Transitioning from shift work to skilled visits.

[guest1143647]

Anyone transition from skilled pdn shift work in the home to intermittent skilled visits?I've did shift work for 17 years. Mostly it was the same vents,trachs,feeding tubes. Not much much IV's,wound care, and foley caths. I think I worked on 1 case,and that was in 2009.

I am thinking it is similar with a similar skill set,but is it?I mostly work PEDS with shift work,but skilled visits is mostly seniors.

I would need to learn IV skills and wound care all over again, Plus,I have to learn the  dreaded OASIS.

Was it a difficult transition?

[TheMoonisMyLantern, ADN, LPN, RN]

I did skilled visits as an LPN years ago.

The skillset is rather broad and does include foleys, IV's, IM's, central line management, lab draws. There is a LOT of wound care and disease/medication education, and so much more. It's really varied. OASIS is a nightmare and seems to get worse every time they change it.

Go for it, a lot of people flourish in home health.

[Floor_Nurse]

It sounds like you'll do just fine with home health, even though there's a big difference between peds & elderly patients. But sometimes taking care of a trach/vent patient in a home environment can be challenging, if not a lot of work. I used to work in a facility, now I only do home health (not quite 3 years so far). It's worked out nicely for me. 

[guest1143647]

I already do home health but I sit in the patient's home for 8 hours as opposed to one to two hour visits. I do not draw labs,deal with any IV's,and barely do wound care. As I understand it,skilled  intermittent visiting nurses barely deal with trachs and vents.

[guest1143647]

On 1/31/2021 at 3:21 AM, TheMoonisMyLantern said:

I did skilled visits as an LPN years ago.

The skillset is rather broad and does include foleys, IV's, IM's, central line management, lab draws. There is a LOT of wound care and disease/medication education, and so much more. It's really varied. OASIS is a nightmare and seems to get worse every time they change it.

Go for it, a lot of people flourish in home health.

I did,that is why I did it for 17 years. But I never did skilled visits. I only did skilled shifts in the home.

 

Instead of visiting 4 patients in a 8 hour shift,I just stay with one patient for 8 hours. 

[TheMoonisMyLantern, ADN, LPN, RN]

6 minutes ago, Runsoncoffee99 said:

I did,that is why I did it for 17 years. But I never did skilled visits. I only did skilled shifts in the home.

 

Instead of visiting 4 patients in a 8 hour shift,I just stay with one patient for 8 hours. 

I see. The think with doing home health skilled visits is that of course you're on your own in the patient's house so you have to be pretty confident in your skills to treat the patient. You have supervisor who can help you troubleshoot things by phone but other than that it's all on you. Because of this you may want to consider working a year in either a SNF on a skilled/rehab unit or med/surg floor to refresh and relearn some of those skills.

If this isn't an option and you decide to pursue skilled home health I would make sure that you get a thorough orientation, I just worry it would be overwhelming trying to learn new skills AND the charting in skilled home health which is terrible.

[guest1143647]

5 hours ago, TheMoonisMyLantern said:

I see. The think with doing home health skilled visits is that of course you're on your own in the patient's house so you have to be pretty confident in your skills to treat the patient. You have supervisor who can help you troubleshoot things by phone but other than that it's all on you. Because of this you may want to consider working a year in either a SNF on a skilled/rehab unit or med/surg floor to refresh and relearn some of those skills.

If this isn't an option and you decide to pursue skilled home health I would make sure that you get a thorough orientation, I just worry it would be overwhelming trying to learn new skills AND the charting in skilled home health which is terrible.

It is the same with shift work in the home. We are on our own.

Practically the only difference is that I am with one patient in the home for the whole 8 hours. The charting is different too. I finish all of the charting in the home before I leave.