Transitioning From 10 years of Home Care Consultant/Home Infusion Nurse to Med-Surg Nights.

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Looking for some honest feedback.  I became a nurse at 30 and couldnt obtain a job in acute care upon graduation with an ASN.  I worked as a home care consultant for 5 years and a home infusion nurse for another 5 years.  After 10 years Im finally going into acute care, specifically med-surg nights.  I'm excited, yet nervous, as I feel I have a massive learning curve to overcome, and also have a 1 year old baby at home.  Any tips, advice, reality checks from nurses who understand my unorthodox career path?  Thanks in advance!!  

  

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Specializes in Med-surg, home care.

Wow. Most nurses I know go the opposite route and with good reason in my opinion! Also I am surprised you were able to get a home care job as a new grad since they usually want acute care experience prior. Anyway I was a med surg nurse for almost 2 years and just started home care (I literally started orientation 2 weeks ago). I can tell you the pace will be different and is very fast paced although I worked day shift so maybe nights a little less so. I averaged 7:1 patient ratio and while home health nurses may see the same number of patients a day, home care is one to one with patients, not in med-surg! I literally would be non- stop some shifts for 12 (or 13 or 14) hours and I find this is typical for many med-surg units. Time management and prioritizing will be crucial since you may have to address multiple patient issues at the same time. Patients in med-surg are less stable and more unpredictable than home care patients, particularly now with COVID; teaching is more difficult to do in a hospital setting due to to time constraints and patients receptivity. Med-surg can be very "tasky" but assessing still important since you may have patients on your unit that probably need a higher level of care. I personally could not see myself working long- term in an acute care setting, especially not med-surg. With that being said, my experience, while relatively short, made me stronger. I learned to assess patients, perform a variety of nursing skills, plus other skills including interacting with a variety of staff, providers, patients/family members, etc. I have experience as charge nurse and a preceptor; in fact my experience is why I got my current opportunity in home care and probably could have had other opportunities (ICU, ED, etc.) had a chosen it. Floor nursing also means more resources at your disposal. I personally have no desire to go back to med-surg and really hope I don't have to but overall I do not regret my experience as hard as it was.

For reference I am a second career nurse who starting nursing at age 38 years so maybe I would feel differently if I were in my 20s? In any event best of luck to you!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
On 12/5/2020 at 6:44 PM, BrooklynRN35 said:

Looking for some honest feedback.  I became a nurse at 30 and couldnt obtain a job in acute care upon graduation with an ASN.  I worked as a home care consultant for 5 years and a home infusion nurse for another 5 years.  After 10 years Im finally going into acute care, specifically med-surg nights.  I'm excited, yet nervous, as I feel I have a massive learning curve to overcome, and also have a 1 year old baby at home.  Any tips, advice, reality checks from nurses who understand my unorthodox career path?  Thanks in advance!!  

  

First of all, congrats on the new job. I completely understand why you would want to experience acute care if you haven't yet. Yes, it is intense, but even after I left the hospital for a clinic job, I didn't entirely escape the nagging feeling that underneath it all it's bedside care, which most of us envision as "what a nurse does" and what the vast majority of our education is geared toward.

The first thing to consider is the attitude of your employer. If they are the "you should hit the ground running" vs understanding and supportive type, it will greatly affect how well you do.

I would say the same for your future co-workers. Some are going to be unpleasant, perhaps sounding rude or dismissive. So get your thick skin on now because when you're new you think it's you even when it isn't.

Although I never worked nights, I hear again and again that the picture of nights as lots of downtime isn't really accurate in many cases.

For me personally though, the most important thing wasn't skills, but time management and the ability to prioritize in your head when multiple issues seem to all hit at once. I had a tendency to freeze when that happened, but even this is a skill that can be learned.

Hope this helps a little and best wishes!

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On 12/18/2020 at 7:54 PM, thecareerchanger said:

Wow. Most nurses I know go the opposite route and with good reason in my opinion! Also I am surprised you were able to get a home care job as a new grad since they usually want acute care experience prior. Anyway I was a med surg nurse for almost 2 years and just started home care (I literally started orientation 2 weeks ago). I can tell you the pace will be different and is very fast paced although I worked day shift so maybe nights a little less so. I averaged 7:1 patient ratio and while home health nurses may see the same number of patients a day, home care is one to one with patients, not in med-surg! I literally would be non- stop some shifts for 12 (or 13 or 14) hours and I find this is typical for many med-surg units. Time management and prioritizing will be crucial since you may have to address multiple patient issues at the same time. Patients in med-surg are less stable and more unpredictable than home care patients, particularly now with COVID; teaching is more difficult to do in a hospital setting due to to time constraints and patients receptivity. Med-surg can be very "tasky" but assessing still important since you may have patients on your unit that probably need a higher level of care. I personally could not see myself working long- term in an acute care setting, especially not med-surg. With that being said, my experience, while relatively short, made me stronger. I learned to assess patients, perform a variety of nursing skills, plus other skills including interacting with a variety of staff, providers, patients/family members, etc. I have experience as charge nurse and a preceptor; in fact my experience is why I got my current opportunity in home care and probably could have had other opportunities (ICU, ED, etc.) had a chosen it. Floor nursing also means more resources at your disposal. I personally have no desire to go back to med-surg and really hope I don't have to but overall I do not regret my experience as hard as it was.

For reference I am a second career nurse who starting nursing at age 38 years so maybe I would feel differently if I were in my 20s? In any event best of luck to you!

Thank you for your kind words.  I am a bit nervous, but excited to learn what, for most nurses,  are nursing basics.  

 

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On 12/5/2020 at 9:44 PM, BrooklynRN35 said:

Looking for some honest feedback.  I became a nurse at 30 and couldnt obtain a job in acute care upon graduation with an ASN.  I worked as a home care consultant for 5 years and a home infusion nurse for another 5 years.  After 10 years Im finally going into acute care, specifically med-surg nights.  I'm excited, yet nervous, as I feel I have a massive learning curve to overcome, and also have a 1 year old baby at home.  Any tips, advice, reality checks from nurses who understand my unorthodox career path?  Thanks in advance!!  

  

I know this is an old post but on the outset you are still following it..I'm curious as to how making the change worked out for you and if you like working med/surg.

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Specializes in Progressive Care, Sub-Acute, Hospice, Geriatrics.

Yes I second this. How was your transition to med-surge?

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