Is starting out your nursing career with HH a good idea?

caliotter3 · May 13, 2009

Starting out in the hospital would be best for you in the long run, both for a home health career and if you ever decide to go into other areas in the future. As with any specialty, if you start out in home health, you will become experienced with the routine home health type cases. When you change specialties, you would have to learn a new set of routine cases that relates to that area of nursing. Nobody can know it all or be experienced in all of it six months or nine months out of school. That is why they advise new grads to start out in med surg for one to two years to gain a broad range of nursing experience on which to base their skill set.

Riverhopper · May 13, 2009

Thank you for the advice, do you know though if it is possible to go from HH to MedSurg or other specialties, will my experience in HH be seen as an asset or a liability. From your comments it looks like that MedSurg should be the obvious choice for a new grad but I was wondering if, as an alternative, I could go into HH now and still be employable later in hospitals. Many thanks.

caliotter3 · May 13, 2009

I really can't answer that question. I would think that someone with hh experience would have an advantage over a new grad, but beyond that I can't say. I know of one person who went from hh (LVN) to a hospital (RN), but I don't know the prior background. I imagine it is possible.

RN1263 · May 14, 2009

I work as a home health RN and I only had 2 mos of med/surg and 1 mos of psych hosp. experience, been doing HH now for 1 1/2 yrs and i can tell you that yes I could get a med/surg hosp job now if I wanted, because what I'm doing is med/surg just in the home. But the pace is WAY different, the med/surg job is fast paced and home health is one patient at a time therefore you have more time with each patient. But home health isn't for everyone you have a different set of challenges in home health (oasis regulations, filthy homes, bad neighborhoods, ect) and home health in and of it self IS a specialty. Anyway, I couldn't stand working in the hospital and wanted an unconventional type of nursing and home health was a good match for me. My advice is try what you REALLY want to do and don't over think it too much....

Good luck

chenoaspirit, ASN, RN · May 14, 2009

After I graduated, I did med/surg for 4 years (I just switched to HH 3 weeks ago). I truely believe that the med/surg experience prepared me. There are alot of skills to learn and master when you first graduate and the hospital is a great place to learn them because you have alot of support/coworkers surrounding you to help you. With homehealth, I think it would be harder to learn skills and master them. You will be out in the field alone, unless your manager agrees for someone to go with you for all your "firsts", which will be alot. I know I couldnt have successfully done homehealth as a new grad nurse. But I do know a few people who have done so. If you do start out in homehealth, I dont see how it would hinder your future employment in a hospital. If the HH agency is willing to train you and thats what you want, then give it a try. But for any new grad, I do recommend med/surg for at least a year. Good luck in whatever choice you make. You will do fine.

Riverhopper · May 14, 2009

Many thanx to you all. This is why I luv this forum. Much appreciated.

KateRN1 · May 15, 2009

I'll repeat the same things that I've said on other threads about this topic. Nursing school prepares the graduate nurse to sit NCLEX and maybe land an entry-level job. Entry-level jobs generally take the novice practitioner, hone and refine her* skills for the real world of nursing, mold her nursing identity, and give her lots of support. (Even in the worst-case scenario hospitals, you're not out there by yourself, even if you often feel that you are. There's always back-up.) HH, on the other hand, expects and needs an independent practitioner, one who has experience with assessment, documentation, time management, and critical thinking skills. You need to be comfortable and confident with your skills through use and practice, not through passing skills checklists in school. The beginning nurse is just that--a beginner and home health, IMHO, is not the best forum for a beginner who has not had previous nursing experience. For someone who has been an LPN with experience and bridges up to RN, her nursing skills are likely already honed and now all that's different is the addition of supervisory visits and a taller mountain of paperwork.

Starting out in HH really does a disservice to the new grad, I think. If you decide that HH is not for you, getting into hospital nursing may be more difficult (depending on your area) because you may get passed over in favor of those who've had hospital experience. I would heartily recommend at least a year or two of basic nursing experience, either in the hospital or a large skilled nursing facility with a sub-acute population. It really will benefit you in the long run, as well as your future home health patients.

* personal pronoun "her" used for general purposes, no disrespect to the many fine nurses out there of the male gender

prettygirllpn · May 21, 2009

I started HH right out of nursing school and have been doing it for almost a year. I live and work in a fairly small community but I have had more experience than some of my nursing school classmates who are now in the hospital. I have done many wound vacs and wound care, trachs, PICCs, etc. I know i would be able to transition to a med surg unit without much problem, except for the hours. Because HH is so much about teaching and education, i have learned quite a bit about the disease process and have fine tuned my critical thinking abilities. I still hate those words!

Personally, starting off in HH was the best for me but everyone's situation is different. I hope this helps!

Riverhopper · May 23, 2009

Thank you all for ur comments.

dmdrn73 · May 31, 2009

I started out in Home Health as well. When I graduated in 94 in Philly there were actually very few jobs for new grads even in nursing homes, I was out of work for almost a year after I passed my Boards so I took a job as a HHA at a newly forming agency. They gradually worked me in as an RN, gradually letting me di private duty assessments, B/P screenings, etc. Also giving me more complicated patients to see as HHA. Then when I actually was hired, I had orientation and they kept me with my preceptor for a few weeks longer than the usual orientation, maybe letting me go out on 1 or 2 visits/day on my own after about 2 weeks. They made sure to send me with someone for any "firsts". I did that job for about 6 years then when I moved to Va, I decided to try Hospital work, I actually had no problem getting a job, they actually saw it as an asset that I had that much HH experience as it was very varied, some cardiac, some ortho, lots of wound care, etc. (FYI I am back in HH again)