New Grad Pediatric Home Health Care Help?

[mandalynn.mandolin]

Hi!

Last time I posted I wasn't in school yet and now here I am about to graduate as an LPN! ?

I have been looking into a position in Pediatric Home Health Care (in NJ) and am wondering what an acceptable pay rate for a new grad in this specialty/type of field is.

My biggest question, however, is what is it like?

I have been a PCT in acute care and in mother/baby before, but obviously in the hospital setting. I have never done Home Health Care.

I am wondering if this is a good position for a new grad (I really want to work peds and eventually mother/baby or L&D but those positions in NJ are not available to LPNs at least not that it have seen and I have spent a year looking).

What is the average day/case like? Is it better/worse than working in a hospital or nursing home? What is an acceptable payment rate? Should I also look for a second job? Tips and Tricks?

thanks for the help! ?

[caliotter3]

Look at the many threads in the forum for extended care home health: “private duty”.

[adventure_rn, MSN, NP]

I don't mean to discourage you, but if you check out the Home Health or Private Duty forums, you'll probably find a bunch of posts discouraging new grads from starting in these fields.

When you're in a home setting, you have very little support. If you have a question, there's no other nurse or provider there to give you guidance. For concerning, your patient could be exhibiting signs of very serious distress, and you might not even realize it because you haven't yet learned what to look for. As a new grad, you don't know what you don't know, and so you may not realize when you're in over your head. It can be very helpful to have another nurse nearby, answering questions and pointing out things you might have missed. Think about it--if you've got a trach-dependent baby whose ventilator suddenly malfunctions in the middle of the night, will you feel comfortable knowing what to do?

Maybe it would be a little safer if you'd had extensive experience working closely with sick peds patients as a PCT. Honestly, I don't think adult acute care or mom-baby will have been terribly helpful (since the adults are so different from babies, and the babies in mom-baby are all healthy--no trachs, g-tubes, ostomies, etc.).

I'd be skeptical, even if you do get a job offer. Make sure that they will give you a very thorough orientation accompanied by another nurse. If they're desperate enough for staff, it's possible that they'll try to send you out on your own without adequate training, even if it puts you (and the kids) in an unsafe situation.

[LubbDubb77, BSN, RN]

I will agree, it is a bad idea for a new grad to be in home with a medially fragile child annnnnd I would advise against it. Usually the companies will say they will give you additional hours of inhome training, like 40 hours total. Additionally they might provide a day long ventilator class, which is nice. I've seen them say that as a new grad they will give you lower acuity pts with parents that will be home during the care. Either way, it is not enough. Also,  as a new grad you will have lots of questions and basically no support. You have to call for every question and you will have a million questions. Parents are not healthcare licensed, I wouldn't take their advice...all the time. It is your brand new shiny license on the line, be careful. 

I worked peds inhome care as a new grad and it was HORRIBLE. You really do need another nurse there with you to ask questions or bounce ideas off of and you cant do that with the parents in a lot of ways. What I encountered was the parents always wanting to veer outside of orders. Or, parents  micromanaging during cares or nursing interventions. I just couldn't do it. Also, just simply the lack of experience is tough overall. 

I went on to work with medically fragile children in a long term facility. The kids typically came from PICU's and we would take respite. It took me probably 2-3 months of working full time with another nurse on duty to feel okay.