Is it a waste of my talent to go into Home Health?

[Nurse Beth, MSN]

Dear Nurse Beth,

I work on a busy cardiac telemetry floor at a large hospital. I love my job most days despite how hectic and stressful it sometimes gets. The only problem is that the hospital is 75 miles from where I live. When I took the job the plan was that me and my family would move. Things have changed and we are not moving. Recently I have been offered a full time position in home healthcare that is closer to home and will pay more money. For several reasons I have decided that the job will be better for me and my family. In addition to being able to be home more and better money, I think that a small company has better room for advancement.

I gave my manager my notice of resignation today. She told me that she was disappointed that she spent the resources to train me (understandable). She also said that it is a waste of my talent to go into home healthcare. I don't believe her, but should I? It is making me second guess myself.

I don't have a clear idea of how my future will look as a nurse and in what area I would like to advance. I have been doing home healthcare prn so I know that it definitely requires critical thinking and assessment skills. The only thing that I can think of that is missing is watching and learning from others.

I guess what I am asking for is some words of wisdom. Thank you.

Dear Second Guessing,

Your manager may believe that acute care is more challenging than home health, and while many may share that belief, it is only an opinion. I'm sure many home health nurses would have a different point of view, and there are definitely opportunities for advancement.

Remember your manager is speaking out of her own disappointment and not necessarily what's best for you and your family.

Choosing home health at an early juncture in your career is choosing a narrow specialty. There's nothing wrong with specializing but know that the longer you stay, the harder it is to go back later. Within 2 years or so, you may not be seen as eligible for acute care.

This is really a question of values, and as with every decision, there are gains and losses. Only you can decide what's important and best for you and your family. You can never do wrong when you do the right thing for your family.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[Kaisu]

Home health as all specialties, requires specialized skills and thus is suitable for some and not for others. Wasting of talents occurs when your personal gifts are underutilized and your weaknesses are cast into glaring relief. Acute beside care is demanding but I have yet to find any job in nursing that is easy. For me personally, Home health allows my strengths to flourish, strengths that in the acute care setting were not primary requirements. In my case, acute care would have been wasting my talents.

Your mileage may vary...

[caliotter3]

Home health as all specialties, requires specialized skills and thus is suitable for some and not for others. Wasting of talents occurs when your personal gifts are underutilized and your weaknesses are cast into glaring relief. Acute beside care is demanding but I have yet to find any job in nursing that is easy. For me personally, Home health allows my strengths to flourish, strengths that in the acute care setting were not primary requirements. In my case, acute care would have been wasting my talents.

Your mileage may vary...

Well said. Use of the "waste of my talent" phrase in the thread title only points out the not so subtle prevalent negative attitude often portrayed.

[Oldmahubbard]

After realizing the hospital was not my thing, I worked in Home Health for about 5 years. In no way is it a waste of anyone's talent. If anything, you have to be even sharper, because there is no one around to ask.

From there, I realized my real passion was for mental health, and I pursued my APRN.

Your nurse manager is simply disappointed you are leaving.

Myths about home care abound. I can remember when I left the hospital, co-workers saying "you'll make less money". I made more money, and it was a much better work/life balance.

I don't see how a daily 150 mile commute is sustainable. But that is a separate issue.

[kbrn2002, ADN, RN]

No nursing specialty is a "waste of talent." It is sadly a way too common bias that nurses working in acute care are somehow better nurses than those that choose to work outside the hospital setting. You'll even see that bias among nurses that work in acute care, seems every department thinks their nurses are the only nurses with real talent. Let your soon to be previous nurse manager's acute care bias roll off your back, it has way more to do with her not wanting to lose you than your talents as a nurse.

[Daisy4RN]

Agree with the other posters that your Manager is bias in that opinion. You are already working Home Health prn and know that good assessment/intervention/critical thinking skills are highly necessary, so no waste of skills there (or any other RN position). You need to do what is right for you and your family. I hope it works for you, but just in case it doesn't, you can always go back to the hospital setting (maybe even the same one). And, there are still others to learn from even if they are not right beside you, they are just a phone call away.

[Alex_RN, BSN]

Can you stay per diem in acute care to stay current?

[Kaisu]

Can you stay per diem in acute care to stay current?

When you are on your own dealing with very complex cases without the support of others, you stay current because you are forced to know what you are dealing with. If you are any good that is....

[aanwyn, BSN, RN]

Hi there,

I agree with others who say your manager was speaking out of her own disappointment. I have been a nurse for 9yrs. In that 9yrs I had been unable to get into the hospital. I finally did on an insanely busy surgical floor. I worked nights. Before that I did home care for about 1 yr full time. Quite frankly, home care adequately prepared me for that surgical floor. I trained for one month and was flying solo without issue. I found that I actually hated acute care. Now, I do it only per diem. I still work home care but not full time either. For me, the work-life balance in home care was not great but I think it may have more to do with how the company organized itself and its requirements of its full time case managers. Home care prepared me to change IV dsgs, pull PICC lines, change wound vac dsgs, remove staples/sutures, and a host of other things. I'm surprised your manager would say that considering the fact that patients are discharged from hospitals in a matter of days. Every nursing specialty is different, but aside from the technical skills, home care requires very astute and keen assessment skills. Although many agencies will hire new grads, I think it is the worst place for a new graduate because you must rely completely on your own assessment skills since there is no one else around. Also, you do quite a bit of educating in home care and it allows you a very good picture of the patient and what is leading to repeat ER visits/hospitalizations. I truly believe home care is one of the best fields to help change the course of a chronic illness for a pt who is willing. The pay is actually quite good as well. Look for a company that will supply a car and a phone or else you'll have pts. and MD offices calling you after hours and when you're not working. Good luck!

[DallasRN]

You know, it's all in the way you look at it. I did acute care for many, many years...SICU, MICU, CICU, ER. I did a stint in Med-Surg after many years in the critical care areas (and that kicked my fanny for sure!). I did case management. Except for L&D and Peds, I've done most of it. And then I went into home health. That initial foray didn't turn out too well for me due to the agency I worked for. Still, in the short time I was there, I learned so much. Different things, to be sure, but learning all the same. Home health is not the cakewalk some of us (me?) had assumed it to be. However, for me, it was the type of nursing I had been searching for for the last many years. Time to actually LISTEN to and HEAR my patients. True family interaction. Tons of teaching with generally receptive patients and families. I found most doctors to be receptive to and supportive of nurses in the field. Not once did I call a doctor that did not call me back in a reasonable time and if urgent, would immediately take my call. You will lose some skills and true, you won't be as marketable in the acute care arena after a couple of years. But the upside IMHO is that healthcare is shifting more towards home care. The faster you can get a patient out of the (bacteria riddled) hospital, the safer that patient will be and the better outcomes you will get ***with skilled home health nurse*** involvement.

For me, I love it and I'm now searching for a decent agency that will take me with only 3 months experience. If a decent agency is offering you the opportunity with no experience, I would seriously consider making the transition. Whatever you decide, best of luck in your career.