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Home Health   (10,430 Views 17 Comments)
by ffliper2777 ffliper2777 (New Member) New Member

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Hi

I just passed my NCLEX and received my license. I have a question. A friend of mine is recommending me to apply at a home health co. because they are desperately in need of new nurses. I have a basic understanding of what home health is, but can someone tell me in more detail what a HH nurse does? Also, how much could I expect to make as a HH nurse? and last question, do most HH companies hire nurses as independent contractors? or as direct employees? Any information would be greatly appreciated

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Silverdragon102 has 30 years experience as a BSN and specializes in Medical and general practice now LTC.

6 Followers; 1 Article; 142,149 Visitors; 38,728 Posts

Moved to the home health nursing forum

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3 Followers; 96,566 Visitors; 36,680 Posts

There are many threads and posts in the home health forum that you can read to get an idea of how hh is. First you need to think about what kind of hh job you want. Do you want to do extended care or intermittent visit type work? Extended care is generally 'easier' in that you only work with one patient for an entire shift, doing routine care for a patient who is stable. Intermittent visits are just that, you drive around during your workday, doing short visits for specific tasks. Think, assessment and wound care for a post-op patient. This patient will be discharged at a given point in time. The extended care patient can remain on service until the end. Some nurses work with the same patient for many years. How well you adapt may depend mainly on the orientation and support you get from your agency. It can be difficult to find an agency that will give a new nurse the orientation they need. You have to be proactive and do a lot for yourself. Extended care or visit work aside, you are mainly on your own. Although you should be able to contact your supervisor for help, you can not count on them to assist you with no notice. Look for agencies that treat you like an employee, less room for cheating you out of pay. Pay depends on the individual agency policies and the reimbursement rates. You can expect more pay, in general, from a private pay patient case, than from a patient case where the reimbursement is from a medicaid source. Check out the hh forum for more info.

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722 Visitors; 4 Posts

thnks, where would i find the HH forum? im new to the site, and im kind of lost

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hlfpnt is a BSN, RN and specializes in LTAC, Homehealth, Hospice Case Manager.

1 Article; 8,900 Visitors; 665 Posts

Home health agencies vary in employment status. Some hire as independent contractor's (which puts you dealing with your own taxes) & some as direct employees. The pay is also variable. Some agencies are pay-per-visit, which means your income will vary with the census & how much a specific type of visit pays, and some are salary. So far in my experience, I've found the salary positions to be the most reliable income-wise. There's also an awful lot of "off the clock" work with the per-visit situations...you don't get paid for "chart time"...this goes toward what's called "productivity", but doesn't have any financial benefit for you. I've not seen any agencies that don't reimburse for mileage, but the rate for that & how it's paid also varies by agency. As far as what you'll be doing as a HH nurse it's called "case management". You are responsible for the coordination of the pts care...lots of teaching & education, direct care, calling docs, collaborating with other team members such as physical/occupational therapy, ordering supplies, med management, drawing labs, IV therapy, wound care...the whole 9 yards. Homehealth requires exceptional nursing skills as there is a great deal of autonomy with this job...more times than not, you're very much on your own in the field. It's a very difficult, but rewarding job that requires a great deal of critical thinking & being on your toes. Personally, and because of the amount of autonomy & responsibility, I would not recommend homecare to a new grad. Get some floor experience (get comfortable in your new role as a nurse), even just 6 months, & then give it some thought. Congrats on passing NCLEX & all my best to you! :)

P.S.

A good GPS is a nice little investment for the HH nurse! ;)

Edited by hlfpnt

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704 Visitors; 9 Posts

I do home health and I would highly suggest starting in a hospital! You dont do a lot of "nursing" that you learned in school. Its more paper work. Trust me go to a hospital first and get some hands on experience! It would make it much harder to go from home health to a clinical setting that the other way around :) Good Luck!

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3,672 Visitors; 202 Posts

I do home health and I would highly suggest starting in a hospital! You dont do a lot of "nursing" that you learned in school. Its more paper work. Trust me go to a hospital first and get some hands on experience! It would make it much harder to go from home health to a clinical setting that the other way around :) Good Luck!

I totally agree with Ash2012. You really should get some hands on clinical experience before you go into home health. In a hospital setting there is always someone to consult or to act as a preceptor when you are faced with new experiences. Most HH Agencies require experience before they will hire you. Mine requires a year. You will feel much more confident out there on your own if you have some experience under your belt. Good luck to you as you start your career!

Kyasi

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mumarada has 10 years experience as a BSN, RN and specializes in Med/Surg, Tele, ICU/CCU, GE Lab.

5,506 Visitors; 34 Posts

I'm reading this thread with great interest. I've been out of the hospital for 5 years, currently work in a doctor's office in cardiology, part time. I was thinking of doing HH, part time also. I have 3 kids. Would I need a refresher course? anything online, maybe

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3 Followers; 96,566 Visitors; 36,680 Posts

I'm reading this thread with great interest. I've been out of the hospital for 5 years, currently work in a doctor's office in cardiology, part time. I was thinking of doing HH, part time also. I have 3 kids. Would I need a refresher course? anything online, maybe

You wouldn't necessarily need a refresher course, although it probably would not hurt. If you choose extended care, you will be oriented to each case as you start. Routine care for stable patients, no big thing, for the most part. If you choose intermittent visit work or a nursing supervisor position, you could expect more orientation to the job, particularly the paperwork aspect of it. You should ask to shadow a field nurse for as long as it takes you to get the hang of it. Study up on assessment and wound care. Ask what you can expect in the way of types of assignments and review accordingly. I don't think you would have a very difficult time, considering that new grads take these positions and survive. Good luck.

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3,672 Visitors; 202 Posts

I'm reading this thread with great interest. I've been out of the hospital for 5 years, currently work in a doctor's office in cardiology, part time. I was thinking of doing HH, part time also. I have 3 kids. Would I need a refresher course? anything online, maybe

mumarada,

You don't mention how much hospital experience you had before you started working for the doctor's office. I had 5 yrs of hospital experience in ICU, CCU, Post Pump, and Labor and Delivery and then took 4.5 yrs off completely to have my kids. I had no problem transitioning to HH after not working at all for over 4 yrs. I think if you have hospital experience as well as MD office experience, you will do fine in Home Care. It is very different though from what you are used to. I remember the biggest shock for me going into Home care was the lack of sterile technique in a home. (my first patient's suction catheter was kept on the carpet and the dog was walking over it!) I had to learn not to be "Nancy Nurse". You can't go into a home and treat it like a hospital and tell the parents/family all the things they should do differently (although it's very tempting!) If you can change your mind set a bit, respect the family/patient, you can do home care. That first patient's family finally did start keeping the catheter wrapped in a clean towel, something I gradually implemented.

Good luck!

Kyasi

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2,067 Visitors; 32 Posts

Theres a difference in home care and home health. I was a new grad hired for a home health agency, and now I've been doing this for 1 year and 6 months. It wasn't a smooth ride, but I am proud I stuck to this. Cuz so many times, I felt like quitting. The hourly rate... when it comes down... after the driving time, charting hours considered... I wasn't getting paid like a RN whatsoever! It took me 30-60 minutes to drive to a pt's home... I got paid $22/visit... took 15 minutes/visit for paperwork... it felt like it wasn't worth it at first. While you still have that NEW GRAD title, go look for a hospital position! Cuz once that year is over... like me, you're no longer a new nurse... you'll just be an "old nurse" with "no acute care experience"

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