First Job: Rehab or Homecare

Rehab. I'm in homecare now and I don't think it's really appropriate for a new grad. Rehab is closer to "hospital nursing," also.

I wouldn't recommend home care as your first ever job. I was a nurse with three years of LTC/SNF/Sub-acute and Primary Care office nurse experience and three years of LTC/SNF CNA experience when I got involved in home care, and it's been a steep, steep learning curve. There is usually minimal orientation before you're expected, with no other coworkers/ancillary personnel/supervisors around, to troubleshoot some very, very serious and critical situations or to serve as a resource/backup/even an extra pair of hands. It's just you, with a very critical patient, having to possibly make life or death decisions based on your assessment skills. For example, what one of my cases requires in the home for care (continuous ventilation, trach, suctioning, G/J tube management, port, TPN, etc) meant that when he went into the hospital they sent him to the ICU for management because he was too complex for the Med Surg team (which grinds my gears, because the same hospital won't consider my experience/skills in home care as being good enough for even their Med Surg unit...but that's another topic entirely).

Of the two, I'd recommend rehab, even if it is more the sub-acute-attached-to-SNF rehab situation which tends to suffer from high patient-to-nurse ratios. At least there's the safety net of having a whole team around you for backup support while you grow your assessment skills.

Why do you think that it is not appropriate?

When you're a new grad, you don't know what you don't know.

In home care, you're a bit of a lone wolf. A visit may be only thirty minutes or so and quite possibly just one or two visits per week. Not like a shift at a hospital or facility that is eight hours long.

In home care, you can't go back and recheck your assessment, you can't ask your charge nurse to check on the patient if something is off.

And when people are in their home environments, they a lot of times simply do not look nearly as sick as they are. They may appear within normal limits, but the problem is that when you're a new grad, "normal" isn't something that is carved out yet.

I started homecare after nearly 11 years of nursing and I see new things constantly!

I feel like rehab is a better first job because you would theoretically have other nurses working around you that you could turn to if you were unsure of how to handle a situation. In homecare it is just you with 911 for backup. If you mean homecare of the sort where you care for just one patient all day long, that is not going to provide the variety of exposure you need to learn as a new nurse. I did my first couple of years in rehab and learned A LOT and had no difficulty moving on to what I really wanted to do.

Ok, makes sense. In a way, it seems like a more advance role than working as a nurse at a hospital. I just don't understand why I am getting so many interviews for this type of role. Must be a shortage, though the compensation for at least the ones contacting me are not that great.

Please use the quote button so we know who you are responding to. I think rehab would be a better place to start. Rehab facilities can be brutal though, find out how many patients you will be responsible for. In rehab you will have another nurse to learn from.

Home health is begging for you because there are MANY home health agencies that make big bucks off of your visit. I don't think any new grad should start in home health. YOU are the only set of eyes on that patient. You don't have the experience to make the right call.

Best wishes.