New Grads Training in HHC

[KarenJordan]

I am a DON at a HHA that has never used new grads before. As a favor to the administrator, I must hire a new grad RN. I am used to training/orientation, but the nurses always have some experience. My question is - what does a new grad orientee need to know about HHC the most? For newer nurses, what do you wish you had more training on before you went on your own?

[paradiseboundRN]

If you don't already have this book, you should get it. Tina Marelli: The Handbook of Home Health Standards: Quality, Documentation and Reimbursement.You could teach by the chapters in the book.

[St_Claire, ADN, RN]

The paperwork and charting. We do not get even a hint of this in school.

Checklists such as all the things we need to complete for an admit, recent, etc.

Time management suggestions.

Patience. We are eager to learn and will make our share of mistakes.

[smurfynursey]

How you do things differently in home care. I've trained a few new grads in settings that are not the hospital, and they are heck-bent on doing it the exact.same.way as they did in school. It doesn't happen that way all the time and the paradigm shift takes some getting used to.

[loricole]

I have worked as a nurse in Home Care for 20 years. Our policy is that a nurse must have 2 years experience in med surg. before being considered for the job. There are many times when we are 30 miles from the hospital by ourselves with a patient, so we must be able to make good nursing judgments and have excellent assessment skills. A new grad would probably find this frustrating and may be putting herself/himself and the patient at risk.

[tktjRN]

Granted we all were there at one time, but being alone with no experience is very scary. I don't think they'll last to long.

[ctrn3478]

I'm a new grad RN in home health, i was a HHA in college. I love my job for the most part, and like others said i really wish i had a more organized training in documentation. It is disorganized where I am now (we have paper documentation only and are slowly changing to electronic) and I wish I knew better guidelines for simply what they wanted and when they want it, I was getting difference answers from everyone in the beginning. A do not use list would have been great (ex. I was asked to not write N/A in certain OASIS sections that did not apply but to put zero or leave blank..). I would say set them up to care for the patients they train on along with a nurse present for a certain amount of time until they are comfortable with a familiar patient and are able to be own their own with patients in which they fully understand the patients baseline and care plan. I found it was very comfortable learning procedures with patients who I knew what their normal reactions and VS/assessments were. Even then though there are times when new things arise and I just wasnt sure, in this case it is important to make sure they know when its emergent to contact the agency, PCP, and/or 911, provide them with specific guidelines for the agency w/ s/s and VS ranges if possible if they are not specified in the care plan. Finally, there were several times I was unsure but knew a situation was not emergent and was able to step aside and contact another nurse. It would be helpful to set them up with 1-2 preceptors and make them familiar with all the other nurses, especially nurses with common patients for support in these situations. Make sure you stay in touch with them and know if they are ever overwhelmed or uncomfortable with an assignment but afraid to say why. Its definitely hard and not the ideal first job but I think with proper training, communication, and support it can be do-able. sorry this is so long but hope it helps!

[KarenJordan]

Thank you all.