ICU vs. Home Health. What to do??

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Specializes in ICU.

Hello all. I have been an RN for 9 years. All 9 years have been in the hospital. Medical ICU and Cardio-Thoracic Surgical ICU. @ 3 months ago I received a significant injury including a Lisfranc injury and a meniscus tear in my knee. Also, I have back issues including spondylosis and 2 bulging discs. Very often at the end of my 2 or 3 shifts I can barely get out of bed due to pain. Anyway, this lead me to consider if I can tolerate 12hr physically demanding shifts on my feet. I applied for and was offered a Baylor RN Home Health position. Still 12hr shifts, but has to be less physical! I can't say I like my job. I do love working 3 nights one week and 2 nights the next. Because I work weekends the pay is very nice. BUT, I am tired of the hospital drama and politics. The catty women I work with. No appreciation for what we do from patients. families, and upper management.

I have read so many positive and negative statements about HH nursing, so I'm struggling with whether to make the transition or not.

The agency I would work for is a pay-per-visit. $40 for reg visits, $80 for admits. 0.40/mile. Benefits include Med/Dental, 401, and paid time off.

Can anyone that made this type of change let me know if it was the best decision you made, or do you regret it? I just am so undecided.

Thank you in advance for any advice :)

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Specializes in Oncology, Med-Surg.

I have been in home health for many years and have never looked back. You couldn't get me back in a hospital for anything! It sounds like you have good pay and benefits. If you have doubts, you could stay PRN/pool where you're at. Some of the complaining about home health is nurses who work for bad companies. There were many home health and hospice start-up in the last decade by people who are non-medical and are all about profit. These places really slave nurses. Try to get in at an established agency or one associated with a hospital system.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

In my experience, occasionally ICU nurses don't make it in home care as they are so used to controlling their work environments while patients call the shots in home health. Many agencies offer applicants an unpaid "ride along" day with an experienced Home Health staffer to understand exactly what home care entails. Most make a yea or nay decision afterward.

I left Telemetry/Resp step down in 1993 and truly found my nursing nitch.

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Specializes in Home Health, MS, Oncology, Case Manageme.

Does the hospital where you work have a home care company? I've seen nurses do this transfer and they are able to keep their current benefits including seniority. And I have seen nurses who haven't liked home care easily transfer back into the hospital.

There really is no way to know for sure if you're going to like it. Its a much slower pace but definitely less physical. I started in home health after a back injury, and that was 11 yrs ago. Like the OP, I can't imagine working in the hospital again! If you do decide to go for it, remember that HC is a specialty and it will take 6 mos for you to really know what you're doing. I see that as a great challenge but I know other nurses that got discouraged because they didn't know everything in 1 month. Good luck!

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Specializes in ICU.

Thanks for the advice. I did try to get into Home Health within my hospital, but wasn't even picked to interview due to "other more qualified applicants". I didn't know to take into consideration what type of agency it is. This one has been around @20 yrs, but less than a year in my location. I did ask about turnover, they have had one a month for the past 5 months......that kind of worried me.

Besides hospital based HH, what would you guys say are good, reputable agencies. Or how exactly can I determine how they are?

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Specializes in Home Health, MS, Oncology, Case Manageme.

Any hospital based agency is usually the best, even if its not your hospital. The other choices are "mom and pop" and large agencies (multi-locations). I got my start at a great m&P. The territory was small so I never had to drive far. Everyone was very nice and shared their knowledge with me. However, the owner never marketed and after I was there 4 years, the big HC's took her business and she went bankrupt. The biggest problem with the m&P's is lack of business so they don't like to hire nurses full time and can't afford to pay benefits. They most often pay per visit which isn't the best. Hourly is best.

The large HC's can be good or bad. They usually have a lot of business so will hire full time. But they often have a large territory, so it means more driving. And some can be pretty greedy as all their decisions are made at a corporate level. They often pay salary which is good.

As far as turn-over, you should ask why they left. Some nurses leave HC because they tried it and it didn't work for their lifestyle. It has nothing to do with the company. My advice is to ask a lot of questions. I'm going to start a post about questions to ask when evaluating an agency.

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