New Grad-Is Home Health a good idea?

[NCRN77]

I am a new grad, who just passed my boards on June 6. I am ready to work, and so far have put in about 20 applications. I CANNOT seem to get an interview anywhere so far, and my passion is ICU nursing. I don't expect to get a job in the ICU right off the bat, but would love to start in a hospital. I got an offer from a lady at church whose son-in-law runs a home health business, and I have an interview with him tomorrow. My fear is that if I am hired, will I be able to keep my skills that would assist me in getting a job in the hospital? And also, I have heard that working in certain places makes you "unhireable" to some employers. I love patient care, and realize that I can give good pt care no matter where I am. I'm just scared and wondering if I'm doing the right thing, or what the right thing even is. Help!!! Thank you!

[floridaRN38]

Where do u live that they don't hire new grads in the hospital!?

[HouTx, BSN, MSN, EdD]

Check your state's Nurse Practice Act - some states, including mine, do not support new grads practicing in any area without direct supervision by qualified RNs for a specific period of time. In a Home Care environment, you are working solo, and the even the best-case scenario would entail significant delay if you are involved in a crisis/emergency situation and need help.

Home Care is a very low-profit business these days. Because of historically lax enforcement, this industry has been a magnet for unscrupulous folks who used fraudulent practices to amass huge profits from governmental programs (Medicare & Medicaid). The Feds finally got their act together a few years ago and implemented much higher levels of surveillance/audits that have shut down lots of these fly-by-night agencies but the remaining ones are still under a lot of scrutiny. Unfortunately, the 'good' agencies are also suffering from the fallout. They have to expend a lot of resources to jump through all the billing hoops that are needed to get reimbursed.

Most agencies do not really have much of a clinical orientation - they just focus on filling out the paperwork. This is problematic because most nursing education programs do not spend much time on home care so there isn't even an awareness of the basic principles of home care nursing.. like "bag technique" or conducting an environmental assessment. Without additional clinical training, you may end up violating acceptable nursing practice through no fault of your own.

[ashleyrosesf]

Since your end-goal is to work in an ICU, from what I've heard working in home health doesn't equate well to transitioning to acute care. Hospitals don't really see it as the golden "1 year of acute care experience" required for ICUs. Most of those I know who work as RNs in home care love it and have stayed there and forgot about acute care entirely!

That being said, have you looked into new graduate programs in your area? They frequently hire into the ICU (at least where I'm from) and, while the spots are few, are definitely worth fighting for if that's what you love.

Best of luck! I worked in home health throughout nursing school and loved it. It allows you to get such independent and hands-on care with patients that you rarely get in the hospital setting. :-)

[Not_A_Hat_Person, RN]

What kind of orientation will you get? What kind of support will be available? The agency I work for has extensive orientation for new nurses and specific orientation for clients, but they don't hire new grads.

If you can find an agency that offers extensive orientation and telephone support, I'd recommend going for the job.