Home Health...Can I do it? HELP

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Specializes in Neurology- briefly, Oncology/Hematology.

Hello! I am currently a nights RN on a neuroscience floor. I graduated from MU in July and have been working since August. I've dealt with central lines, gastic tubes of all types and feedings, IV therapy, blood administration, and I float to floors all over the hospital. I have only successfully started about 3-4 peripheral IVs. That's probably out of about 5-7 attemps. My biggest area I could improve on is self confidence.

I might have an interview for home health in my area. I know I'll be on my own, so second opinions probably won't exist. If I get stuck I'm the only one there, and that does make me nervous. However my confidence is improving every day and I think I have great critical thinking skills.

I want a job that is a calmer pace than the hospital, but I still feel like I'm utilizing my skills. So I need some help. Can anyone give me a good home health overview? Do you think this area of nursing is for me? Thanks!

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For most stress relief you will probably want to do extended care, also called continuous care or shift work, rather than intermittent visits. At least in the beginning. In extended care, you do one shift with one patient, produce one nurses note, and only drive to one home, typically, each day you work, unless you choose to do more than one shift. You can choose how many clients and how many days and which shifts you work each week. You can have a set schedule if you want. Most of the frustration comes when you work with intermittent visits. Lots of miles on the car and in many situations, lots of uncompensated work time doing paperwork, calling MD, etc. Before you interview for the first time, think about whether you want to do extended care or intermittent visits as a start. At any rate, your present experience will set well with the interviewer and you should have no problem getting hired. Good luck and hope you like hh.

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Hello! I am currently a nights RN on a neuroscience floor. I graduated from MU in July and have been working since August. I've dealt with central lines, gastic tubes of all types and feedings, IV therapy, blood administration, and I float to floors all over the hospital. I have only successfully started about 3-4 peripheral IVs. That's probably out of about 5-7 attemps. My biggest area I could improve on is self confidence.

I might have an interview for home health in my area. I know I'll be on my own, so second opinions probably won't exist. If I get stuck I'm the only one there, and that does make me nervous. However my confidence is improving every day and I think I have great critical thinking skills.

I want a job that is a calmer pace than the hospital, but I still feel like I'm utilizing my skills. So I need some help. Can anyone give me a good home health overview? Do you think this area of nursing is for me? Thanks!

There are a variety of stressful factors in home care.

Just for example, one of the agencies I work for told me today that the paychecks did not arrive and the owner of the agency is not available due to an emergency.

I have had several paychecks bounce in the last year and have worked for several agencies that no longer exist for various reasons.

Be careful about the agency you work for. Times are difficult for home health agencies these days due to multiple factors such as reimbursement, recovery audit contractors, fraud and excessive numbers of agencies making it difficult to keep census stable or make enough to pay the employees. Good luck to you.

There is no aspect or type of home health nursing that I would ever recommend to anyone.

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Specializes in jack of all trades.

I went from chronic dialysis to working HHC and LOVE it. Fortunately I bounced into a good office with much support from my co-workers. I honestly wish I had done it long long time ago. It all depends on who you work for and how the immediate managers are. I had to go do a start yesterday on a wound care pt that I really felt stumped on and had much support to call and give me advice. I heard someone in another thread say "any bad day in hhc is better than any day in the hospital" and I agree. At least it has worked for me.

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Specializes in COS-C, Risk Management.

You can read all sorts of threads here that will give you a good idea of what home health entails, but I can tell you that it's not for someone with little confidence. You have to be confident in what you're doing and what you're teaching.

On the brighter side, don't feel bad about your IV skills. Everyone has their own best skill set and it's really a very small part of being a nurse. IVs were never my best skill, no matter how much practice I had, but I can draw blood from just about anyone and never met an NG tube I couldn't sink. You learn what your best skills are and "trade" them when you need to.

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Specializes in Neurology- briefly, Oncology/Hematology.

Thanks everyone! This is really helpful so far. Kate, I think my confidence is growing rapidly, and as long as I can call someone if I get stumped I'll feel better. I'm asking for less and less advice/help at work already. As far as the agency goes, they sounded like they would probably give me an interview before even looking at my resume. That made me nervous. Are they desperate? But then I looked at their website. They are the largest HH provider in eastern MO and southern IL. They've been around since 1917 and they offer employees tuition reimbursement and competitive pay. Sounds pretty good huh? Lacie, thanks. I've heard that too. I feel like I might cry or puke at the hospital some days. I usually don't have time to pee. My shifts run over 12hrs frequently. Caliotter, is that one patient service something all HH agencies provide?

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To your question about one client. There are basically two types of home health work for the field staff. Intermittent visits, where you visit several clients in one day or extended care, where you work with one client for a shift that can range from four to 12 hours in length. Some agencies offer both types of work, while other agencies offer one or the other, but not both. If you know for a fact that you don't want to do one type of hh nursing, it is probably best to call the agency beforehand and determine whether they offer the type of work that you are willing to accept.

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Specializes in Hemodialysis, Home Health.
I went from chronic dialysis to working HHC and LOVE it. Fortunately I bounced into a good office with much support from my co-workers. I honestly wish I had done it long long time ago. It all depends on who you work for and how the immediate managers are. I had to go do a start yesterday on a wound care pt that I really felt stumped on and had much support to call and give me advice. I heard someone in another thread say "any bad day in hhc is better than any day in the hospital" and I agree. At least it has worked for me.

I did the same thing several years ago, Lacie... outpatient dialysis to HH. Soooooooooo liberating !!!

And like you, I was fortunate enough to have found a really, really GOOD agency with tons of support ! :up: :) :up:

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i'd work pt in hh first, while holding down your hospital job. just jumping into hh can be financially devastating to some, pay and agencies aren't as stable as hospitals generally are.

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Specializes in jack of all trades.
I did the same thing several years ago, Lacie... outpatient dialysis to HH. Soooooooooo liberating !!!

And like you, I was fortunate enough to have found a really, really GOOD agency with tons of support ! :up: :) :up:

Isnt it though? I was beating my brains and body out working chronics and now wonder why I even bothered lol. Now I'm making better pay, less hours, get to actually drink a glass of water and pee when I need too!!!:yeah:Best of all my director doesnt allow verbal or any other abuse in my office where as in chronic dialysis I have been hit, cursed, and just over all abused. It was allowed. Now I dont have to worry about it.

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Specializes in Neurology- briefly, Oncology/Hematology.

Ok, a few more questions. I'm gonna get a little personal. I make on average $23/hr at the hospital. Is home health salary or hourly? Anyone care to tell me a good guess what they might offer me pay wise? This agency is the largest in Eastern MO/Southern IL and they say they offer competitive pay and tuition reimbursement, if that helps.

What if a patient needs something I'm not familiar with? Or what if I have a question? For example, for being a new nurse I have a lot of skills stacked up already. Unfortunately though I've only put in a urinary cath once in a female. That's it. What if my pt needs one and I can't get it? I feel pretty confident and when I shadowed HH in school I know I could easily do everything I saw that day, but you never know what might pop up.

Do all HH agencies let you chart at home after visits if you choose? Are you paid for that time? Or only if you chart in the home?

Who generally thinks HH is less stressful than standard floor nursing care at a hospital? Thanks for all your help!

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Wow- Did I read right that you are an RN? I only ask because I am an LVN doing HH. I make $29 hour. Now I am in California in the Bay Area. Does that make a difference?

As far as your concern about in countering procedures that you have a low skill set in/have not done in a long time I wanted to say that when I started in HH 3 years ago I felt the same way! The good news was that the agency was awesome at in service and would review anything with me that was I unsure about before working on a case. It is amazing how it all comes back to you. Also many great teaching videos can be found on the Internet. The most common procedures I have been doing are vent/trach care and changes, GT, straight cath male, diabetes care/insulin and injections. I am now with 1 pt. on a consistent schedule/shift and love it. I do miss the fun variety of different home visits but not the driving. Oh- and the charting. We had to do it all at the pt. site but it may be different for RN.

I think you will do just great in HH and will enjoy the change(as long as you are with a good agency!)

Good luck

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