2 job offers

Been there,done that, ASN, RN · Sep 30, 2014

You won't really be getting hands on experience in a dialysis clinic.

Research on this site to get a feel for what the position entails. You will be working 16- 17 hour shifts in a revolving door of treatments. Dialysis is monotonous with a brutal schedule.

The assessment position may not be "hand's on", but you will be using more important nursing skills of observation and assessment.

You could always find a per diem position that would teach you those hands on skills I am trying so desperately to forget.

I would take the HH position in a heartbeat. Do what YOU gotta do.

Good luck, keep us posted.

Long Term Care Columnist / Guide · Sep 30, 2014

Well, you know what they say---"use it or lose it".

If you had the choice between med/surg and home health, I'd advise you to go for the M/S position because it would give you plenty of opportunities to use your skills. But because you're looking at dialysis vs. home health, I would hesitate to recommend dialysis because it's a fairly narrow specialty---you use a specific set of skills, but you don't get a lot of all-around experience. It's also extremely hard work and long hours. At least with the home health job, you would be using and continually improving your assessment skills, and you'd definitely make better money. But it has its downside too: traveling in all kinds of weather conditions, dealing with families and less than ideal home situations, being on-call 24/7 for as long as a week at a time, getting emergency admissions that may interfere with your life outside of work.

Both jobs have pluses and minuses. It's a tough choice. I wish you the best of luck!

firstinfamily, RN · Sep 30, 2014

I also vote for the Home Health position, mostly because you will be using your assessment skills and those are needed in any area of nursing. With the changes in healthcare, there will be more opportunities in home health, the goals are to maintain the patients at home instead of having them come to the acute care environment. You most likely will be called upon to make assessments when there are some acute changes and you may be the one to decide if the pt needs to go to the acute facility for further follow-up. Are there any MDs in the area that make home visits? I found very limited availability of MDs when I was doing Home Health. YOu may be the one who will be finalizing the follow-up for any medical treatments to make sure they have been completed etc. I think this position involves more than what you may be told, it is almost like a case manager type of position. The dialysis may seem more rewarding in that you will be having hands on but it also will be very monotonous after awhile. The same sick people coming in for the same treatment etc. I truly don't think it is going to make you more marketable later on. You could do what VivaLasViejas suggested by working PRN in an acute facility to learn the med/surg aspect and keep the RN Assessment position as your full-time job. You will be making decisions that will affect how the patients recover at home, consults for social worker, dietician etc. Good Luck, keep us posted!!! PS: Make sure they give you an orientation period!!

MizChelleRN · Sep 30, 2014

I love hemodialysis but it really truly is a love it or hate it specialty. Your comment about a year in dialysis should land you a hospital job is probably untrue, sometimes I think we get backburnered like LTC nurses......Yes we all know it is "real" nursing, extremely skilled, multisystem involvement, quick assessments, thinking on your feet, but for some reason there is a stigma attatched that it's somehow not "real experience". Odd.

Dialysis can be repetitive yes. I might not say monotonous but it can feel a bit like groundhog day. The schedule is and can be brutal, yes. Long days, early start times. But the pay is pretty good. Once you specialize and become proficient, you'll be invaluable and a hot commodity. But it doesn't sound like you want to commit your career to nephrology. If that's the case, you may be happier seeing a more diverse population in home health.

And I just realized I just said what all the previous posters said. Good luck on your decision.

Bbddll13 · Sep 30, 2014

Thank you for your comments! I wanted to take both hemo and homecare but both positions are full time. However, I just got a call from another homecare agency and they are looking for Per Diem Registered Nurses. So I am planning to take the hemo and the Per Diem home care position...

The RN assesment position (74,000) sounds great but I will have to travel to staten Island during orientation, it will take me around 2hrs (one train 2 buses) because I dont have a car yet

@MizchelleRn you are right, I dont know if I want to commit my career to hemo. I just want to get experience and see what I like and what I dont.

P.S. Tomo is the deadline to make the decision :S

livefully · Oct 1, 2014

Another vote for home health!

Been there,done that, ASN, RN · Oct 1, 2014

Is the per diem position also assessment, or hands on patient care?

How were you going to do the HH assessment without a car?

Bbddll13 · Oct 1, 2014

The per diem position is hands on, so Im going to take the per diem home care position and the dialysis position. I live in NY and all the cases are going to be in the bronx so I dont really need a car I can take the public transportation. I feel VERY happy with my decision because I will be able to do home care and also get the dialisys experience thank you for you advice! Wish me luck!!! :]

bijoutRN, ADN, BSN, LPN, RN · Oct 1, 2014

I strongly recommend Home Health. These are opinions from experienced professionals & we know the field. I hope that you look at what's in front of you now and take the higher paying job instead of regretting it later. Nothing is really considered critical or actute care exp unless in on the floor. Good luck!

Been there,done that, ASN, RN · Oct 1, 2014

Most certainly wish you luck.

Let us know how's it's going.

sourapril · Oct 1, 2014

money can't buy happiness. think about which job would make you want to go to work everyday. Can you ask if you can shadow the nurses? Keep your mind open because it may not be what you think.