New RN working in Home Health?

Up2nogood RN, RN · Jun 28, 2010

There have been many discussions on this topic on the boards here if you try the search function. In my opinion it would be completely unsafe and irresponsible for an agency to place a new grad on their own in home health. There is a reason that a year of experience is required at reputable organizations. I would never trust a company that bypasses this safety measure, they're not looking after their employees or pts but just after the almighty dollar. Good luck I hope you can find something out there without risking your license.

Blackheartednurse · Jun 28, 2010

I would at least give it a try...I'm a new RN working for a home health agency and so far so good! Make sure to let you boss know what skills you are comfortable.I was lucky in that I dont have to draw blood (sometimes start IV).Most of my patients have chronic diseases but so far I havent had a trach patients or vent patients,I basically go in assess the pt from head to toe,weight them (see if they gain weight,if they gain more than 5 pounds in a week I have let the doctor and agency know),take the vital signs,check blood sugar (if of course the patient is diabetic),perform teachings,I also admit patients (head to toe and take their history,reconcile meds).One patient at a time and it gives you the opportunity to practice your assesment (like I see that I'm getting better in assesing lungs every day) And remember ask them to start you slowly (if the agency boss has head on their shoulder they will start you off slowly) Also you can always call your boss if you have a concern about a skill or call your fellow nurse.

Blackheartednurse · Jun 28, 2010

There have been many discussions on this topic on the boards here if you try the search function. In my opinion it would be completely unsafe and irresponsible for an agency to place a new grad on their own in home health. There is a reason that a year of experience is required at reputable organizations. I would never trust a company that bypasses this safety measure, they're not looking after their employees or pts but just after the almighty dollar. Good luck I hope you can find something out there without risking your license.

Not necessarly,it all depends on agency.My agency started me off slowly,gradually and if I dont know something they will send me a nurse to help.Or my boss will come.However in my agency we dont deal with a whole lot of trach and vents,more like chronic diseases,sometimes catheter care,sometimes starting IV.

KateRN1 · Jun 28, 2010

I am absolutely, vehemently opposed to new grads in home care. There are so many rules, regulations, documentation requirements, and case management pieces that it's simply not a good fit for new grads. Nurses with years of experience struggle when new to home health, even experienced home health LPNs moving to an RN-case management position struggle. You need several years of various med-surg experience to be comfortable with basic nursing skills, let alone the attention to detail and case management skills required in home care. I always advise new grads to go anywhere *but* homecare. Long-term care, long-term acute care hospitals, rehab facilities, sub-acute centers, anything is better than starting in home care. You simply don't have the experience and nothing can take the place of that.

misia84 · Jun 28, 2010

OMG..i was also looking at that job because i'm considering moving there..l'm a new grad and i want to move there because it's close to louisiana.please let me know what happen..Goodluck! :nurse:

SlightlyMental_RN · Jun 28, 2010

Please, resist the urge. As a new grad that did this, it was a HUGE mistake. (Not to toot my horn, but I was always considered to be the smart-cookie in my clinicals and I graduated towards the top of a large nursing class, and I was Sooooo out of my comfort-zone.) Thank goodness I kept my other job while I tried it out, is all I can say. (Gave notice after one shift.) I honestly would discourage anyone from doing home health until you've got at least 3-5 years of solid background in med/surg or NICU experience if dealing with infants.

woknblues · Jun 29, 2010

It doesn't hurt to investigate. What if they are willing to train you properly? Everyone will say don't do it; I say have a look. I would. Sit around and wait for that med surg job in a large hospital with 6 months of side by side preceptor job, and you just might never work again. Just sayin'.

mauxtav8r · Jun 29, 2010

It doesn't hurt to investigate. What if they are willing to train you properly? Everyone will say don't do it; I say have a look. I would.

I'd say give it a try. I've lived in cities where there are zero new grad opportunities except in ob or med surg, but I've also lived where a bsn has many opportunities at specialties including ICU work. The reason behind these opportunities is that those hospitals that hire new grads into specialties are prepared for it.

I got less than a year under my belt on a busy med surg floor, then on to hh. Love it.

squatmunkie_RN · Jun 29, 2010

Thanks guys, I really don't think Home health is the job for me either as a new grad. I guess I'll keep looking in the job search..... :crying2:

It is not looking good though....

nicole109 · Jun 29, 2010

I'm certainly not a new grad, but I do consider myself VERY green...I've got only 5 years of nursing under my belt, and I've been a home health nurse for about 8 months now. I'll say that I LOVE it...and I can't see myself ever going back into a hospital, EVER again. However, even with 5 years of nursing (med surg, and ICU) under my belt, I still come across things in home health that make me think. I can not imagine going into home health as a new grad, no how, no way, no shape! There is no amount of training that a home health agency could provide you with that could substitute for good old fashioned on the job training. I spent 5 years in Neuro--and going into patients houses for the first time, I was scared to death of cardiac patients because I had never had to deal with them before, so I had to go back to the books and learn cardiac all over again and then just keep taking cardiac patients over and over again in orientation to learn the proper things to teach them and look for in complications, etc. Imagine, as a new grad having to do that for all of your patients because you have no bedside experience...and not being familiar with medications, etc...again, no way, no how, no thank you. And lets not even get started on the importance of documentation, and the rules that come with homebound status, frequency, etc...all of the administrative pieces alone can be enough to make you pull out your hair!

Scarlette Wings · Jun 29, 2010

i understand the need for having a measure of experience in home care. we didn't allow our nurses to work for our agency unless they had a minimum of one year med/surg. that way they could start iv's, do labs, and if a patient was doing poorly the nurse would be comfortable with their assessment skills. the patient totally relies on you and you are in their home without any back up,or second opinions. no one to help you identify breathe sounds that seem like fine crackles verses bubbling rales.

there has to be a base level of comfort in your skills of assessment, communication with doctors, and seeing changes in a patients condition quickly without all the toys of work. there is no x-ray machine to verify a pneumonia. no abg if they seem hypoxic. they pull out the supra-pubic tube or peg tube you put it back. only you know how comfortable you feel with your skill level, just remember your families look to you to know what to do and how. good luck with whatever choice you make. just know you have to live with it and the patients you see depend on it and you are on your own and can feel quite vulnerable.