New Grad

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I know this topic has been addressed, however I'd really like your opinions :) I am a new grad writing my NCLEX in November. I've had 0 luck with hospital positions, no one is hiring. I'm thinking this may change once I actually have my license, but, in the mean time, I've got an interview with a home care agency (non profit). Now, I have read that new grads and home health don't mix. Here is my situation:

The agency is offering 3 months orientation with an experienced nurse. I've also had a communtiy/home health placement for 4 months that I absolutely loved. I also worked home care as a UCP in summers during school. I really enjoy home health and it's where I want to be. Obviously pt safety and my license are of the utmost importance, but my question is, can it be done with prior placements and a really long orientation? Any input would be appreciated!

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Are you talking about home health (intermittent visits to several homes in a day) or private duty nursing (several hours with one patient)?

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Sorry, I didn't give enough info. I'm taking about home health, not private duty. I would be visiting multiple clients per day.

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My orientation to home health was also 3 months and I was an experienced RN. I don't want to say that it can't be done, but it would be incredibly difficult. It would depend on the supportiveness of your management. Are they available when you are out in the field and have a question? Will they be checking in with you after orientation to see how things are going? Can you be assigned to a mentor of sorts to bounce things off of?

I think the biggest challenge you will face as a new grad is not having had the opportunity for collaboration while developing your assessment skills. While your on orientation, make sure your preceptor is letting you do the assessing and then ask him/her about anything your not sure about while you're still in the patient's home.

I would also check on the agencies method of orientation. If they are giving you 3 months, but not giving your preceptor and productivity credits for preventing you, your orientation probably isn't going to be very good or thorough because your preceptor will be stressed and rushed.

Best of luck! Let us know how it goes!

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I have seen such a huge difference in the patients' experience between having a seasoned nurse knowledgeable in assessment, critical thinking, disease management and hands on skills and having a nurse new to home health and patient care in general. 3 months will teach you the basics of home health regulations, documentation, organizing and scheduling patient visits, basic task oriented care. With today's acuity that's coming home, assessment skills and critical thinking are more essential than ever. An exceptional new grad cannot get that in 3 mos with the best of orientation, in my experience. You will be the only licensed nurse laying eyes on a patient on a particular day, and potentially for weeks, who not too long ago would not have even been discharged yet from acute care, there is no physician making rounds and no next shift to catch what you might have missed.

If you could dedicate the next year to not only an intense learning curve experienced by anyone beginning home health that will be full of frustration following the initial 3 months as well as layering on outside studying on your time off i.e. not much life balance the first year, you will be able to improve your patient care and their experience sooner.

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Thank you both so much for your info. You have given me some really good questions to think about and ask at my interview. I realize, in the community you are on your own. There aren't other nurses there to ask questions of. I will ask them if there will be support/a mentor for me to call if I have questions after an orientation phase. I agree it'd also be good to make sure my preceptor has some sort of incentive to really work with me so I can learn. I don't want him/her overwhelmed and feeling like I am a burden.

Pt safety and quality care is extremely important to me, I want to make sure I am ready to care for these pts. on my own before taking on the responsibility. The agency has part time positions available, perhaps I can work part time in the hospital and part time community. However this may be a tough thing to juggle as well! I have much to think about! I really do love community nursing and if to be good at it I need to spend some time in med/surg then that is what I'll have to do. Thanks again!

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Specializes in Home Health, Case Management, OR.

I went into HH as a new grad. I had an amazing director who taught me so much! It can be done with the right support!

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I wouldn't do it no matter how long the orientation. You really need experience when you start HH, in my opinion. There are so many skills you don't learn in school that you get with experience. Your assessment skills as a new nurse are not at a level that makes home health a good fit.

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