Orientation for New Grad in Home Health

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Hi everyone,

I am a fairly new grad. I just graduated and passed the NCLEX in June. I have been applying to plenty of hospitals all across South Western Ontario and have not been able to find a hospital job. I noticed that a lot of home care agencies were looking for RN's and although I didn't want to do community nursing I figured that at least home care would allow me to use my skills. During my interview I asked about the orientation process and was told that I would have 2 days of in-class orientation and at least 6 days of training with a preceptor. I accepted the job but during my in-class orientation I was informed that I would only have 1 and a half days of in-class and 2 and a half days with a preceptor. I didn't learn much in the in-class orientation and it seemed very unorganized. I had the first day with my preceptor today and I am completely overwhelmed. I feel like after 1 or 2 more days with a preceptor I still won't be ready to care for patients on my own as I have no prior home care experience. I would be working as a visiting nurse with this agency and would have up to 10 patients per day. I am thinking about asking for more training days.

Has anyone else been in a similar situation? And can they refuse to give me more training days?

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Hi everyone,

I am a fairly new grad. I just graduated and passed the NCLEX in June. I have been applying to plenty of hospitals all across South Western Ontario and have not been able to find a hospital job. I noticed that a lot of home care agencies were looking for RN's and although I didn't want to do community nursing I figured that at least home care would allow me to use my skills. During my interview I asked about the orientation process and was told that I would have 2 days of in-class orientation and at least 6 days of training with a preceptor. I accepted the job but during my in-class orientation I was informed that I would only have 1 and a half days of in-class and 2 and a half days with a preceptor. I didn't learn much in the in-class orientation and it seemed very unorganized. I had the first day with my preceptor today and I am completely overwhelmed. I feel like after 1 or 2 more days with a preceptor I still won't be ready to care for patients on my own as I have no prior home care experience. I would be working as a visiting nurse with this agency and would have up to 10 patients per day. I am thinking about asking for more training days.

Has anyone else been in a similar situation? And can they refuse to give me more training days?

home care is not the place for a new grad, sorry. The way you learn and grow skills is by working with others and learning from them. Home care orientations are generally short because it is expected you will have a working skill set (you do not). Ask for a longer (as in weeks to months) orientation or walk away. You aren't going to learn a thing by being thrown into a job you don't have the skills to do.

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cough cough. Are you kidding?! That shouldn't be legal.

We have strict guidelines in California and have to prove how we will address meeting state regs with our new grad orientation. We provide 2-3 weeks classroom then 2 mos minimum one on one with an RN followed by weekly covisits for 4 months tapered down to monthly until an equivalent of 12 mos. With 4-5 visits/day max in the latter 1/2 of the year.

10 visits per day? Unless you're doing simple tasks such as routine injections on stable patients (and maybe that's home health in Canada) 10/day isn't possible. Our patients are high acuity, our experienced nurses can do 6/day and that's still a lot to provide quality care and management.

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Thanks for your response. I talked with my supervisor and she is going to look into getting me one more training shift which I don't feel is enough. My preceptor told me that the supervisors will try and give me patients that I am not trained to work with by telling me that the visit will be quick and easy. I am seriously considering quitting, I'm just worried this will not look good on my resume and may prevent me from getting another job.

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I cannot speak for your area but where I am, those quick and easy visits are rare. In fact if it seems easy, you're probably missing something.

It used to be common to tell someone "this will be an easy visit", that is exactly what we used to call them. Acuities have changed though and hospital readmissions are high. It's catching some experienced nurses off guard.

Again, i don't know Canada but here, 30 days would be barely enough time, and that's only if they control the volume, prep you well and are there for immediate support when you go on your own.

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In Canada it is normal for hospitals to only provide 2-3 weeks of orientation unless you get into a new grad program which provides nurses with three months of orientation but not many hospitals offer this program so it is very difficult to get into.

Today, I was told that two other nurses were sent out into the community on their own without proper training Yikes!

There are so many reasons I want to leave this company as it has been unorganized since day 1, but I have only been with them for a week and I don't know if my next job will be just as unorganized. So many people have been telling me to stick it out because all new nurses hate their first job and it will get easier with time but knowing that I only have one more training shift makes me nervous.

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In Canada it is normal for hospitals to only provide 2-3 weeks of orientation unless you get into a new grad program which provides nurses with three months of orientation but not many hospitals offer this program so it is very difficult to get into.

Today, I was told that two other nurses were sent out into the community on their own without proper training Yikes!

There are so many reasons I want to leave this company as it has been unorganized since day 1, but I have only been with them for a week and I don't know if my next job will be just as unorganized. So many people have been telling me to stick it out because all new nurses hate their first job and it will get easier with time but knowing that I only have one more training shift makes me nervous.

what you are describing is not a case of not loving a first job, but a case of being placed in a situation which you are a danger to your clients. If the are not willing to train you to the job, and you are being told by others they will intentionally mislead you to take a case you can't manage, get out. Now. Always keep in mind that if you accept an assignment you are not capable of it is you who is assuming all the risk. You could loose your nursing license or worse.

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I have decided to quit even though I don't have another job lined up. I can see why some people like home health - the flexible hours, the one on one with the patients but I don't think I am ready for home care. I really don't want to compromise my licence and since they are not offering me the training they promised I am quitting. It's unfortunate that my first nursing job made me feel like a failure but hopefully my next job won't be so bad.

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Fwiw I think it's the right move. I love home care, but I was a hospital nurse 15 years before transitioning. You need a job that helps you grow and developd. Good luck.

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I started as a new grad in home health, in Canada as well. I'm 9 months in now. I love it. I had a full month orientation, with in class plus 14 shifts of precepting and then I had reduced hours as well to ease into a full case load. I've been successful as of now and I really like it. But you need more time. I would definitely ask the agency for more time precepting, and if they don't agree, I would move on. I also don't think I would have lasted this long without all the nurses on my team who I can call for advice and help whenever I need too. I'm with a very supportive agency.

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I have decided to quit even though I don't have another job lined up. I can see why some people like home health - the flexible hours, the one on one with the patients but I don't think I am ready for home care. I really don't want to compromise my licence and since they are not offering me the training they promised I am quitting. It's unfortunate that my first nursing job made me feel like a failure but hopefully my next job won't be so bad.

Saw this after I replied. I think you made the right decision. Good luck in your job search, I hope you find something quickly!

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I am a new RN with 1 year of experience. Looking to switch to home care in Ontario. Wondering how the orientation varies between different agencies and companies? At this point in my career I'd be willing to trade convenience and pay for learning opportunities and support.

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