Several questions from a new HH RN

[NCIANurse]

I'm a nurse with LTC and M/S experience about to start my first HH position. I do have a few questions for the experienced:

1.) My company states that we should wear "Business casual" to our patient's homes. Anyone else have to do this? I was shocked, I can't imagine doing a dressing change, putting in a cath or drawing blood wearing my nice clothes? I wonder if this is a rule that they look the other way at?

2.) Did your company provide you with a bag? I see there's tons of threads on the right bag to buy, but do I really need to? Also, with supplies; I have my great stethoscope and my BP cuff... anything else I should buy that my company probably wouldn't supply?

3.) Do you feel you get a lot of clinical support when needed? If not, what do you do? IE: I've never had to draw blood, we always had phlebotomists that came in to do that, and I'm sure I will need to with my new position. I'm nervous to be out in the field and not have a clue what I'm doing.

Any info you have would be great, I really want to hit the ground running!

[Isabelle49]

I've been in home health for 9 years. I have always worn scrubs, except maybe on a weekend urgent visit to a patient that I had been seeing for a long time. I've tried multiple bags and the one I like most is a large tote bag. Be very careful if you put a needle box in the bag, since not all boxes stay closed and may leak contents. The psych nurses that work for out agency frequently wear casual clothes to see their patients. I guess it's less intimidating to the patients. Drawing blood in the field can be a challenge, just take your time. If you can't get the sample after 3 tries (patient consenting), stop and notify your office. They'll have to send another nurse out, or patient may have to go to a lab. Lab draws are not considered a skill by medicare. Good Luck.

[caliotter3]

I am uncomfortable in business casual to do patient care. If I were you I would wear scrubs with a white jacket or lab coat, if necessary. If you have to get down on the floor and crawl around like I have done on occasion, you will see why it is better to wear scrubs. As long as you wear your company ID, they should have no problem with your uniform choice. As for the bag, the company may provide a bag with contents. You can find many posts with a search on this forum concerning bag and contents. As for orientation and any assistance that you require: speak up. Request orientation, instruction, or help. Many agencies only provide assistance to the extent that a person asks for it. You can't be faulted for asking to be shown a new skill, or told what a policy is. Good luck.

[mommy1975]

You SHOULD have to go through a check off process wherein you perform every skill, complete a quiz, and verbally walk through a procedure before doing one on your own as part of your orientation. I have never heard of anyone having to wear business casual to a pt's home. We can if we want, but it is not a requirement, and most of the staff wears scrubs. Good luck!

[HealthyNurse]

I disagree with the other posters about wearing scrubs. I have worked at agencies where the policy is business casual- no scrubs allowed. So, you really need to double-check with the agency. If it is business casual, buy some black pants that you don't mind washing frequently. The reason for business casual is often because it looks more professional and it doesn't identify you as a target as much by others in the community.

Most agencies I've worked out have provided bags, but there are some that don't. For infection control purposes, I would not recommend a tote bag. You need a bag that has separate sections that you can organize your "clean" and "dirty" (not actually dirty) supplies. Dirty supplies are those that you disinfect, but then reuse on patients (stethoscopes, BP cuffs, etc.) Clean supplies are those that are one-time use. Your company should review their bag technique policy with you.

In home health, there is a lot of autonomy because you are out in the field by yourself. Some larger agencies may have educators that can go out into the field to help you troubleshoot or learn new skills. During your orientation, be sure to request practice with skills that you're not comfortable with, so that you can have your preceptor there for assistance. If there is ever a situation where you can't perform the skill, the agency may send another nurse to try.

Good luck in your new role! I hope you enjoy it!

[mommy1975]

The reason for business casual is often because it looks more professional and it doesn't identify you as a target as much by others in the community.

This is a good point, I hadn't thought of that. . . . .