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Discussion

Typical Orientation

Hi. What is a typical length for orientation for HH nursing? Keep in mind I have practically no experience in it. We were in class for 4 days and then 1 day shadowing, class, shadow, class, shadow. Then they tell us they expect us to be seeing our own patients by next week!! My head is so full of information it might explode. Some of what I've heard has stuck, but the rest is bouncing around in there looking for a place to land.

How long is orientation at most agencies?

Thanks.

Featured Replies

the nurse that lost her job where i am was on orientation for something like four weeks! and she had experience. granted, one full week was on laptop charting only. but still , she had another 3 weeks of orientation. yours seems really short.

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  • Expert

If you are going to be doing shift work then you are oriented to the case. At my agencies, this could last from none at all, (typically paid 2 hrs, maybe 4 hrs paid); prior to beginning the case; perhaps the first 2 hrs of your first shift. Orientation done by another nurse assigned to the case, or by a family member. After the orientation, you can state whether or not you want to accept the case (or you can be accepted/not accepted by the pt/family).

Intermittent cases; whatever they think is appropriate for you to learn the paperwork, etc.

Some agencies have advertised orientations up to 3 months for nurses who have never worked home health. It just depends. If you are needed, and you need a certain amount, kind of orientation, your agency should be willing to work with you in order to get you functional. Good luck. After you get used to it, you should find that there are plenty of things to like about home hlth.

Mine was similar to caliotter3. I got 1 day of orientation for 2 of my Peds HH patients and 2 days for the other - I requested the 2nd day because that patient is incredibly involved medically. I was also fortunate that mom stayed home the first day I was there in case I needed anything and she is always a phone call away. I work almost exclusively with this patient now and love it. Part time HH has also proven to be easy to work my school schedule into.

PLEASE RESPOND SOMEONE!! Is it possible to do a good job in HH with very little nursing experience. My greatest fear is not knowing how to handle a situation and being by myself.

Post note: I graduated in Dec, 2005 work two jobs for 6 weeks each (VA & local hospital - horrid experiences - four-day orientations, hateful nurses, etc. it was awful) and quit nursing. I just started in Jan, 2007 at a rehab hosp in SCI and though the orientation was great and the nurses wonderful - I just don't like hospital nursing - staffing, scheduling, you know. BUT I'm tired of searching for my "niche" and many people (most of them nurses) have told me I would be good at HH. I don't want to change jobs again and then find I'm frustrated (and fearful) b/c of lack of experience.

Thanks to anyone who'll give advice.

  • Author

Everyone is different so maybe HH is right for you. I worked for a home health agency straight out of nursing school but it was different then. I had one patient all day and most of them weren't sick. They either had lots of money or worried family members who wanted mom to be watched over.

Today there are complicated cases at home and I think it would be difficult for a new nurse to deal with it. You have to assess,teach,reassess...be able to deal with noncompliant patients, troublesome family members, docs who won't call back because if the patient is at home how sick can they be.

I've only been back to HH for two weeks after working in LTC for years. I can't imagine doing this without experience.

I find experience with various types of patients too valuable to ignore. Many HH patient have hidden issues, can you see yourself being able to pick these up? Are you comfortable with tubes, like changing catheters?

Meds? Do you have access to real teaching tools regarding meds? I will admit to hating HH. Yes, I hated HH. Too many issues went unaddressed, but I could and can do it. My experience was the only thing I had going for me in HH and I found it too valuable to even begin to appreciate.

  • Expert

csiln

It is possible to work hh without experience, but the agency must be committed to orienting you to the case thoroughly. You could ask for an extensive orientation with one of their better nurses. If they want you badly enough they will be willing to do this.

I suggest that you keep your present job and move into a hh position on a part time basis until you have enough exposure to decide whether a complete change is workable for you. There are a lot of people who do hh sporadically, usually to keep their nursing skills from disappearing: I knew a man who worked one shift a week for a pt after he transitioned into full time elementary school teaching; another nurse works only one shift per month so that she can practice her nursing skills because she has a desk job. There are flexible situations out there, you have to be willing to ask for them. Good luck with your decision.

I started doing pediatric HH right out of PN school. My primary patient is quite involved (GJ, trach, bipap, etc.). Mom is only a phone call away at any time if something comes up. I may not be getting varied experiences of some of my classmates but I love it and it's easy to work around my school schedule (transitioning LPN to RN)

Most here are commenting on home care?private duty and that is a totally different animal.

I recently, after 30 years ina hospital setting and not wanting to start over in another, was a case manager for a home care agency.

My orientation was terrible.....given many videos to watch and take tests on things like wound care and even the lovely OASIS. Well i am a doer not a reader or watcher and so after taking my time doing this as i did not want to get out in the real world again because of what happened at the only job i had since graduating, but since i did not get paid for orientation until i began seeing my own patients (which the clinical supervisor that hired me failed to tell me this until i was watching and reading and trying not to fall asleep with the vids for bout a week) i stepped it up.

This woman had been seeing the patients i was being given and she wanted to get me out there so she could be in the office as she was the supervisor.

So after a day on the road with her i got the charts and waited for the next week as these were mostly medisets with a few others that had recently been seen. Soon after she told me that one of the 3 rn's had given her 2 week notice and i would be getting her patients as well that were in my area.

well never having done homecare was i overwhelmed.

No report from this nurse or the supervisor, just a list and what payer/s they had and frequency of the visits needed.

As i have always been up for a challenge, i dove in.

What i didn't realize until they were due was that most of the patients i had needed reserts at almost the same time......

long story short as i am rambling....

Take whatever orientation for field home care you can get as there are way many gray areas and if you have a supervisor like i did with every question i asked *you should have got that in orientation*

My regret is i didn't resign sooner before establishing relationships with patients, families, and several goo hhc cna's.

*sorry for the ramble*:o

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