Private duty nursing vs. LTC nursing

[dukesgal]

I am a new grad, living in a small town. There are not many jobs here, most people who can afford to hold out for a good job are waiting it out or applying to hospitals in larger cities. I was fortunate enough to be offered a job at a rehab/LTC facility. I was hired to work FT over a month ago, but to date have only worked 3 shifts due to issues w/ training CNAs and RNs at the same time. I am more than willing to work, and the facility has apologized about not being able to schedule me more but census is down and they wanted to get the CNAs trained first. Meanwhile, I have bills to pay and need to make ends meet. Well, last week a home health agency contacted me and I spoke with them, they would like me to work 12 hr. day shifts to care primary for one pt. in their home as well as pick up additional hours doing assessments, blood draws, etc. The LTC is giving me a 6 day oreintation which I have only completed half of, but as a new grad it is nice to have other nurses around to offer advice and help when needed. In the home health position, they have not mentioned anything about orientation w/ another RN - just that a CNA would be there to assist w/ bathing, transferring, etc and I would be responsible for meds, tx and assessment of this pt. Basically I would be making more money doing primary nursing for this one pt instead of the 30 I have at the rehab facility. Obviously before I officially accept the position, I would ask more specific questions regarding orientation.

I feel very fortunate that the rehab facility was willing to take a chance on a new grad, and the residents I care for there are great. The nursing staff is composed of relatively new nurses, they are all very patient and encouraging. It is a lot of work, we are expected to pass meds and tx for 30ish pts in 7 hours, I don't have time to sit wth residents and listen to them, and I am rushed to perform my duties. I know time management and less and less time w/ each pt. is an issue no matter what area of nursing I end up in.

Nurses that have worked private duty, what are your thoughts?

[BillyMae]

My thought is that you need to acquire more nursing experience, as a new grad. You won't achieve that taking care of one client. To build your resume, you should want more vast experience, LTC will give you that. Good luck :)

[caliotter3]

In terms of job security the LTC facility is more secure, provided you don't get overwhelmed during your first year. Anything can happen with that 12 hour shift extended care patient, to include the family telling the agency they don't want you anymore after you have worked there for four months. Then you are at the mercy of the agency. Whereas, with the LTC facility, once you are on full-time, they should not be cutting back on your hours, theoretically. I would stick with the LTC agency as my primary job and go part time with the home health agency. But definitely go with both employers for maximum job security.

[nursel56]

I agree with the others. Even though you will run your tail off in the LTC, the experience of interacting with a broader variety of clientele, honing your assessment skills, learning the ropes of "office politics" and time management are things that will build your confidence and effectiveness in the HH field. Best wishes to you!