Starting in Home Health - Is the Experience Viable?

[HappierTimesAreComing]

Hello fellow AllNurses,

I just recently got offered a job as a home-health RN as a new grad. Honestly, my end-game in terms of my career aligns more with working within a hospital-setting, but the job market has seemed particularly rough for a new grad at this time and I'm not really getting any callbacks/interviews for my applications. While my initial plan was to work per-diem as a home-health RN and continue applying for hospital RN jobs as I built up my experience, some of my colleagues have brought to my attention that home-health experience was not seen as "transferrable" or "applicable" experience for hospital RN positions. This was compounded by the fact that my interviewer did later mention that RNs have a tougher time gaining access to hospital RN positions with this experience because they don't believe that the home-health experience encapsulates the work you would be doing within the hospital. Do you think I should take the home-health position and continue applying for hospital RN jobs or do you think I should continue applying for jobs and hope that something comes up? Do you think that the home-health experience will benefit my future applications for hospital RN position or do you think that it may be seen as a not-so-great fit for experience? Any constructive advice or wisdom would be greatly appreciated.

[RNNPICU, BSN, RN]

I think if you want home health as a new grad ask yourself the following questions and how comfortable are you doing them BY YOURSELF

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1. Indpendently giving meds and knowing correct doses as well as reasons why a medication is outside parameters

2. How to calculate medications mg/kg or mcg/kg

3. How to nasal suction, how to suction a trach

4. How to change a trach and trach ties

5. WHen to emergently change a trach

6. How to troubleshoot a BiPap, CPAP or ventilator and the different types of vents

7. How to unclog a G-Tube

8. How to respond if a G/J tube falls out

9. How to recognize respiratory distress and intervene appropriately

10. How to administer or increase oxygen, give nebs.

This is just a small list but gives you the idea of the assessment skills and skill set you need on DAY ONE. No week long orientation will give you any of this.

Really think if you are truly ready to jump in and care for someone without a doctor in the house. Remember if you are in the home setting and call the doctor, it may be 1-2 hours before they would get back to you. It is all on you.

[HappierTimesAreComing]

Thanks everyone for their advice and such! I recognize how important updates are in terms of my decision-making and what I learned from this experience. So I initially accepted the job offer, but after I started orientation, it was relatively clear that the training would be short and that I would be out alone in a short period of time, which made me very uncomfortable. The hours were also a bit all over the place (which is so characteristic of home health), and there were a million things I had to account for before even seeing a patient (getting there on time, traffic, stocking supplies, checking orders, etc.), which I thought was frustrating, because I would only get paid for the visit and technically not all the time I funneled into the patient's care (which included charting). So when I got another job offer that offered me stable pay and hours, I put my two-weeks notice in for the home health agency. I do agree with most users when they note that home health is definitely for more seasoned nurses, and I don't know if I would entirely recommend it for a new grad like myself. Best of luck everyone!

[marchboy12, LVN]

On 11/26/2019 at 2:40 PM, Asystole RN said:

The hospital chose me in a sense. Areas like home health and even LTC allow for a degree of specialization that is unobtainable in a hospital within the same time for an ambitious individual.

I will give you an example. In the hospital it is relatively difficult to get enough experience dealing with wounds to become a recognized wound care specialist but not so in home health and LTC, if you like wounds you will swim in all kinds of wounds. Work hard at it, specialize in it, study it, become certified in it and the hospital will recruit you.

There are other things you can specialize in such as infusion therapy, case management, rheumatology, oncology, etc but wound care is a common example. I personally specialized in infusion therapy and vascular access well before entering a hospital. By the time I even desired to work for a hospital I was being recruited because I was one of a few with the specialization and training they needed.

Home health is the wild west of healthcare which is why a lot of nurses shy away from it. Most people have a hard time with the lack of structure and well-defined boundaries. I used that wildness to pursue a specialization that would otherwise be unavailable to me in something like Med Surg. Like many things, it is what you make of it.

Hello! I am a new grad and Im currently having a hard time getting into hospitals. I do want to specialize in Infusion therapy but majority of job postings require hospital experience. It grabbed my attention when you said that you said that you specialized in infusion therapy before entering a hospital. Can you elaborate more on how you were able to do that?