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Need Advice of different jobs PLEASE!

kwagner_51 kwagner_51 (Member)

Specializes in Geriatrics, Pediatrics, Home Health.

As most of you know I was fired again on Dec 6. from a NH. First job was on an acute Rehab unit in the hospital. [Worked 89 days, no absences, always on time, not trained to be an RN, was nurse extern/graduate nurse. Hired 07/11/05 fired 10/10/05 6 days AFTER I passed boards!]

I put out my resume at several hospitals/heathcare places in my area the Sunday before Chrismas. I got called in for interviews on 4 of them.

The first one is in Evansville Indiana about an hour and a half from home. The hours are great. it is a renal/diabetic unit. From what I understand, the patients are fequent flyers d/t non compliance. So it would be easy for me to get attached. The shifts they have open are: Saturday/Sunday nights, Sunday Monday, Tuesday nights, and 2 day shift positions. I would work 12 hour shifts from 7p to 7A.

The second one is Regional in Terre Haute, IN about 1 hour from home. I don't know the unit, the starting wage is $16.75 hr. I drove through holiday traffic to get to this interview and was there for 15 minutes. :angryfire The interviewer was more interested in telling me about the benefits and stated that the reason she told me what the starting wage was so I could compare it with other places in case I wanted to 'shop around'. After I got home I did some research on the fact that they are members of HCA. I decided that even if they call, I am not going to work there!

The third one is also in Terre Haute. Union is a member of Assension and is a part of the Clarion group in Indianapolis [iU med center, Methodist and Riley hospitals]. They also start out at $16.75 hr and when I finish orientation it will go up to $17.00. The position is float and I know from an interview in the Summer that it will NOT include OB, CCU, ICU or Peds. I like the idea of floating, based on my experience on the Rehab unit. I HATE office politics and want NOTHING to do with it!! What scared me about this interview is she wrote down that I had 6 MONTHS experience in nursing!!! I have about 6 weeks experience and only 7 DAYS experience ON MY OWN!!

The last one is Heartland Home Health. I would be working in my town and in Sullivan about a half hr away. I would be on call for 1 week, every 6 weeks from 4PM to 8AM. They offer 4 weeks orientation and will teach me all nursing skills [like starting IV's. I will learn OASIS paperwork and if I understood him correctly, each admission is $60.00 and each discharge is $30.00. He asked me what my salary requirements were and I said $40,000.00 a year. He was SURE they could do that and will let me know by Friday whether I have the job or not!

Which would you choose? The one in Evansville said they would let me know, no later than the 2nd. Union in Terre Haute said no later that the 2nd for a second intereview. Evansville [st. Mary's] mission is the same as mine. HeartLand home Health will let me know by this Friday!!

HELP!!

Thanks!!

____________________________________

In His Grace,

Karen

Failure is NOT an option!!

Daytonite, BSN, RN

Has 40 years experience. Specializes in med/surg, telemetry, IV therapy, mgmt.

Hi, Karen! It's good to see that you have been job shopping and I wish you all the luck in the world! I don't think it would be fair of me to say one way or another which job you should take. I wanted, however, to tell you some of the things I discussed with my mother's home health nurse. I will PM you the name of the company she worked for, but do not want to print it here publicly. I can tell you that Heartland is a national company in case you did not know that. They also own a slew of nursing homes around the country. They are also connected to the Manor Care group of nursing homes.

We saw probably 4 different RN's while my mom was on home care, but her primary nurse was a very cool person. Mom's primary nurse would come at least once a week and she took the time to sit and talk with mom. She made things so comfortable. I was a bit worried because my mom is a pack rat and tends to collect junk around her that she really should be throwing out. Marilyn didn't even let it phase her. She wasn't pushy about introducing equipment my mom needed, she would discuss it with mom and suggest what she would be able to do. No uniforms (I saw that as a plus). She did tell me that she had a pretty extensive area to service. She was paid per client visit. I asked her plenty of questions when I could because I really didn't know a lot about home health care. She told me she pretty much set her own appointments throughout the day. A cell phone is a must. She would call in the morning to let us know she would be dropping by that day and about what time. She always called again to let us know she was on her way over and would be here in 30 minutes or so. She did draw my mother's blood a number of times (my mother is on Coumadin). She also is the one who got the other people of healthcare to see her.

She had also been a hospital staff nurse, but liked this much better. In the home she only had to deal with one patient and sometimes the family. This, I think, would be something that would attract you to this kind of position. She was able to work her patient visits around her family (she had school age children). She said she made better money than she did in the hospital. However, she did say there was a lot of paperwork she had to do. I never saw her doing it in front of us except when she was doing the initial evaluation.

She also told me that there was a big turn over of RNs within the agency she was working for. She said she oriented a lot of new RN employees, many of whom left within 3 months. She didn't understand why, but felt that a lot of it had to do with the paperwork because the actual physical work of it was not that hard. The other thing she mentioned was that new RN employees had some problems with learning all the resources that were available to suggest to the patients. However, the longer a person stays at this job, the more you learn about the resources available if you make that a goal. My impression was that home health nursing involves a great deal of patient management of resources. As the home health RN, you would decide (if it hasn't been ordered by the doctor) if the patient needs oxygen, physical therapy or a visit from a social service person and get a doctor's order to get those things. I do remember her saying one time that her company preferred that their nurses take care of all patient problems, but that she wasn't going to put her license in jeopardy and if she felt it necessary the patient be seen in the ER, she would call 911 herself for them. She had to have some knowledge of the Medicare and insurance rules for reimbursement because most of the clients using home health services have them paid by a third party insurer.

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