I need advice and input, GN in HH

[JenniferSews]

I finally got hired, thanks to someone I know, in home health. When I worked in HH before as an aide I was assigned a full pt load and found it to be a reliable and wonderful job. But as the market is for new nurses I'm not finding it that way for a GN. I was supposed to orient with someone to watch an admission. When I called yesterday the answer I got from the RN was vague about time or even day this might take place. A new admit must be seen within 48 hours so nailing it down between days didn't seem like a lot to ask. I mentioned I needed to arrainge childcare and needed an hour or so notice, and the conversation broke down to "we'll see....."

Today I went to get my ID pic taken and the owner asked how I planned to work when I had children. I told her confidently that we have childcare and I needed just an hour or so notice. She didn't seem as impressed as she was yesterday. She then mentioned shadowing for line draws on Monday and watching an infusion. It sounded like it would be left up to the RNs to remember to call me if and when they had a pt scheduled I should observe. Fine, but the time I spend shadowing is not paid, although I still pay daycare for 2 kids. I don't need to watch someone do a line draw or hang a bag of antibiotics. I scared to be left to shadow for eternity with people I have to badger to allow me in. How can I be proactive about this? I need this job like a fish needs water, and feel I can succeed if I'm given half a chance. I'm sure it's a lack of confidence in my skills but if I can't even see a pt how can I prove myself?

[HouTx, BSN, MSN, EdD]

I really don't want to rain on your parade, but I think that there are some real problems with this company. H H is a nursing specialty area which includes an enormous number of unique issues/situations that inpt nurses can't even imagine. In addition, there are very specific skills that you need to learn. My opinion is based on the fact that I spent a number of years developing curriculum and instruction for a big HH company.

You should be provided with education and training prior to making any home visits but it doesn't sound like this company even has an educator. Procedures for ensuring your own safety, managing infection control, dealing with unexpected events in the patient's home, transporting supplies & medications, managing contaminated supplies/equipment -- all essential skills for HH nursing practice. Has anyone taught you 'bag technique' yet? Are you familiar with acceptable practices for transporting specimens to the lab? Do you know that some things are considered 'bio hazards' and if you don't follow Federal EPA regulations, you (personally) are culpable? Oh - and the admissions process is very different, documentation requirements are very exacting, communication protocols (physician, lab, etc) have to be followed... .

Your gut seems to be telling you something - you should listen.

[caliotter3]

They are not making much of an effort to orient you are they? Get childcare for the day, go in first thing in the morning and tell them you are ready to orient. Give them a day or two notice. Otherwise, nobody will ever think to call you to go out with them. And meanwhile, you need to continue your job search. I do not see this one panning out.

[JenniferSews]

Well she called this am and offered an office position. I took it. I'm sad to give up on pt care and this barely covers daycare while I'm working but it's something, without the obvious problems of being thrown into pts homes right away. I'm doing the type of work I did before I went to nursing school, at a fraction of the pay. Why did I go to school again?

[caliotter3]

Be thankful for the job. I would do anything for an office job right now. For patient care, consider this. Go to another hh agency and sign on to do shift care once a week or every other week, just to keep your feet wet. One of my daughter's coworkers has an office job and she does a hh shift once a month to keep up with patient care. It works for her. Good luck with the new job. Hope it works out.

[JenniferSews]

Be thankful for the job. I would do anything for an office job right now.

You're 100% right, and I am thankful. I said I wouldn't be picky as a new grad in this market, and I won't. I'm going to make the best of this. I just need to kick myself in the butt and get over myself first.

[caliotter3]

Oh, something else to think about. You can expect to be asked to go out in the field when they need someone in a pinch. So you may be doing more than just office work. On any given day be prepared to do patient care at the drop of a hat.