New grad - trying to get into the groove of things.

[dirtyhippiegirl, BSN, RN]

So I'm a new grad who was recently hired with a pediatric home health agency. So far, the kids that I've taken care of have been very stable. (Honestly, I feel like I'm basically doing what the parents have already been trained to do. The biggest learning curve for me has been learning how to do ADLs -- I've never diapered a squirming 100 lb child with the mental capacity of a 6 month old before. There have been some...embarrassing moments in front of family.)

My question is -- how long before you get into the groove of things? I'm really struggling with the presence of a home health nurse versus a hospital nurse. I feel more comfortable when the family isn't there at all, honestly. But with most of my patients -- family is there, or at least coming and going. Many live in small homes, so I am with my patient in the midst of people coming and going. My assignments are usually for 6-8 hours each so I'm there for quite a stretch.

I've cared for several different kiddos so far and it seems like the families fall into two categories: those who completely ignore you and seem annoyed when you have a question/need help or those who want to help out to the point that I don't feel like I'm providing much of a service to the family.

Also, because I'm so used to the hectic pace of hospital life and caring for several patients at once, I feel *nervous* when I'm not directly interacting with my patients. I do day shifts so they usually aren't sleeping -- but many have no interest in interacting with me continuously or even much at all. One family had to practically drag me out of a patient's room and sit me down in a little corner that they'd arranged for the home health nurse -- complete with baby radio so I knew what she was doing, cushy chair and well stocked with magazines and a good view of the TV. Cue the whole: I'm getting paid to do THIS?! worrying.

Any advice would be welcome! The most frustrating thing about home health is not having a lot of other nurses to bounce ideas off of.

[NurseLoveJoy88, ASN, RN]

I'm also new to HH and I have the same concerns as you. I look forward to any advice also.

[dirtyhippiegirl, BSN, RN]

Eep! Thanks. :) I feel like such a noob for asking these questions. I asked the nurse that I was shadowing the same questions - she's been a ped HH nurse for 20+ years - and all she could say was "Well, getting into a routine is the hardest part but you get over it."

I'm like...does. not. help. Aaah!

[PhilliesFan26]

I felt the same way when I first started as I also do longer shifts! health has much more downtime than hospitals especially with the more stable patients! I've only been doing it a little under a year but it gets better! I've learned to just do what I need to.. Do my assessment.. Give meds.. And then chart and other things when not needed! (or in my case right now.. Check all nurses while Pt is asleep!)

During the day in downtime I check supplies, equipment, make sure the chart is in order, make sure the PTs area is neat, etc! Sometimes I'll ask mom if she wants me to fold my patients laundry and put it away. It's weird and not what school technically prepared me for but I enjoy the stressfree environment!

Maybe ask your agency for a copy of your responsibilities just so you know what they expect of you. And if all is done during the day and patient is stable, then yes I sit in the cushy chair my Pt has for me and I watch tv and go online until I am needed or something comes up! Best of luck xoxo

[caliotter3]

PhilliesFan gives you a run down of things to do to keep busy. If you find yourself staring into space for too long a period, remember, there is always something in the patient area that could use a cursory or a good cleaning. Get out of the chair and straighten the area. You will get used to this. And most of us feel better when the family is gone, no matter how long we have been at this.