Terrible case of jitters - going into home health travel nursing

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Hi all. I'm hoping you can help me with my jitters. I have made the decision to get back into travel nursing after being out of it for may years. When I did it before it was as an ICU/ER nurse. Then I came back and did ER nursing at a trauma center, then did 2 years of rehab, and for the past 4 years I've been in home health.

Since it's been so long since I've done acute care, the only area of travel nursing I'm qualified to do now is home health. I talked to a career consultant at MSSI and she has a few travel nursing positions open in home health in WI and MN. She sent me the skills checklist and I was honest on it - and I only scored a 2.8. They said they like for people to score a 3. The reason I scored so low was because about 1/2 of the questions were about neonatal and peds and pregnancy etc, and ventilators. I haven't done anything with a ventilator since back in my ICU days. The home health agency I work for very very rarely does infants and peds are quite uncommon. I have never taken care of anyone who had a ventilator at home. Almost all of our patients are elderly people with surgical issues, pressure ulcers, cardiac issues etc. plus a few quadriplegics and cancer patients etc.

I'm quite flexible and learn rapidly. I'm just as smart as the next nurse. But I'd hate to get into a home health agency as a travel nurse and be sent to take care of ventilator patients or very sick infants without at least being oriented to the ventilator and any equipment we're using on the infants first.....is this going to happen? Maybe I rated myself too low on the checklist, but I don't want to find myself in over my head.

Thanks in advance for any support.

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You are right to do the skills checklist accurately. Where you may be missing the boat is dealing with an agency with just a couple of jobs and a recruiter who is non-clinical. Assignments vary widely on the skills needed. Talk to a few more agencies and try larger ones. You need an agency willing to submit you and let the manager decide if you are a match for their needs. There seems to be an increasing need for home health, perhaps because of ACA. I've seen some very high bill rates in California for home health.

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Thank you very much, Ned.

I eventually want to travel all over but my husband isn't retiring until May. Until then I'd like to take jobs in WI so I'll be close enough for him to drive to visit me. Do you have any recommendations for what companies to go with?

I've never heard of this "prophecy" thing before. They never had anything like it when I was doing travel nursing before. When you fill out the skills checklist do they just submit your general score or do they submit your score in each area, or your actual answers? I'm not going to say I'm an expert on a ventilator and then have a company read that and feel safe sending me to the home of a pt on a ventilator without an orientation first. Do they really have home health nurses take care of vents in some places? I would think an agency that took vent patients would have respiratory therapists. I do feel that I am a much better than average nurse. Anybody who works with me would say the same thing, I often find myself in the role of mentor. So if I have to be a little less humble on other areas of the exam to up my score, that's what I have to do.

For example - I answered that I'm no expert in pediatric feeding tubes. I have done lots of feeding tubes but not lots of peds. I'd probably be safe answering that I'm good at them because after a very short review I'd trust my judgment more than that of many nurses, but at this moment I'm not an expert. Know what I mean?

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Specializes in Complex pedi to LTC/SA & now a manager.

Pediatric private duty/home health nurses care for children, teens, and young adults with tracheostomies, ventilator support and GT/NGT/GJT nutrition on a regular bases. Vent management is within the scope of an RN or LPN with proper support & orientation. I can't speak for travel but I just wanted to answer this. Reputable pediatric agencies require nurses to demonstrate competency & reliability for at least a year caring for the medically complex/fragile pediatric population basic cases (basic BPD/asthma, GT feed, seizure management) before considering a nurse to train on high tech trach vent or infusion cases

There are not too many adult home health patients that are on ventilator support/vent dependent as far skilled visit home health. Even the pediatric high tech cases are 4-16 hour shifts not skilled visits.

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Prophecy is simply a third party testing site. All agencies have stuff like skills checklists, medication testing, OHSHA training and so on, and some use third parties. Skills checklists are almost uniformly horrible, overly long, and stupid. Grading skills checklists is a new level of horrible. You just cannot do that. Chances that you will be needed primarily for adult care is about 95 percent, and you are being docked for the 5 percent of stuff you won't be doing. That is really bad. Move on!

Yes, ventilators are part of the home health spectrum, but if you don't do them, well... you won't be taking those patients. Right? Same with complex peds. Besides a skills checklist, your manager will be interviewing you prior to the assignment to further determine if it is a good fit. Mutual decision, you don't have to take it if you are uncomfortable with anything.

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I didn't know home care travel nurses were needed. I would love that.

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Home health, hospice, house supervisor, clinic, case management, and just about any specialty that nurses do have travel needs too.

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