New Grad Home Health

Specialties Home Health

Published

Hey Everyone!!!,

I am a new grad RN and I am considering going into home health. Hospital jobs are scarce these days and after filling out countless apps with no prospects of an interview I had to get this show on the road.Moving along I began to apply at nursing homes and what do you know I have work, but I hate it. I work on a rehab unit in a nursing home I have 40-46 pts on a regular basis(well I work 7p-7a so from 7 to 11 I only have 12- 20(rehab side) the other 28 are pretty much ltc, 12-14 of these pts are skilled which means I have to chart I have tube feeds (9),diabetics, ppl with wound vacs,dialysis pts,pts transferred directly from the hospital, and ****** unsupportive coworkers, plus I'm suppose to know everything bc I'm the RN (that's what they say smh) . Sometimes I have to float to other units and yikes. I have been at this job since July 3rd and I'm ready to throw in the towel. I wanted to do 6 mos, then it was october bc in that time I can pay off my bills,now I'm like.....I work 3-12's thank god for that only 3 days in that place. Iam miserable but I need money, but I'd wrather not jeapordize my license but.....I know bashing my job won't help but I always have to stay over I mean hrs sometimes I get off at 9:30 and I don't get paid OT.

Enough with the background info. My mom is a home health nurse and she loves it. So I am thinking of following mommy but she worked in a facility for a number of years before becoming a home health nurse. I have two job prospects at the moment. So what do you gals/guys think. Should I try it? Or should I continue to work in this unsafe environment.

Any insight would be helpful.

Wow this thread has taken a mind of it's own. I have been doing homehealth since september of 2010 (roughly 2 mos now) and I like it.I work with DD clients I see them every 60 days, create their MARS, sipervise the Aides, make sure they do what they are suppose to. I do SOC, ROC, transfers to inpatient facilites, and discharges. I call doctors, and parmacies, case managers, support administrators, parents. There are not many skilled services I provide outside of education/teaching (wounds, trachs). My patients are relatively stable I haven't run into anything I couldn't fix yet. I work with excellent nurses and I have support. I can't believe how upset people are. My patients are very well taken care of by me and their hha's. An acute care oppurtunity has come my way and I will be pursueing that as well. I :heartbeat home health!!!!! I do believe I need to refine my skills so I can provide better care but so far I'm doing ok.

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Wow this thread has taken a mind of it's own. I have been doing homehealth since september of 2010 (roughly 2 mos now) and I like it.I work with DD clients I see them every 60 days, create their MARS, sipervise the Aides, make sure they do what they are suppose to. I do SOC, ROC, transfers to inpatient facilites, and discharges. I call doctors, and parmacies, case managers, support administrators, parents. There are not many skilled services I provide outside of education/teaching (wounds, trachs). My patients are relatively stable I haven't run into anything I couldn't fix yet. I work with excellent nurses and I have support. I can't believe how upset people are. My patients are very well taken care of by me and their hha's. An acute care oppurtunity has come my way and I will be pursueing that as well. I :heartbeat home health!!!!! I do believe I need to refine my skills so I can provide better care but so far I'm doing ok.

In my neck of the woods, you are called a case manager. I am also being barred from those positions until I gain more experience. I prefer home health to hospital work. I was grateful to be employed after being turned down over and over too. I wish it paid better.

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Specializes in Home health.
Wow this thread has taken a mind of it's own. I have been doing homehealth since september of 2010 (roughly 2 mos now) and I like it.I work with DD clients I see them every 60 days, create their MARS, sipervise the Aides, make sure they do what they are suppose to. I do SOC, ROC, transfers to inpatient facilites, and discharges. I call doctors, and parmacies, case managers, support administrators, parents. There are not many skilled services I provide outside of education/teaching (wounds, trachs). My patients are relatively stable I haven't run into anything I couldn't fix yet. I work with excellent nurses and I have support. I can't believe how upset people are. My patients are very well taken care of by me and their hha's. An acute care oppurtunity has come my way and I will be pursueing that as well. I :heartbeat home health!!!!! I do believe I need to refine my skills so I can provide better care but so far I'm doing ok.

I think the home health case management most of the responders are referring to is intermittent skilled visits for Medicare/MediCal & private insurance patients. It would not be case managing only DD clients - it would be case managing a multitude of clients most of them elderly who are (for example) post surgery, uncontrolled diabetics, newly dx CHF and who need skilled care such as in home IV infusions, catheter changes, wound vacs etc. as well as disease process teaching.

I don't know any case managers who only see their patients every 60 days so, I'm wondering what type of case management you are doing. Are you in charge of DD clients that are in a group home setting? If the answer is yes, then that's very different from case managing for a home care agency.

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I think the home health case management most of the responders are referring to is intermittent skilled visits for Medicare/MediCal & private insurance patients. It would not be case managing only DD clients - it would be case managing a multitude of clients most of them elderly who are (for example) post surgery, uncontrolled diabetics, newly dx CHF and who need skilled care such as in home IV infusions, catheter changes, wound vacs etc. as well as disease process teaching.

I don't know any case managers who only see their patients every 60 days so, I'm wondering what type of case management you are doing. Are you in charge of DD clients that are in a group home setting? If the answer is yes, then that's very different from case managing for a home care agency.

^^^^You sound silly. I'm required to see them every 60days for an assessment and sup visit, these are not skilled clients, and no they are not in a group home they are in their own home with help from my hha's (company's hha) I use to see skilled clients and I do their assessment every 60 days, do their skilled visit 1w9 and do the sup visit every other week. Like I said my patients are dd but they have comorbidities such as htn, chf, dm, etc. If they have a change in condition or new meds then I go out and see them more often. I have hha's to be my eyes and ears when I'm not around unless the workshop, parent or doctor calls. I'm pretty sure I have 50 patients or so, It's fine. The part time more skilled nurse see's the patients on State Plan/Skilled. I see patients with I/0 Waiver. I also work in the office a lot qa careplans, mars, and the tests the hha's take.

I'm rambling but nursing wise I am learning about home health. I was a direct service worker/patient care aide, so many different titles from the time I graduated hs until the time I graduated college. In my experience a nurse never saw my patient's I took care of or came to the house. I was allowed to do delegated nursing. I called the home manager not the nurse. If my patient falls, get's a blister, is having an increase in auditory hallucinations the hha call me. I'm done trying to explain the situation to you people.

I:heartbeat my job. I :heartbeat my patients. And I don't like ugly so have a blast saying this and that bc you won't be putting meals on my table, paying any of my bills, taking care of any patients, etc. Ciao!!!!

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Listen, what these fine nurses are trying to explain to you is that HH requires you to able to be in control, have confidence in your abilities, and more than anything, be able to react quickly with critical thinking in an emergency.

Just for example, I understand the concept of what a monitor does and how it works. But monitors are like computers. I may know how to run MSWord, write a business letter, and type; but to do those same things on a Mac requires me to know how it works. It's the same program and concept. . . but different. My agency sent me out expecting me to know the monitor in the homes I was in. The new protocols use a monitor that has its own set of nuances like nothing I've ever seen before. And I have worked with lots of monitors. To turn off the very loud alarm, you have to hold down both the on/off switch and the reset button. Well, I didn't know that when I first went into HH this time. Shoot, I didn't know why it was alarming because I am used to seeing at least some numbers. The only indication for why it is alarming is simple colored lights. Thats it. If you don't know what those colors mean, you're sunk. The number readouts are hidden if the parents keep the monitor in its protective case. I didn't know that either. There was nobody professional there to ask what to do. What would you have done? I had the life of that infant in my hands, parents who are expecting me to know what I'm doing, and a potential situation that could cost me my paycheck and license. I needed to utilize my nursing skills. . . FAST. Almost unconscioiusly, I did a quick evaluation of my baby. I could see that he was breathing fine, not feverish (which could cause those changes), smiling and pink. So I knew he wasn't in any distress. I have a sixth sense about breathing. When I don't hear that soft flow of air, I know it is time to start acting. Do you? Turns out the lead had come loose. Needless to say, the whole house was woken up my first night as I fumbled around with this monitor. To correct that, I found the manual online and read it.

911 is available to us. But 911 is 5-10 minutes away. Can you understand that a lot can happen in that time? That's why your complaint is throwing up red flags here. People think HH is easy street. It isn't.

Not to be rude I wouldn't have took this case. I have limited vent experience and taking people under the age of

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Specializes in acute rehab, med surg, LTC, peds, home c.

If you can tough it out for a year it will look better on your resume and you will def be prepared for home health.

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Specializes in Home health.
^^^^You sound silly. I'm required to see them every 60days for an assessment and sup visit, these are not skilled clients, and no they are not in a group home they are in their own home with help from my hha's (company's hha) I use to see skilled clients and I do their assessment every 60 days, do their skilled visit 1w9 and do the sup visit every other week. Like I said my patients are dd but they have comorbidities such as htn, chf, dm, etc. If they have a change in condition or new meds then I go out and see them more often. I have hha's to be my eyes and ears when I'm not around unless the workshop, parent or doctor calls. I'm pretty sure I have 50 patients or so, It's fine. The part time more skilled nurse see's the patients on State Plan/Skilled. I see patients with I/0 Waiver. I also work in the office a lot qa careplans, mars, and the tests the hha's take.

I'm rambling but nursing wise I am learning about home health. I was a direct service worker/patient care aide, so many different titles from the time I graduated hs until the time I graduated college. In my experience a nurse never saw my patient's I took care of or came to the house. I was allowed to do delegated nursing. I called the home manager not the nurse. If my patient falls, get's a blister, is having an increase in auditory hallucinations the hha call me. I'm done trying to explain the situation to you people.

I:heartbeat my job. I :heartbeat my patients. And I don't like ugly so have a blast saying this and that bc you won't be putting meals on my table, paying any of my bills, taking care of any patients, etc. Ciao!!!!

I may sound silly, but honestly your posts are difficult to follow. Yes, you're right you do ramble on quite a bit and after reading all you have to say I still don't know what type of case manager you are.

You do sound happy though............... so best of luck.

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Specializes in Home Health- LTAC- Telemetry-.
If I am not mistaken, you are the same nurse that posted a while back. Guess what? We are probably neighbors working at the same agency. :cool: Don't want to say that too loud because I've been trying to keep a low profile. But I was so grateful for your post a while back because I honestly thought it was just me. I was nurse from 1980-90 in the place you live. I decided to stay at home and educate my children for 18 years and then go back to work. The hospital I worked for even encouraged that and told me that the door was always opened. My husband and I had a huge financial setback about ten years ago that we haven't recovered from. Because of that, I couldn't afford at the time to renew my license. So I let it lapse, which I know was very stupid now. If I had just worked a day or two here and there, it would have been better than what I chose to do. I opted to retake the NCLEX to get my license back. I passed with flying colors. I was ecstatic. :monkeydance: But like you, I started applying for jobs only to discover that the local hospitals (and you know who I'm talking about because they have a huge monopoly here) refused to hire me and continue to refuse. Since May 2009, I have also submitted over 200 applications to that hospital. My forte is NICU and anything infant related. I am very good at it as well. So when said hospital sends me a computer generated letter from their outsourcing company that says, "There are other candidates more qualified," it makes me sort of mad. :madface: But of course, I can't be mad. I'm a nurse. :chair:

In my day, as a new grad, everyone rolled out the red carpet. Today, this is me as a nurse: :bowingpur I have taken quite a lot of abuse that I would never have put up with many years ago simply because I didn't have to. I was in demand and respected.

Anywho, all that to say that I was so grateful to see your letter that day because I realized that I am not the only one. I would love to make waves and figure out a way to argue that point, but what good would that do? :icon_roll So, I'm biding my time and waiting to see what happens. This week, for the first time ever, I thought there might be a glimmer of hope at one of the hospitals I used to work at. We shall see.

I am glad to hear you are doing better and that darkness is turning into light. Thats why I love thios forum because there is always someone you can identify with, there is always some tipe of support and good energies (there are a couple of bitter nurses out there but from those i just refuse to learn) ;-D

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