Looking for tips on Home health clinical

cathrn64 · Mar 30, 2011

Hopefully you will be with a nurse for more than 1 or 2 visits. (I like to have a student stay with me for the full day) I usually have my student's observe at first, maybe get a set of vitals at the first or second home. Then the student can see the flow of a visit and get an idea of what happens. Than, depending on the expectations have them do more of the visit as the day goes on. (I have had some schools where the student is just supposed to watch, and others where the instructor wants the student to do a full visit.) As far as teaching goes, it varies on the pt and the visit. Sometimes the teaching opportunity is obvious and sometimes you have to just pick a med or diagnosis and teach on it. Your preceptor should tell you if there is a specific goal that is to be covered on that visit.

KateRN1 · Mar 31, 2011

If you can get a copy of the 485 plan of care, that will tell you a lot about your patient. Actually, if you just know enough to ask for the 485, that alone may get you some points. The 485 has the patient's diagnoses, the nursing interventions, and the patient goals. Review the 485 then ask what goals the patient has already met and which ones are still a work in progress. Make sure you have an understanding of the diagnoses, look them up if you're not familiar. Remember that the whole family is your patient, not just the name on the 485, and watch for things like caregiver strain, abuse/neglect situations, poor economic status, poor literacy level, etc. And if you don't know something, ASK. That's the best way to get information. Good luck!

student_nurse123 · May 4, 2011

thanks for your inputs! :up:

RN1263 · May 5, 2011

I have no clinical expectations of a student that goes with me for the day. I find that the student can relax and really take in the experience if they don't feel they will be put in the hot seat at any moment.

However, our students also don't have "objectives" that must be met, except to be with a HH nurse for the day. I remember when I did my HH rotation...I was VERY nervous and thankful when the nurse I was with said I would be just watching. I fell in love with HH that day and became a HH nurse after only 3 months med/surg, that was hhmmm about 3 yrs ago....

LoveThisNurse · May 20, 2011

I have no clinical expectations of a student that goes with me for the day. I find that the student can relax and really take in the experience if they don't feel they will be put in the hot seat at any moment.
However, our students also don't have "objectives" that must be met, except to be with a HH nurse for the day. I remember when I did my HH rotation...I was VERY nervous and thankful when the nurse I was with said I would be just watching. I fell in love with HH that day and became a HH nurse after only 3 months med/surg, that was hhmmm about 3 yrs ago....

After 3 months? that's so cool! I'm 3 weeks into home health. I have about a year and a half of peds experience and i jumped into home health. learning about wound care just makes me so nervous! I'm getting the hang of it. I see my first pt tomorrow with my educator.. yikes! How did you feel your first time going out? When did you start to get comfortable? It would be great to hear from you! Thanks =o)

RN1263 · May 20, 2011

After 3 months? that's so cool! I'm 3 weeks into home health. I have about a year and a half of peds experience and i jumped into home health. learning about wound care just makes me so nervous! I'm getting the hang of it. I see my first pt tomorrow with my educator.. yikes! How did you feel your first time going out? When did you start to get comfortable? It would be great to hear from you! Thanks =o)

I did fail to say I was an EMT years ago, so I was comfortable going into peoples homes and making decisions on the spot. However, I was a "basic" EMT not a paramedic, but I worked with paramedics. I also worked in an ER for 2 yrs as a ER tech, but all that was 15 years before nursing school.

Anyways..... wound care made me nervous too, you just have to do it and if you're not sure what treatment would be best for a wound with no current orders then call someone at your office, explain the wound and go from there. Learn all you can about pressure ulcers (staging), stasis ulcers, ect. so you will know at least what kind of wound you're looking. They have small flip reference guides with pictures you could carry with you, if your company doesn't have one, then maybe you could order one? (don't know) I got one from my work when I was new.

When I first started in home health they new I was a new grad RN (took a chance on me, because of my EMT work history) and let me go with the same nurse doing regular visits for 3 weeks (long time for regular visits- no Oasis) and I did bits and pieces of the visits as I felt more comfortable, then I told them I was ready to do a visit on my own.... Honestly, I wasn't nervous, however I was just doing regular assessment/teaching visits for the first few visits I was on my own. After about a week they had me start going with a nurse to learn the Oasis visits (SOC, RECERT, D/C, ROC), then I got a bit nervous because I didn't understand the Oasis and how certain questions were suppose to be answered, but I sat next to the most seasoned nurse they had and would ask questions after my Oasis visits, if I was confused and she helped ALOT.

So, when did I get comfortable with all of it you ask (visits and Oasis paperwork)....probably 3 months. Now that doesn't include certain specific skills such as IV's, PEG feedings, colostomy......we don't do those skills often, even though we do acute care. They come in waves I swear......like I won't do any IV's for 6 months , then all of a sudden we'll have 5-10 plus IV patients, it's kinda weird. Anyways, I get rusty with some of my skills and have to look up proper procedure here and there... or really have to concentrate to make sure I don't flub it up...eeks. So far though in 3+ yrs. never had a skill or problem that I couldn't figure out, even if I had to call the office or a pharmacy- you have to know when to ask for help, just step out of the room or home, so you don't freak the patient out if you "really" don't know what you're doing.

Good Luck