Inadequate orientation

[PeacockMaiden]

I was recently hired as a per diem RN at a home health agency. I am new to home health. I have been working in a SNF for a little over one year, so I'm still a fairly new nurse.

The company promised me orientation of 1-2 weeks or "as long as you need to feel comfortable". They also said they'd have a nurse go with me on my first visits to make sure it was going well for me.

Well, I got 1.5 days in the office for the Oasis and general computer documentation and then I got only a half a day shadowing another nurse doing revisits.

I did not get the opportunity to shadow a nurse doing a SOC visit. I really wanted to see that process, since the whole Oasis documentation seemed very overwhelming, writing orders, care plans, determining need and frequency of services.

Another problem is that as part of my hiring agreement the agency said they'd arrange for me to have a physical exam before I could see patients. I kept reminding them that I needed to complete this, and they kept saying they were working on getting the company to authorize it. They encouraged me to have my own doctor give me a physical (at my own expense).

So they called me and asked me to take a SOC patient in a few days. I felt uneasy about it since I don't feel I had adequate training. I initially said that I'd take the patient, only if I could go out and shadow a nurse doing a SOC before my own SOC visit in a few days. They said not a problem.

Well the next day I call the office, asking them who I will be shadowing that day. They said that none of the nurses want to have anyone shadow them, they do not want to be teachers. So there is no one I can shadow before I do my own SOC for the first time.

At this point, the office starts to tell me more about the SOC patient they want me to do. I told them that I was not comfortable with the lack of training, plus they never authorized me to get my physical exam as required by their policy before I could see patients. I told them this company was not a good fit for me, and I will not put my license in jeopardy seeing a patient when I don't feel comfortable with the the SOC process. I told them I will not see the patient and I was terminating my employment with them.

No real question here, just a vent about my disappointing experience. It seems like very short training periods are common in home health. Sigh.

[SuesquatchRN, BSN, RN]

This is not at all surprising.

[canadianhungarian]

I'm so sorry this happened to you! My friend started in home health and had the same experience. Only one week of orientation and then they expected her to do oncall immediately when she was a new grad. She didn't last long and moved to something more fit for her.

[SubSippi]

If an organization doesn't want to properly train a nurse who is new to that field, why wouldn't they require more experience from their applicants?

[iPink, BSN, RN]

I'm a new nurse myself, currently working in acute care. Beside is not for me and looking into HH. I guess if I can expect a short orientation. OP, are you still interested in working in HH?

[SuesquatchRN, BSN, RN]

If an organization doesn't want to properly train a nurse who is new to that field, why wouldn't they require more experience from their applicants?

There's a lot of money to be made in HH and the owners of the agencies often don't care at all if they burn you out or if poor care is delivered as long as they can bill Medicare for those visits.

[ttouslee]

I have to disagree with a few of these comments. There is not a lot of money to be made in Home Health. It is the agency you are working for that has a problem. I take it very personal to properly train my staff and am available any given moment for questions or help with an oasis. It's a shame that such poorly ran HHA could make the rest of us look bad. Medicare pays very poorly and the requirements that they demand are ridiculous! My agency is 85% medicare and we don't always show a profit. HHA is pretty much considered a public service. Research an agency prior to agreeing to work for them. Home Health is an awesome place to work, if you are with the right agency with the right goals; serving those that are unable to care for themselves.

[LaRN]

Love how they totally disregard promises they made to you just days before. and they were probably surprised.