophrenia, when they are not stable, can be very difficult. You didn't mention experience with schizophrenia. This is a concern!

As far as safety goes, calling 911 only is helpful if you're able to call. Going into a questionable environment is....well....questionable. Your information about yourself doesn't say if you're male or female. If you're a big burly man it's one thing. If you're a little pretty woman, it could be another another.

Would you be permitted to refuse to see a client that you thought might harm you? Would you be permitted to refuse to go into a dangerous neighborhood, building, or situation (tense family stuff, etc.)? I think those questions need answers before you take the job. In other words, how does the agency back you up besides saying you can call 911?

[jamkpb]

It seems to me that a good percentage of home visits would be to clients who have schizophrenia. People who have schizophrenia, when they are not stable, can be very difficult.

My experience has entailed clients who are on meds and stable

If you're a little pretty woman, it could be another another. I'm a petite woman

Would you be permitted to refuse to see a client that you thought might harm you? yes, I was told that if I didn't feel safe, to trust my gut and that the organization puts safety first

I am not sure if there are ways to know whether someone has been consistently taking meds before I would be going to do my visits. That is certainly a concer of mine

[ArizonaMark]

Should you decide to take the position, dress the part. In other words, I would not go into a sketchy area of town dressed too conspicuously. Blue jeans, a simple top, so on. Perhaps a personal protective device of your choice, mace, a loud horn perhaps. Definitely a cell phone with auto 911.

And, go with your instinct. If you feel unsafe for some reason, if your hair stands on end, leave first, ask questions later.

My two bits from a former bounty hunter, correctional officer, street urchin as a youth.

ps You'll likely know if your patient has not been compliant with their meds the moment you walk in the door.

Mark

[caliotter3]

I am speaking from my experience. I was assaulted in a home while doing home care. When you are assaulted in a home or are involved in violence going to or from work, it is a different situation than when you are at work in a facility. The support just isn't there. For that reason, I don't believe the pay increase is worth the risk or the worry.

[jamkpb]

Thank you all for your input...I decided not to take the position b/c of my safety concerns. Hopefully it brings me one step closer to my dream job!