How to Decide to Take a HH position?

[BDavisRN]

I apologize in advance because this is going to be long.

I've been a RN for a little over a year. I started out in the hospital on a unit that was sort of a catch all unit. It was supposed to be pediatrics, but depending on our peds population, we could get a little of everything. We also had post-op patients, fetal monitoring, oncology pts., and we partnered with our "sister units" (L&D and nursery) and floated when they needed us.

That was my first job out of school, and I learned a lot, but the orientation and training were not great. I had amazing co-workers and I really feel comfortable with my assessment skills because of that job and their help.

I went to ortho, which is where I currently work, at a surgeons office because I was pregnant and night shift at the hospital with all the mandatory overtime we were covering was not working. I've never felt fulfilled here, mostly because it's not a lot of hands on for me. I don't mind the paperwork at all (and there is a ton of it, between charting the assessments I do, pre-cert and scheduling procedures, nurse notes on phone calls I've taken, etc), but I really want to get back out there and use my nursing skills. I also would like a little more autonomy and flexibility in my daily schedule. Our hours at the office are crazy, and I frequently put in 50+ hours a week. I actually cannot recall the last time I clocked out with less than 45 hours.

I had an interview today with a HH/Hospice company and I was very excited after the interview. It's full time, 8-4:30 are the (usual) hours. I'd be required to take "back up" call at times (they have two nurses who cover on call per night, but they have one back up in case things are really crazy) and they rotate call on holidays.

It's a salaried position. If you have to go to a home when you're on call, or on back up call, you get paid per visit as well, and get paid for mileage.

Normal case load is 5-6 pts/day, unless you have an admit, which counts at 2.5.

They also explained that I would get a six week orientation with a current nurse on staff, then have a "mentor" to help me through the end of my first six months. The mentor wouldn't go on home visits with me necessarily, could come out to the field if I needed her for something, and would check in with me and be available to me should I need anything. They'd start me at 2-3 pts per day when I start on my own and increase from there.

I did speak with someone who works for them and they said the orientation was what they described. I was concerned about that because I was supposed to get 8 weeks of orientation when I started at the hospital and I was on my own at a week and a half, so I wanted to make sure the orientation here was what they said it was. She seems to really like her job.

They seem very flexible and even said they have no issues with their nurses running errands/going to doctor's appointments/etc, as long as the work gets done. They said most weeks are great, as far as flexibility, but some weeks are insane if you end up with a really busy patient load, which is understandable.

Overall, I think it sounds great. It seems like a job where I would actually feel like I'm making a difference. My husband's job is flexible enough that if something comes up and I can't get home until later, he can pick our daughter up. And the prospect of being able to finish early some days and spend more time with her is really nice.

I guess I'm just nervous because if I take this job, I really want to love it. I want to be able to feel like I'm making a difference, and I want to be able to spend more time with my child. I would love for this to be a job that I stay in for a long time. And, still being a new nurse, I want to make sure I'm utilizing my skills.

I know this was insanely long, so I guess I just want to know how you decided to go into HH? And how did you know if the company you interviewed for was a good match?

Thanks. :)