Yosemite, RN

Hospice, maybe. But non-hospital based Home Healthcare is, for the most part, a scam on Medicare in my humble opinion. You would be hiring RNs and LVNs to work like dogs far beyond their actual visit time, especially the RNs. To work "full time" is a 7 day per week, 12 hours (at least) per day with all of the OASIS charting that, in of itself, must be "short cutted" to keep visits within a reasonable time-frame, including drive times/mileage.

Although now retired, I have done 3 stints in home healthcare over the decades. As others have posted, knowing what I know now, I would not have chosen to leave hospital based nursing for that specialty, at least for agencies. One responded about the OASIS, if one were to follow the training videos, your first visit as an RN would take an entire day or more; it is an invitation to "cut corners." Secondly, working for an agency, most of your visits will be "opens" (start of care) and recertifications for those cases where LVNs will be performing the visits; this is difficult as you'll not remain intimately knowledgeable about the case, will need to be updated by the LVN and to read up on much of the cases. Lastly, once out of hospital practice, perhaps a year and definitely by 2 years, it will be virtually impossible to be rehired to acute care facilities. In my opinion, most agency based home healthcare are scams; you will be pressured to justify every visit remotely possible, every recertification and squeeze every visit possible. Perhaps the 3 agencies I worked for throughout the decades was just "bad luck," but they were all agency companies and not hospital based. I've transferred care to hospice agencies/departments, that type of practice might be something to consider if you're SURE you'll not be trying to return to hospital based care in the future. Best wishes in your decision!

Stevostarko: please just keep that base down when you pull up next to me in traffic!

DoGoodThenGo: It was a joke! I have no "uniforms!" I'm male, wear street clothes! I guess I could starch my undergarments, though... (another joke).

Starch! I miss starch!

Jules A: Wow, much worse now than when I was doing it just a few years ago; I most certainly do NOT doubt your accounts! As to emergency medications for adolescents, one of my last few encounters (assisting the Adolescent RN charge nurse after I'd moved on) was the kids actually WANTED to get medicated! I have to admit, I've never had an injection of Geodon or a B52, but I doubt that I would want one, yet some of these kids did! Go figure. One of those kids yelled at me that he wants to grow up "just like my old man!" -in prison. Just how DO you get through to someone like that?

Nurseladyt: Yes, my last couple of "gigs" were intermittent home health care. Yes, the driving in between visits is enjoyable! For me, though, home health care became untenable. Although it's been decades since I worked for an agency that pays hourly, @ least one hospital based agency in my area still does. The idea of having to perform 5.5 "points" per day, average (1.5 = start of care, 1 = revisit), that is all inclusive, i.e., assessment, documentation, "skilled intervention(s), phone calls, scheduling, driving, care plans and on and on is too much. Too many 14+ hour days. I didn't even mention case management duties for the LVNs. Now, back to psych. I agree with Davey Do; if I were to go back & work psych (I would expect to be 5150's if I ever considered it, though!), geriatric population would be my choice. Unfortunately, the 2 facilities I worked in mixed adult and geriatric which necessitated protecting the later from the former. Adolescent psych, as Davey Do explained and as SwampCat elaborated on, takes a personality that I don't have. In my limited adolescent experience, the Axis II in most cases overshadowed the (somewhat) treatable Axis I diagnoses. I found it similar to the Middle East, the only time they quit fighting or trying to have sex was when they conspired to cause chaos and "mess" with the staff and, as I stated previously, they tended to do this when you could least afford to deal with it (some staff @ lunch/break while you're in the middle of an admission, etc.). Unlike the occasional adult cases, and as SwampCat points out, I never really felt like, nor saw significant improvement/outcomes in adolescent psych population.

NurseEryn: I agree; I went part time/per diem with one company and when it was sold, laid off. 2nd company would only give me the worst, last minute desperate and/or those over an hour from home. 3rd company only hired full time. I understand the "business" aspect of home healthcare, but what I don't understand (and they wouldn't tell me) why part time/per diem employment seems to be no longer needed or desired. It seems logical to me that having an employee who will work without benefits, doesn't displace full time employees, doesn't get paid holidays or have vacation or sick time would be golden.

Greater Sacramento area: difficulty (but not impossible) getting foot in the door for acute care; check the job boards for: Kaiser, Sutter, UC Davis, Dignity (Mercy). Google maps for outlaying areas/cities, City-Data.com - Stats about all US cities - real estate, relocation info, crime, house prices, cost of living, races, home value estimator, recent sales, income, photos, schools, maps, weather, neighborhoods, and more for statistics and forums on these cities/areas. Higher housing costs in Placer county (East of Sac), less (but increasing) crime for living; 20 minutes to 1 hour commute depending on location(s) and rush hours traffic/accidents.

Nurseladyt: Davey Do pretty much says it all. The only point that I might add concerns the mix of personality disorders, those patients who have been through "the system" before KNOW the limits of what they can get away with, your responses/interventions, how to push staffs' "buttons," shift schedules and just when to act out to create the most chaos!

Yes, find another job, quit without notice and don't look back. If you're spiteful, know that she'll likely stroke out from her own stress and failures.

Greater Sacramento, CA area, 2 agencies worked for: SOC = $120, RV = $60. Mileage I believe was something like $.55 per mile for the SHORTEST route (not the most efficient), $25 per hour for mandatory meetings/in-services and something like $30 per month phone reimbursement. NO reimbursement for visit preparation, the limitless phone calls, case managing LVN's, the endless negotiations for appointment times with clients/families and route planning, documentation not done in the home and ordering supplies for drop shipping.

Oceanblue52: yes, welcome to home healthcare. Your description is NOT unusual for this niche of the industry. I hate to say it, but you are between a rock and a hard spot. My humble advice would be to stick it out for a full 2 years using what little free time you have continuing a job search. Use every available search tool from Craigslist to the job section of the site, CareerBuilders, networking with friends, associates, former nursing school mates. If and when you get an interview, keep it positive about this job (lie through your teeth with a bright and cheery smile) and praise the "challenges" that were presented. Karma always turns it's wheel and know that your current supervisor, director and owner are also stressed to the max.

"Thanks for the memories" Wow, really brings me back (other than smoking @ the nursing stations and not being able to speak directly to physicians). One of my fondest memories (so as not to submit a duplicate) was during nursing school, 1st pediatric rotation, reconstituting an antibiotic. 70+ year old instructor (must have stood 5' 2") waddling up and slapping me across the face for using my thumb to flip off the top of a plastic saline (or sterile H2O) reconstitution solution into the garbage can (zing! Bounced around in there like a hockey puck before coming to rest) with a strict admonition to NEVER do that again! I was 6' 1", around 225 lbs. and buffed; I recall a brief notion of negasonic destruction, then just laughed. That was her last semester.

I agree that location, specialty and experience makes quite a difference. Although, likely retired, I keep my eye open for a compatible position. I speak mostly for the Greater Sacramento (CA) area. My observation mirrors many comments previously submitted. Where I'm seeing the most positions are in those specialties that are emerging to care for an aging population (long term care, rehab, home healthcare, hospice). Unfortunately, many if not most of the employers are observed to post the same positions going unfilled or post again shortly after an absence. For the very few interviews I've had, the reason is obvious: understaffed (even by "Boomer" standards), "busy" turning out to be near chaos and/or less than stellar pay. I had one home healthcare HR/RN let slip that their biggest complaint from their RN's is "feeling overwhelmed" due to increased admissions, decreased follow-up visits, increased case managing of LVN's, desperate need to perform a start of care with little to no notice and completely reschedule your day (which takes time); as one gets paid by the visit, they have no problem with you working 14+ hour days (no overtime!). Probably the easiest RN or LVN job in this area is home healthcare shift work (8 hour shifts, usually) for pediatric clients on vents and feeding tubes for $16 to $21 per hours (Medicaid payer almost exclusively); this is the only specialty that I regularly see accepting new grads. So, my opinion is that, overall, no significant nursing shortage except for aforementioned "pockets" or for employers who are cruel even by us "Boomer" standards. Now, throw in the H1B visas and you have the near perfect storm with the only light on the horizon is we "Boomers" retiring or being forced to retire due to age and near disabilities.