This is a long email, so I apologize.
Here is my problem. My wife is a VP at an Home Health Care (HHC) company, and the recruiting team cannot find nurses in SOCAL. She is at her wits-end and asked me to TRY to figure this out, so my thought was go to the experts...you, the nurses. Here is my assessment (through the eyes of an HHC nurse, who was a 15-year hospital and ICU nurse) and I would love to hear your thoughts.
"I think that when it comes to ER, OR and ICU nurses, they do procedures in the hospital that HHC nurses typically don’t do in the home environment, so it would make sense if that set of nurses might have concerns about doing high-acuity procedures in the home environment.
OR is obvious, but in the ER or ICU, they are definitely going to do things like A-Lines, new vents, gunshot wounds etc. that need to be stabilized in-patient... but ultimately, those patients come home. So, for nurses who truly have an aptitude and craving for that high acuity bedside nursing, they may need to work in a highly controlled hospital environment to continue to have that exposure. They may think that is their only option.
However, outside of that small clinical window, it is a misconception that you will lose skills in HHC. In fact, the opposite is true. In HHC, we are exposed to a little bit of everything and must have a vast array of clinical expertise in our tool bag, typically “on our own” in the home environment and off of whatever MD order we have, which is often in need of updating once we evaluate the patient. The MD typically takes our suggestions, so we need to know what we’re doing for sure, which is why in CA, it’s a law that an HHC nurses has to have a year of experience to even work in the field. We see everything; but here is a short list of the most common.
Post op or post hospitalized patients. Cardiac, Pulmonary, Trauma, etc.
Bowel and Bladder Ostomies
PICC, IV, Chest port access etc., peripheral line, blood draw etc. Lots of IV antibiotics
Peg tube, TPN, G tube etc.
Plurex, LVAD, Milrinone
Neb, infection training
Medication administration, IV, I'm, PO
Compression wraps, Diabetic ulcers, Stasis Ulcers.
Post op care, drain tubes, staple removal, incisional care
All the wounds you can imagine, from small bed sores to huge trauma wounds that need dressings, vacuums, packing, and teaching for the caregivers. Then just all of the basic nursing care, teaching, training, family support for every possible disease or combination of diseases you can imagine. We truly do a little bit of everything.
It might be helpful to know in particular the type of skills they’re referring to, there are so many misconceptions about HHC because it’s not an avenue typically taught in nursing schools.”
I can tell you that the comp. is the same, you have the autonomy to manage your caseload, which is far less that in the hospital, you do your admin. on your own time, etc, but I would love to here your thoughts.