Only working in Home Health??

jnette, ASN, EMT-I · Jan 3, 2010

Certainly, the hospital is not the "be all and end all." The world of health care has many equally important facets. I do feel, however, that a solid clinical experience lets you bring more to the table. I myself never wanted to work inside a hospital or facility for my career, but I am very glad I had two years experience in the hospital and critical care.

It certainly does provide a good foundation, as well as variety.. with others nearby for support. Especially helpful if one is a new grad or has not had much exposure to nursing yet. :)

allnurses Guide · Jan 4, 2010

I'm applying to a home health agency that offers classes in vent and trach care. What difference does it make if you learn these skills in a hospital or home health setting? The hospital is not the be all end all of nursing care anymore.

I don't think any type of nursing is the "be all and end all" of nursing. Nurses have been going out to people's homes for centuries. I simply said that I felt more confident having some acute care background before venturing out to take care of someone who is kept alive by a machine with no nearby support other than 911. Everything usually goes according to plan, but with vents when they don't go according to plan very bad things can happen.

The first home health agency I worked for offered a 2 hour "vent class". I'll just leave aside that it was not so much a class as a thinly veiled advertisement for this guy's disposable vent circuit company. . . a 2 hour class is no where near adequate training IMO. However, I'm not saying that everybody for sure needs to work in acute care before home care. Acute care gives you more support personnel, a wider variety of patient experiences and plenty of expert back-up. If you feel confident in what you are doing, that's the important thing. Best of luck to you!

havenrn · Jan 14, 2010

I have worked in home care since I graduated from nursing school. Now after seven years I'm confused too. I have LOVED home care and have been happy. But honestly I have not been given opportunities for my skills to grow. I have been too busy doing admission assessments for PT or wound care. I have never had to place an IV, have a pt with a ventilator etc. When I do get to do more skillful care It's only for a week or so until the pt progresses and is dc'd. I now am looking for other opportunities as a nurse part time (I have small children at home so I've worked part time the last four years). I feel like I don't have any skills to sale myself with, except I am a hard worker and I care for my patients to my best ability. Sooo If I were to do it again I think I'd try working for an agency that did a variety of home care services, or did the hospital thing for a year. However home care just fit for me. I have loved my patients and do not feel burn out at all. But now I lack confidence as a nurse, not a great place to be.

Just do what you feel is best for YOU.

darkbeauty · Feb 15, 2010

I'm a new LPN grad too(well I got licensed in Oct.2009). I've also been a CNA and still consider myself one since I haven't been lucky landing an LPN position and still doing CNA work(which I love with all my heart). I'd like to say that I would LOVE to do home health nursing, since the bulk of my experience in healthcare has been in home health. I do not feel like I have to into an acute setting or LTC to shine up my skills then look into home health. The desire to work in LTC is not there, it saddens me to see residents deprived of quality care because a urse has 30 other residents to administer med and do traetments, and therefore I feel like I don ot want to be part of that. I came in to nursing with the willingness to care and provide the best quality care I can, and so far in my observation, home health seems to be the area to provide that.

I've worked with home health agencies that also employ nurses(RN/LPN) and have been the nursing assistant who follows the careplan--I've been exposed to all kinds of clients and patients with all kinds of needs and many kinds of equipements(tracheas, vents, bi-Paps, G,Jtubes, meds)...and I just feel like with adequate training and orientation, I can work in home health nursing.

jbudrick, MSN · Feb 16, 2010

I went into home care immediately after I got my RN license. I did try to get hospital and acute care jobs and quickly discovered that Mothers' with children who need daycare can forget about shift work. Where I live there is daycare available from 7am to 6pm. In 2001, it was the beginning of the nursing shortage and I received wonderful offers that I could not take. I was under the impression homecare nurses needed a BSN so I had not even considered that option. While looking through the paper I found an ad for a homecare agency that encouraged new grads to apply. I was chosen for the job and received a very good three-month orientation. At first it was hard with so much to learn but after one year I was comfortable.

After four years I thought I was missing out on not having that acute care experience. I got a job working four days per week at a rehab facility that specialized in dementia patients. The pay and benefits were terrific. No overtime was required. All of the aspects of nursing I loved disappeared. In homecare the emphasis was on teaching and assessment, wound care, new diabetics and people trying to regain their independence. In rehab the emphasis was on getting the meds out and making sure the patients didn't do anything completely unacceptable. Nurse "bullies" who were truly ignorant tried to undermine me.

It was not the experience I had hoped and I quit after four months. I got another homecare job and got my BSN. I have been at my current job as a case manager/primary care nurse for five years. In retrospect, I gained knowledge of the various types of dementia and I can usually tell which dementia the patient has after the admission visit, even it wasn't on the paperwork. In my current position I help patients and their family with the goal of keeping the patient in the community with chronic conditions and I became an ANCC Pyschiatric/Mental Health Nurse.

From my story, I hope the graduate nurses realize that the first year of nursing is hard no matter what the work setting. Homecare can be ideal if you receive a throrough orientation and are willing to put the work and time in to develop good assessment and teaching skills.

darkbeauty · Feb 16, 2010

What a great reply....only wish the same home health agencies who believed in you as a new grad, believe in us too as new grads! Thankyou! :):):):):):):):):):):):)