Need Advice....

jnette, ASN, EMT-I · Apr 25, 2009

Hi Muffin... and WELCOME to HH nursing ! :w00t:

You will need to brush up on your assessment skills... VERY important in HH, so you don't miss anything. Look at the patient thoroughly.. check for bed/pressure sores, even if you don't think they have any.

You will be using your basic medsurge skills in HH, lots of wound care, occasional IVs, etc.

Read through the HH forum and glean any info there you might need. Wish you the best !!! :)

muffin7 · Apr 25, 2009

Thank you jnette. I appreciate your advice.

jnette, ASN, EMT-I · Apr 25, 2009

Thank you jnette. I appreciate your advice.

Sure thing... there are plenty of threads here on the HH forum which wil give you some insight as to what to expect and what you will need to know. HH is truly the best, I hope you enjoy it as much as I do ! :)

Don't hesitate to ask all the questions you want here, and be sure to ask for a decent orientation.. about 4-6 weeks. Watch what the other nurses do, and pitch in. Before you know it, they'll be giving you 2-3 patients a week, then 3-4, then 4-6. Six is usually about average.. although I have had 6-8 on occasion when things were really busy or some nurses were out sick or on vacation.

Give it a whirl, and let us know how things are going for you ! :up:

scrappygirl123 · Jun 5, 2009

I, too, have been working in the OR for 28 years and just started HH. I have been over whelmed! I just don't think that it is for me, as I feel that I have lost many of the skills that you need for HH. I have only been doing HH for 1 1/2 weeks, and all ready have had 5 patients per day. today (as well as 2 days ago) I just broke down and cried. I feel so inadaquate.

caliotter3 · Jun 5, 2009

I, too, have been working in the OR for 28 years and just started HH. I have been over whelmed! I just don't think that it is for me, as I feel that I have lost many of the skills that you need for HH. I have only been doing HH for 1 1/2 weeks, and all ready have had 5 patients per day. today (as well as 2 days ago) I just broke down and cried. I feel so inadaquate.

You should ask your employer if you can do shift work rather than intermittent visits. One client, one shift, one nurses note, each day and you are done. Routine nursing care for stable patients. Very easy to adapt. Talk to your employer. Good luck.

muffin7 · Jun 6, 2009

I agree, you should do routine nursing care for stable patients. My Director understood my knowledge base and has given me client that fit what I can handle. I feel that my assessment skills have improved in the month or so of doing HH. Hand in there, you will be surprised. Also, don't be afraid to ask questions!!!!!!!!!!

Are you paid by the visit? Why so many patients in such a short time. I don't feel that's right to do to someone new to HH. You need to speak up for yourself.

Just like anything else there is a growth factor. Hang in there and don't give up. I promise you it will get easier once you get used to all of the different paperwork.

My emphasis for you is stable patients!!!!!!!!!

P.S. I am going to be working in an Ambulatory surg center after I get clearance. I'm excited because there weren't that many patients for me to see. I was seeing three patients once a week. It was not enough for me financially. I will continue to see one patient that I have and hope to acquire more that I can see on my days off (Mon/Tues/Sat). I'll be working at the surg center Wed Thurs and Fri. I really do miss the OR.

Wishinonastar, BSN · Jun 18, 2009

I, too, have been working in the OR for 28 years and just started HH. I have been over whelmed! I just don't think that it is for me, as I feel that I have lost many of the skills that you need for HH. I have only been doing HH for 1 1/2 weeks, and all ready have had 5 patients per day. today (as well as 2 days ago) I just broke down and cried. I feel so inadaquate.

In my experience, 1 day in the office, 1 day with another nurse while you watch, then 1 day with another nurse watching you is typical orientation. Then you start with a couple of patients, then 3, then 4, then 5, finally 6. That is normal orientation and they are probably giving you easy cases. Employers can't afford to give an extensive orientation. You are slower because you don't know the paperwork, etc. yet. It is a big transition for you, but all you have to do is pick up the phone and call the supervisor, or ask someone if you need help. Hang in there, it takes about a year to really feel you know what you are doing. Home health is complex because there are so many regs and so many different types of patients. Make a friend- find someone you can trust to go to with questions. It does get better.

CooperNurseRN · Jun 20, 2009

As a HH Administrator, it seems that OR nurses really struggle with not being able to fully complete all patient related tasks by the end of the day. That is the nature of case management. Surgery is a controlled environment. Home Health is not. Plus, you are in a constant mode of prioritization and planning for tomorrow. But you must always be ready for last minute changes and surprises. The nurses who truly want to be finished with everything at the end of the day really have a hard time with that concept. I've learned that home health isn't for everyone. You need to give yourself 6 months to get oriented before you say it's not for you though.

muffin7 · Jun 22, 2009

As a HH Administrator, it seems that OR nurses really struggle with not being able to fully complete all patient related tasks by the end of the day. That is the nature of case management. Surgery is a controlled environment. Home Health is not. Plus, you are in a constant mode of prioritization and planning for tomorrow. But you must always be ready for last minute changes and surprises. The nurses who truly want to be finished with everything at the end of the day really have a hard time with that concept. I've learned that home health isn't for everyone. You need to give yourself 6 months to get oriented before you say it's not for you though.

Have you ever been in the OR? Surgery is anything but a controlled environment. A patient can be rushed to the OR with Multiple Gunshot Wounds to the chest and oracotomy and things can change one second to the next. In the OR you prioritize from one minute to the next, you must be ready for anything even in a scheduled case. You have to be a really quick thinker.

I'm back in the OR and didn't realize how much I missed it until my first day:yeah:

Nurse4life09 · Jun 24, 2009

Hi there,

I came from the OR into HH. One thing that will be incredibly in your favor is your excellent sterile technique. The homes we go to can be pretty messy, the cat is jumping up on the patient, there might not be a clean place to even put your bag down. So that will help you. Also it is very similiar because you are with one patient for however long focusing on that patient, meanwhile constantly thinking ahead and figuring out what you need for later in the case, or day for HH. Good luck with your interview! Alot of patients I see in HH have had surgery and are always so curious about what goes on....they like to hear about how the surgeon does such and such.

CooperNurseRN · Jun 25, 2009

Don't be offended by what I wrote. I've never worked in the OR but I have quite of bit experience as a trauma RN in the ER. So I understand what you mean. When I said controlled environment....I mean that we don't have everything we need right there at the time that we need it. I understand that the OR requires constant prioritization. The OR nurses that I've hired really dislike the fact that they are never really "finished" with that patient until the end of the cert period and they don't like the feeling that their work day never ends. As you know, with home health, you prioritize and do what you can get completed in your day. You shift everything else to the next day and it starts all over. Some people just don't like that type of feeling. I've hired 2 OR nurses in the past year. Neither have worked out. My comments come from the issues that they struggled with. Both were very sharp nurses. Home Health just wasn't for them.