I suppose I am writing this to vent, express my opinion, generate comments and opinions, and maybe even help others who may relate and find a solace in reading my post.
I say sorta new grad because I was an LPN at a nursing home for a year (RN there for a couple months before I left ... more pay but same duties). So I'm a new grad RN with a previous nursing job but still pretty much a baby. Haha.
I took the first job I got offered so I could make the move to VT. Bayada home health. It's only my second week. Caring for a young man in his 20s with a trach and g tube .... brain damage is present so there's really no verbal communication.... I'm overnight 10-8. I have a little experience with g tubes from LTC but only touched on trachs in clinical. So I was nervous.
At first I was overworked and completely physically being affected... the other nurse who cares for him is out so I've had to pick up the load. Luckily, the agency is very understanding and supportive and have reduced me to 4 ten hr overnights instead of 5 in a row and worked out a pretty flexible schedule for me and it seems like it's able to be tweaked if I find something doesn't work for me or works better for me. So you gotta give a little of course but they are flexible here if you voice your concerns or requests. (Which I'm learning to do ... depending on when the other nurse comes back I'm supposed to do every other weekend so I can have full weekends off sometimes soon ... I'm just pulling the weight right now doing them every week right now however it's temp plus I did request sat off and they were super flexible about it!)
oriented for 2 1/2 nights which at first felt like not enough but turns out I actually felt more at ease when my preceptor left because I was able to go by my own routine and schedule.
I've been checked off on skills and now just have to turn in a written exam and I am "adult trach certified" which they said I can carry with me into future jobs. I honestly don't feel very certified in trachs.... I can suction and I know the protocols if the trach comes out and luckily if his did he's pretty stable without it .... I don't know what I'd do with a mmore dependent patient if complications arose. I'm still having trouble changing trach ties .... it's so difficult to fit them in the slots!
I never wanted to get into HH. I want to be in the hospital as soon as I can be. I want to do hospital skills. Work with IVs. Experience different patients. Work alongside other colleagues. I guess the trach and g tube skills will help? While this is not my thing ... I at least feel like it's more bearable than I did a few days ago. And I know it's thst way with any new job. Especially since I had started the night of the day I moved into my new apt so I got no rest for several days straight ha.
Emotionally: you'd think I'd feel more compassionate working with this patient ... his poor mom slaves away caring for him when we're not here and others his age have much better quality of life. I'm a very sweet and caring person so I was surprised I didn't feel much. Made me feel guilty. After Talking with some people and reading an article I realized this is normal sometimes... as nurses we may sometimes block feelings without realizing it as a defense mechanism.... this doesn't make us bad people. And sometimes one patient gets to us more than another and that's just human. And it's okay if when I go home I don't worry about my patient because work and personal life are separate. And naturally, if this isn't my niche, I may feel a little differently but it doesn't mean I won't give quality care to my patient.
Let me tell you ... I'd be totally fine doing three 12 hr night shifts in the hospital ... four (at least not 5 now ...4 is manageable) 10 hr shifts overnight in a row are just different when you're alone and only have one patient to care for. Also, know what my biggest issue is?? Not the high tech care but TURNING AND CHANG ING BRIEFS! I am tiny and it's very straining on me when my patient is dead weight ... at least in LTC I could get help from the CNAs if needed. I'm completely alone here. I've been shown techniques to help me so I'm gonna try those but the fact of the matter is it is still more difficult.
I feel that as a new grad HH is not the most optimal place to start out. Both in LTC and now HH, I have virtually been on my own when I feel like I need coworkers and mentors around to help me learn and perfect my skills. With both jobs I have the same patients/residents and I feel it's hard to learn new things that way. I do feel lucky to work for a decent HH agency though, they're supportive and flexible and I feel welcome to call if I have questions on my shift. I am also the only nurse right now for this patient while the other nurse is out and even then it seems there are no PRN nurses?! (I used to get full time hours if i desired at LTC when i went prn!) So it's pressuring to fulfill shifts knowing if I'm not here his mother is slaving away . But that's where I'm learning to take care of myself and say no if I'm over exerted and maintain my own life outside of work .... being flexible to the family's preferences when and if I can. Do I want to do this forever? No. Actually waiting to hear back from a new grad hospital nurse residency program. Will I be flexible and generous with my time and notice when I leave this agency because they've been good to me? Definitely.
They know that I'm very intent on working with peds patients but they didn't have any upon hire but told me I could transition to them if they come up. Will I be here long enough for that? Idk but if so I'll be happy to take on peds patients. Is my heart still yearning for the hospital? Yes. I'd love to do NICU, or at least peds, or oncology. I will take any floor in the hospital to just get my foot in the door and start doing hospital skills though haha.
Do I think new grads should start out in HH? if hospital work is what you want, it's probably not ideal BUT, like with me, it might just work out that you started in HH first and then hospital instead of the other way around and any experience is good experience as a new grad. And I know the g tube but especially trach experience and cert will look good for hospital work. If HH is where you want to go and stay,even though I'm sure hospital experience would be helpful, then I say jump right in if you don't plan on doing anything else because if you don't ever plan to work in acute care then might as well jump in and learn in the area you plan on sticking with!
So in conclusion.... honestly? I don't really like my job that much .... it's not the patients fault of course, just not my niche. I don't hate it though like I did the first few days! (Stress relief, sleep, and eating helped me hate it less haha). Some people love HH.... I don't and that's ok. I feel neutral about it now which is better than hating it and crying before i go in like i did before. Do i still give quality care? Indeed. Do I feel important and respected for my job? Yes. Will I end up at the hospital? Definitely. Who knows if in the future I won't want to do this .... but for now I am and looking for hospital work. Hoping that if I get into the new grad program, I think they have different start dates for different units so it's possible I wouldn't start for a few months after hire so I can put in plenty of notice at the HH agency and work with them just like they've worked with me to give my services as long as I can before they have to find someone else.
The end! My thoughts. Any comments or opinions of your own are welcome!
