Switch from CCU to Home Health...

[BarbieRN09]

Hi all! This is to those who've made the switch from hospital/bedside nursing, to home health.

I currently work as a critical care RN caring for those with acute MIs, CABG, AAA, and other critical cardiac issues. I love the critical thinking aspect of it all, and putting everything together in order to better the patients' outcome, but the bedside aspect is killing me (and I've only been a nurse for ONE year!). Of coorifice a little 120lb nurse would not have the easiest time picking up these 300lb men out of bed every morning. At 22 years old, my back is telling me I'm 62! Soooo....I've been looking into home health. I like the case management side of the job, and still getting to do all the "nursey" skills, but is there much of the bedside stuff (baths,etc.) to do to or is that more of a "as needed" thing? And do you feel that communication with the doctors is efficient or are they are to get a hold of? It's all looking wonderful to me, but I'd like a very realistic view of home health before I take the plunge out of CCU/CVU.

Thanks for your input!

[caliotter3]

Some of this depends on whether you will be doing extended care or shift work versus intermittent visits. And then, there is the nursing supervisor's job, which does not entail patient care. Even if you accept an extended care position, you can tailor your job to the type of cases where you do not have to do heavy lifting. Just insist that you get little babies that weigh no more than 20 lbs. I have met many nurses who say that they stick to babies because the hardest strain on their back is to move the baby from side to side, when changing the diaper. The agency will understand your concerns and attempt to work with you to provide you this type of case; or, any other type of patient, where you are not doing lifting or transferring. Just ask.

[Kyasi]

My hospital background was ICU, PPU, Post Pump, ER, Labor Room, and Cath Lab. Then I quit nursing altogether to have my kids. After 4 1/2 years of not working at all, I decided to go into home care. I started taking care of a young boy who had a central line, trach, G tube feedings etc. It was a perfect way for me to get my 'sea legs' back. I didn't feel like I wanted or could go back to high tech areas in the hospital after being out of it so long. I did hands on care for many years and then started doing nursing home visits (blood draws, removing stables from post Open heart surgery patients, dressing changes etc) I did that for a number of years until there were some funding changes and the job got intolerable. (long hours, fee per visit and I was traveling too much without good reimbursement.) I went back to direct patient care for about 12 yrs and loved it. About 18 mos ago I started as the nursing supervisor of a Home Health Agency. I am in the office all day and after so many years of direct care, I have to say I don't miss it at all. I am enjoying the challenges of this job and find all the years of experience I've had are used daily. The flexibility of Home Health was perfect for me when my kids were little.

The one thing I noticed though about hospital nurses making the transition (esp from ICU or high tech areas) is the tendency to try to take control in the home and to tell parents/patients the 'right' way to do things. I saw a lot of hospital nurses come and go for that very reason. Home care is very different and it is not the strict sterile environment of a hospital. It takes some adjustment when you see a catheter being used for 24 hrs to suction a trach, and in between uses, it's sitting on the floor with a dog and cats walking over it. I almost had a stroke when I saw that on my first home case. I at least was able to get the family to keep it wrapped in a clean towel! But you know, that kid never got an URI.

Good luck to you in whatever you decide.

Kyasi