The love of home health

Kcorder4 · Nov 14, 2012

I can try to answer any questions regarding this field, but keep in mind I am still learning myself!

Miss Molly · Nov 14, 2012

I actually really want to do home health when I graduate in about a year, but I wasn't sure what kind of experience I need first. Is it possible for new grads to do home health, or do I need to work in a hosoital first? Thanks!

Barnstormin' PMHNP · Nov 14, 2012

Congratulations! Could you expand on how your visit schedule is set up and how large of a geographical area you cover? how does your time management work?

HeadingWest · Nov 16, 2012

If you don't mind me jumping into the conversation I would be happy to answer some questions.

I'm new ADN grad working in home health. Home health isn't my preferred specialty, but the agency I work for is the only place to offer me a job so far. I applied at 3 other agencies that all wanted hospital or home health experience before applying at for my current position. This was in addition to dozens of hospital positions that never responded.

The consensus on allnurses seems to be that home health is no place for new grads, but that really depends on the person and your employer. I worked as a paramedic before and during nursing school, so I am used to walking into situations that are far more dire than any of my clients *knock on wood* have been in so far. Also, my employer recognizes that I am a new grad and don't have the experience that other nurses at the agency have. They don't push more clients on me than I am comfortable taking, and they ensure I am able to provide any care that has been ordered before giving me opens or new clients to carry. I also have team leaders that are more than happy to provide me with guidance regarding case management since that was not covered in my program at all.

I'm trying to build up my load of clients, so scheduling isn't bad for me yet. I try and respect the times people would like to be seen, but that is rapidly becoming impossible when it seems like everyone only wants to be seen between 1300 and 1500. I can't really give you an answer on time management since I am still working on that myself.

So far I am liking home health. I'm a bit of a talker, so I enjoy building rapport and using that to guide how I teach my clients. I still find myself reviewing pathophys before seeing clients which serves to increase and reinforce the knowledge I already have. I've already seen patients in their home with conditions that nurses with 20+ years of experience haven't seen which only makes me enjoy the job more since I get to expand my knowledge base while subsequently sharing it with my patients and peers.

KountryPrincess · Nov 16, 2012

Hi guys.....I am glad to see the interest in home care, but as someone mentioned, I feel that you need 2-3 years of acute experience, preferably more, before coming to home care. I noticed that the above poster has paramedic/emergency type experience.....congrats, that is not a field I have experience in, I am sure you will be a fab nurse.....however....it is not "dire" situations where inexperience shows. Those are the easiest things to deal with in home care....call EMS. It is the day to day managment of patients, watching their response to meds and treatments, and making good clinical decisions where inexperience really shows. In a hospital, you have the benefit of learning from other nurses, docs, resp therapists, etc......you also have the ability to be exposed to numerous pt situations that will allow you to develop your "sixth nursing sense". That is the sense you need when your pt appears fine....all vs wnl, no apparent problem. An experienced RN can detect things.....the sublte shade of color, a smell, an expression....something you cannot put your finger on and you cannot teach, but something that tells you something is amiss....and then, an experienced nurse will have a suspicion of what it is and how to deal with it. The thing is guys, you don't know what you don't know. In homecare, as you may have discovered, certian sitiations come up once in a blue moon. In the hospital, you would have regular exposure to those situations.....daily, whereas in home care you might see them once or twice a year. The only way to quickly become a jack of all trades is that hospital experience. I understand people are desperate for jobs and that may be how some new grads are ending up in home health, but I encourage you to keep looking at the hospital, maybe a per deim position in acute care to compliment what you are learning in the home setting? I think you will be surprised at what you learn. I did inpatient oncology for five years, but have spent the past ten in homecare, so I do know a bit about it. My agency has never hired new grads, and they rarely even hire an RN without homecare experience, so you guys are lucky to have found jobs. Good luck to all of you, and welcome to home care!

AZMOMO2 · Nov 16, 2012

I think its pretty common for this thought process... I mean people think the hospital is the be all end all for nurses. I was going to post about this very topic.

I have worked as a Homecare nurse for 2 years now and LOVE it!! I mean I have had some bad cases and some crazy things happen but when you find that perfect family or client... it really cements it.

I always thought I would end up in beside nursing at the hospital somewhere, but maybe I don't want to. Maybe I like the autonomy and there are times when even as an LPN I have had to break out the acute care interventions and assessment skills... just because these people are at home does not mean they are stable!

Now with that being said, I did work in a skilled nursing facility for a little over a year before heading out into the Homecare field, but as I transition now to my RN, I do plan to stay in Homecare for awhile as I work on getting my BSN and heck maybe even after that. Who knows what the future holds in this market.

uthscsa2011 · Dec 3, 2012

Hello Kcorder4,

I am a new grad (graduated nursing school Dec.2011, didn't hired at any hospital) so took the first job that called me back which was for a RN school nurse). I was looking into Home Health for the weekends and summer, but was concerned because I do not have any clinical skills, since I went straight into a school nurse setting. Will this a hinderance for me? Do they offer training for trachs/foleys/g-tubes/vents/stomas?