New Nurse and HH?

3.24.95, LPN · Apr 14, 2019

Based on a lot of experience, observation and fact -- IMO -- HH is neck-n-neck with the majority of "nursing homes," as the most "hostile work environment(s)" in the medical field.

If doing the right thing, making a difference in people's lives and helping those less able is truly what you're looking for, you will not find it in any agency that I'm aware of.

In fact the more compassionate, helpful and intelligent you are, the more likely you will be taken advantage of and manipulated.

I wish I could offer something more encouraging or positive : / but my honest recommendation is Don't. Do. It.

tlucero49, BSN · Apr 15, 2019

Well, my experience is that some nurses think that home health is easier than floor nursing and that can be true in some aspects but to do your recommended # of pt, travel time, and supposed to be charting at the houses, nurses have to have good time mgmt skills. Most of my pts were in the mountain areas and sketchy internet access, so I did my charting mostly at home. And for a PRN nurse I was pretty much working 5-12hr shifts plus rotating on-call weekends/holidays. Great pay but my agency wouldn't give me full-time benefits for working a full time shift so I went to hospital nursing. But I gained a lot of experience, especially with wounds that some of hospital nurses don't get, unless they are on the woundcare team. PS, I was a new nurse with only 2 months of SNF experience and stayed with HH for over a yr.

Kaisu · Apr 16, 2019

3.24.95, LPN I am so sorry for the terrible experience it sounds like you had. Notwithstanding, my experience could not be any different. When I first got the job, I would pinch myself because I thought I was dreaming. The care I was able to provide was the reason I went to nursing school in the first place. One on one with all the support I needed from the agency. It was truly satisfying part of my nursing career.

I know I helped a lot of people. I would get cards and letter from patients telling me how I had improved their lives. It was truly wonderful.

3.24.95, LPN · Apr 26, 2019

I assumed the reference to "Home Health" was actually "Private Duty," as that's how Aveanna/PSA/Maxim, Bayada (mostly) refer to themselves.

I did HH years ago & loved it!

PDN, not so much

Princelady8, BSN · Apr 29, 2019

Congratulations on making it through nursing school! I don't think we give ourselves enough credit for such a great feat ?

I was in the acute care setting for seven years prior to transitioning to home health. I would say that having the critical thinking skills that come from working in the acute setting definitely helped me in my role. However, one of my colleagues from nursing school went straight into home health right out of nursing school and she has never had the desire to do anything else. Today, she is an amazing nurse who now specializes in wounds.

I think it all depends on your reasons for disliking floor nursing and on what your expectations are for being in a different setting such as home health. I chose home health not because I disliked floor nursing, but for the autonomy and the opportunity to educate patients and their families without being pulled in a million directions. I also did it for the flexibility- it allowed me to work and be a present mom at the same time.

Like others have mentioned in their replies, some days can be very long depending on travel distance/time and how long your visits are. Some patients and families are super kind and grateful, while others not so much. The documentation can be a drag as well if you don't keep up with it, but that's where your time management skills come in.

The beauty of nursing is, if you hate it, you can always move on to something else. If I were doing this as a new nurse, I would choose to work for a company where support and resources are readily available. Sometimes you need someone to bounce ideas off of.

Best of luck! Let us know how it goes.

Zippy83 · Apr 30, 2019

It really depends on the agency that you work with, and the type of mentoring you get. Some agencies want to spend zero time or energy on training and will just throw you out to the field just because you have some clinical experience. Home health is its own animal, and in order to be successful even the most experienced nurses from other fields need some orientation.

I have worked for a couple of agencies that just threw me out there and it was pretty miserable. And then I found a wonderful agency where they had all kinds of patients with different issues and I would do two shadow visits anytime a patient presented a new skill that this specific agency had not observed or trained me on, even if I had previous experience. This was awesome because I was able to strengthen my skills as well as learn new things and become very confident.

Depending on where you live, the driving could really be awful, the charting really piles up, and there are all kinds of dangers lurking when your visits are in the community. Some days really feel like I’m in some medical version of Alice in Wonderland.

I absolutely love working independently though, and I like every day being a little different than the last. If you thrive on these things you may really enjoy it, but if you like routine and predictability I would stay away from home health.

Alexandra Lucia · May 15, 2019

Hey Fellow Nurses !!

I'm in the Denver area and recently left my job at a major HCA facility because I was truly concerned for my license and I was also beginning to hate nursing. It was unsafe for both nurses and patients due to the lack of staff, support and resources. I worked at this level 1 Trauma hospital 9 mos on a busy med-surg floor that was really like a step-down unit with the high acuity of patients.

That being said I am now looking for work and am thinking home healthcare might be a good option for now. I've seen negative reviews about a lot of agencies. Does anyone have any suggestions for decent ones that treat their staff decently?

Thanks for any guidance and/or advice.

ModelMom, ASN, BSN, MSN, RN · May 19, 2019

Hi!

Congratulations on graduation, and I wish you ALL the success and prosperity in home health...I'm sure you are going to slay it ?!

I've been in the HH arena for almost 8 years now, and I've had the pleasure of working in two states that were drastically different as it pertains to HH nursing. I began in Maryland which hadn't really taken to the 30 minute skilled nurse visits as California had. I thoroughly enjoyed HH nursing in California, but it was hugely unregulated and very autonomous for the nurse. However, with that autonomy came huge repercussions on your nursing license if things were to go horribly wrong!

I'm sure your experience will depend on if you accept an 8-12 hour agency position or a start of care/30 minute follow up position. Either way, I found it very useful to know and understand

the nursing scope in your state,
the documentation tools and procedures of your agency, and
your nursing strengths and witnesses.

Be prepared to learn a lot on your own as it pertains to documentation, because your documentation is the primary source for Medicare and Medicaid reimbursements for home health services that you provide.

As long as you present yourself well, make yourself the expert on your patients and their health situations, and arrive prepared...you will be wonderful! If you ever have any questions feel free to message me ?!

Remember, We RN this together

Trischana