Home health or telemetry

[MadisonCorkran]

Hey guys! Looking for some advice as an upcoming grad. I graduate in December 2019 and have been offered two jobs. The first job is in a hospital on a telemetry floor where I’m currently working on it as a nursing extern. (nurse aid). After graduation I will be moving in about an hour and 20 minutes from this job. The second job offer was a home health agency very close to my new home. I don’t like the pace with hospitals and really want to have a relationship with my patients. But I’ve heard that hospital experience is a necessity for a new grad. Any thoughts? Thanks in advance!

[Hoosier_RN, MSN]

Home health is a very bad idea for a new grad, no matter what your prior experience is. You need to be able to make independent decisions based on assessment skills that you don't have yet. After a year or so, you will. The company doesn't care, it's not their license that they're risking by putting you out there-run, don't walk, from that offer. I'd look for something else. There have been new grads on here who have done the same, despite the same advice, that come back a bit later and wonder why they got burnt and the company doesn't care, the job is horrible, the charting, blah-blah-blah. A hospital will generally give support, and lengthy orientation to a new grad.

Home health (both MCR and MCD) expect you to be able to be independent very quickly. Sometimes no orientation, but usually up to a week. Some will promise more, but then, "oh, so and so quit/out sick/etc, you're on your own"...don't let that happen.

Good luck whichever job you choose, that's just my thoughts

[caliotter3]

I would definitely take the hospital job over the hh job. Offers of hh employment are usually plentiful where those coveted hospital jobs can be very hard to come by, especially for a new grad. Don't blow your opportunity to get your foot in the door of a hospital. Instead, I would look at ways to make that commute more palatable. Perhaps renting a room, or staying with a former classmate (for consideration). While an hour and 20 minutes is doable, it will wear you and your car down over time.

[Forest2]

I can tell you from experience that a long commute to work is a killer. It takes away your sleep time so you don't get rested between shifts. The pace like you inferred is 100 miles per hour. You will be exhausted when you get home. Otherwise, your telemetry floor would be a good place to start because it is hospital work and you already know the unit, coworkers and the EMR. This will reduce the stress quite measurably in regards to orientation.

The home health nurse duties include being able to make clinical decisions on your own, there is no one down the hall to ask or help if you get in a bad spot. Doctors expect you to take care of things, meaning you call them with what the patient needs and have a recommendation ready( Doc you gave them 2 UPC's 5 weeks ago, do you want a follow up CBC again?). You educate the patient on what they need to know. How are your teaching skills? The home care nurse is basically in charge and needs to know these things and be confident enough to ask for them or do them without being told to. I don't think a new grad would be able to do that. You are 100% managing the case. If therapy is in there, do you know what you want them to do? A home care nurse must function independently. A new grad needs OJT and support.

AND I almost forgot to mention, that you often don't know what you are getting into. You could enter a room with 5 men and they all look shady or like they could be the patient. You have to be able to handle all sorts of "situations" and unhealthy environments.