New Grad- possible home care job- need advice

[FuturePN]

So here's a little bit of back story- after high school i went to college for Early Chilldhood Education, worked as a day care teacher for a long time as well as a nanny, went back to school in the mean time for my medical assistant certification when i realized i wanted to be in the medical field, then worked in a pediatric primary care office after obtaining that, then went on to work at a major pedi hospital's satellite full time while going to school to complete my LPN. I just graduated in January and passed my boards last month.

so- needless to say- peds is my passion :) Ive been searching for a job for a while now and the majority either are with the elderly population, or won't look at me because I'm a new grad- despite having more than a decade of clinical experience as a medical assistant, it's not the same (obviously)

I've been interested particularly in pedi urgent care or home care. I REALLY like the idea of home care, but im nervous that as a new grad I wont get the benefit of working alongside other nurses every day.

Anyway, i got a call back regarding a pedi only home care job i applied to, which was extremely exciting. I had my interview yesterday. the interview went really really well. I adored the case manager that I met with- she's been there as a home care nurse and now manager since the company was founded 17 years ago. It was a very lengthy and thorough interview... there were a lot of "scenario" questions. It was challenging at times but i really, really actually enjoyed it. It would be shift work which i like- just one or two families that you really get to know. They seem to provide ample training which i love, and it was a very new nurse friendly environment (dont be afraid to ask questions... you WILL make a med error in your career and this is what you do...)

so here are my concerns: they asked me to come to their general orientation next week to fill out the CORI... get tax stuff straightened away... go over policies... etc. So that SOUNDS kinda like im hired... but they didnt say that at any point. I finally asked when "if" i was hired would be the first day of work, and they said it would be when i started orienting to a particular case. But like... would I get an offer letter? how would i go about giving notice to my current job? and is there a chance that i could start orienting to the case and then not *get* the job, or is that truly the official start date? I'm just not sure if home care is different than what I know, since it all seemed kind of vague. my plan right now is to just go to orientation next week and take it from there.

secondly, they are a very Catholic organization which doesnt really align with my beliefs (or lack there of) I obviously have nothing against anyone and their religion but I've never worked for a company like that before, and mostly i fear for what that would mean in terms of health insurance (as a 35 year old woman who doesnt think she wants kids I sure do like my birth control...) They are also extremely pro-intervention and against palliative care for children- this was even in their mission statement on their welcome page, and was mentioned in the interview.

and thirdly- they are asking that I sign a document stating that I won't leave for a year, with the penalty being $5,000. is this fairly standard? They said it's because of the investment into new grads that they offer and the fact that as a pedi agency they want to ensure stability as much as possible. It makes sense to me but it does give me pause. They claim that they have had turn over in the past because they are a non profit and their rates are not very competitive. i found their rates to be VERY competitive, it was exactly what i am looking for, but that is because I am a new grad. The rates are the same across the board so if i was an LPN with 20 years of experience- yes, i would be upset. They are currently petitioning the state to raise the rates and i read the owner's transcript of her speech in front of the state and it was very moving and wonderful (she founded the company due to her own chronically ill child) I am certainly not looking to leave my first LPN job within a year. I am loyal... i was at my pedi primary care job for almost 5 years and have been where i am now for 4.5, so i don't plan on job hopping. but it does make me a little uncomfortable.

So I guess i am just looking for any advice that you may have about home care, wondering if these things are standard for home care, and any tips you may have.

thanks SO much!!!

[NurseSpeedy, ADN, LPN, RN]

Do not sign that contract. They have a problem with retainment- this means other nurses had a reason to bail also. Contracts are to benefit the employer-not you.

Home care companies are a dime a dozen. The smaller ones will take a new grad in a heart beat-you need experience, they know it, Medicaid cases don't pay worth a crap, and therefore you will not be paid much from the agency. Once you have experience, other companies will hire you, and then the agency is trying to fill the position again.

Your orientation is likely based on a client need. You would go out, meet the patient and family, be checked off (and family approved) on the skills needed by the child, and based on how things go, you may be assigned to the case, parent permitting.

This sounds like per diem work. How do they plan on giving you work when your client is hospitalized? I went 4 weeks without a paycheck. The agency would not reassign me because they needed me to staff that case when they returned home. Health benefits were based on hours worked...drop below and bye bye healthcare coverage (had mine through husband). As far as birth control coverage, many companies don't pay for all/much of it. I think I saved a couple dollars a month on the pill with coverage.

My opinion, scrap the contract or look for other work

[caliotter3]

There are too many home care agencies available to take a position with one that does not seem "right" for you at the beginning. Most companies do not bother with offer letters. You are right to assume that you can orient on a case but not end up working on that case. You may, or may not, even be paid for the time that you orient (yes, there are agencies that expect you to orient on your own dime). Since the religion thing bothers you, I would not go with this agency. Find another agency, and start out very part time while keeping your present job until you find that the new one will work out. As a matter of fact, many nurses who work in a hospital environment also work very part time doing home care shift work to supplement their main paycheck. This is the way to go, if possible. In home care, there is too much "job today, no job tomorrow". The client families can, and do, get rid of their nurses on a whim. And when that happens, you have no paycheck if the agency does not place you.

[FuturePN]

i appreciate the advice! i'm still so torn. It's really my dream job, I just don't know if it's the right TIME in my career. The cases I would be starting with are G tubes/J tubes and again, they offer a lot of training. I don't know.

[Entlover]

I worked in pediatric home health for about 4 years, and found it very rewarding. The two cases I had were both children with trachs, so I had to take the boy to school and stay there with him. As mentioned, when he got sick, I wasn't paid, which was fairly often as he was pretty fragile.

I finally had another job offer, telephone nursing, and took it since I could no longer haul a heavy suction machine and a sometimes recalcitrant 4- then 5 year old onto a school bus every day.

I would have another conversation with your case manager, and explain that you really like the job, but need more information. You need to earn enough to live on, so want some assurance you will actually be assigned. And you need to know when you would start so you can give adequate notice. (usually 2 weeks). I would hesitate to sign a contract with a penalty clause -- I've been asked if I planned to stay on a job, but never heard of such a penalty. I would just assure them that if it works out and they can give you enough work, you will stay.

I'm a Catholic convert, so can't advise you on that issue, except to say that Catholics are very prolife, and certainly regard each child's life as precious. Look into the reasons why Catholics frown on contraceptives, it's an interesting issue that feminists should appreciate.

Good luck!