Upsetting Email about HH

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Specializes in oncology, trauma, home health.

I've been pretty excited/anxious/nervous about my new job in HH. I am getting great pay and great benefits and am very happy to be leaving my awful unit now. I asked around for advice and received this email from a nurse friend. It kind of upset me but didn't make me change my mind. Do any of you have an opinion on this? True/Untrue??

Thanks a lot for any help (yet again) By the way, I'm almost 40.

Email:

Here is what I think. Can you hang on another three months? Having at least a year on the same unit seems to be important for a resume, especially for a new nurse.

Secondly, and this is personal and from what I have seen, home care is a pathway to a dead end for a young nurse. I am not saying that to be mean, because I did some work in home hospice and LOVED it. But the staff there told me as well -- home care is for nurses with several years of hospital experience and for nurses who are winding down their careers.

I guess it all depends on what you see your path in life/nursing. Do you want to always be able to get work? Home health jobs can be hard to come by. Do you want to stay in the same town? Do you want to be comfortable at your job and have predictability?

Home health is very lovely, but I personally think you will get bored within a few years. Then, you might want to go back to the hospital because that is where the jobs are. However, moving back into the acute care setting will be very difficult! That is why home health is often a step into home health and then retirement or an office job.

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Specializes in Home Care, Hospice, OB.

couldn't disagree more. nursing is a second career for me, and i did the "mandatory" 3 years in the hospital before going into home care and hospice (similar but not the same). i adore it, and there is always a shortage of hh nurses. many folks, nurses included, think it is a cakewalk, which it is not. the stresses are different, but the insensity of nursing care is high, as well as the autonomy and responsiblilty..there is no one around to ask "what does this look like to you???"

as for it being a "dead end"...that is "dead wrong"!!!:no:

many of us love hh, have been doing it for years, and plan on doing it for years more. you have the potential of seeing, at home, anything you'd see on a med-surg, ob, or peds floor: vents, iv's, monitors, ports, huge wounds...you get the idea.

your friend may be projecting her limited experience unto you. if you were a 26 year old adrenilin junkie, home care wouldn't be for you---just like the er wouldn't work for me. but, with your maturity, if you love autonomy, driving, and have great assessment and communication skills---you'll probably love it!!

pm me if you have any other questions or concerns!!:typing

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I agree with the previous post. Home Health is anything but dead end. You are out there on your own, you have to make snap judgements at times for the safety of your patient, and I think home health patients just get better nursing care period. You are not being timed so much on how long you are with a patient. I know we are overworked at times but when I am doing a new admission I take all the time I need, it can go anywhere from 2 hours to 4 hours for one admission but you are doing a thorough job, and are not being rushed to give meds, hurry up and do this or do that. That is what I like about it. You can have flexibility in scheduling your patients. And the most important part, your patients appreciate what you are doing for them. I think most hospital nurses are just misinformed on what home health nursing is really all about. You will see anything in home health that you see on med/surg floor and sometimes more so.

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Specializes in OB, M/S, HH, Medical Imaging RN.

what i would like to know is why this chick is getting into your personal business? and what's it to her anyway? i think i would totally ignore the e-mail and not even reply.

i worked hh full-time and the hospital prn and now just the opposite, the hospital full-time and hh prn. the change was due to insurance benefits. i love hh. don't let anyone tell you hh isn't challenging. you have a great deal of autonomy and you have to have good assessment skills and critical thinking. there's not a problem going from the hospital to hh or visa versa.

enjoy your new hh position. hh is nursing best kept secret! :twocents:

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Specializes in Maternal - Child Health.

Sounds like a bitter old witch. Tell her to blow it out her ear.

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Specializes in ICU/CCU/MICU/SICU/CTICU.

There are so many people who say that home care isnt real nursing....those same people think that all home care nurses do is take vital signs and do a little charting, dont have to work holidays, weekends, and that is a cake walk........ it is obvious that they have never done true home care.

They do not realize that you become the eyes of the physician.... you get to know your patients and family so well that you can walk in the door and without the patient saying a word...you know if they are having a good day or not..... or take Mr G's BP and it is 130/70.........and know that is NOT normal for him............they also do not realize just how inventive home care nurses can be when you dont have supplies......... or how to work with only two hands when you really need 6........... they do not know how to really look at the whole picture of the patient............... they do not know exactly how Medicare or insurance works......... yeah, the patient has Medicare........ but do they have coverage for they medications......does the patient even know what their medicines are for.........

I did home care for many many years........ you actually get to teach the patient and family..... you actually get to see the patient in real life.... in the hospital you see them at their worst.... in the physicians office...they get dressed up to see the doctor......... in home care you see "THEM"....how they live, how they interact with each other, how they cope with their diagnosis......... you do have to have excellent assessment skills........ because you are the only one there......you cant call out to the desk and ask for help........ you build on all of your knowledge from the hospital and adapt it to the home.............. yes it is frustrating at times with all the rules you have to follow for Medicare.... for the agency you work for with "cost containment".........for the schedule that is jam packed for the day and the office is calling to change it AGAIN for the 4th time and it is only 10 am........but there are so many more benefits to home care.

Home care if FAR from the end of the road for nurses. Home care constantly changes.....just when you learn the rules they change again. Just when you have "perfected" one thing, they change the equipment.......

Don't let anyone tell you that you are at the end of nursing........... tell them to ride with you and see exactly what you do.......and what you gain from it.

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

I've never done home health. As an NP, however, I have requested HH involvement with my patients.

When I do, I need nurses just as knowledgeable, and just as skilled, if not more so, than the hospital nurses. I need nurses who can assess the patient, and who can assess the living situation. I need nurses who can sort out a patient's meds, figure out what the patient is actually taking, and help the patient understand what to take and how to take it. I need a nurse who can understand the implications of a patient taking both Lasix and furosemide, or warfarin and Coumadin, and who can act on that information. I may need a nurse who can do a dressing change and assess a wound, who can draw blood, or who can start and maintain an IV.

I don't see any reason why a nurse who can take good care of a home health patient couldn't take just as good care of a hospital patient.

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wow......Where does her knowledge or lack their of come from? Home health is "nursing by the seat of your pants". You better know what to do and how to do it because if you don't you have no one else their to get an opinion or input from. I have Pulm step down and ICU experience and would not go back to facility unless it was my only option. You must remember how nursing is today. The patients that died 5 years ago are in ICU, the patients in stepdown were the 5 year ago ICU people. The med-surg is stepdown and an occasional 5yr ago ICU patient. So, where do people think the old med-surg crew is-you've got it-HOME. I have honestly walked into homes to admit and couldn't believe the person was at home in their condition, but that is the new reality in alot of cases. So, you will use many, many hands on skills along with your critical thinking. You will be suprised how many uses you can find for a good ole wire clotheshanger:rolleyes:. My point is this-try it, what have you got to lose? You can ALWAYS find a hospital job if you don't feel home health is for you. We are always in need of good nurses in home health too...............

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Specializes in OR, ICU, Tele, Psych, LTC, Palliative.

Mim-o wrote, "So, where do people think the old med-surg crew is-you've got it-HOME."

That's so true! I'm just starting in HH as well, coming from LTC and hospital. So many hospital beds were taken up with LTC patients that there were no beds for those that really needed them. Then, because people are living longer due to medical progress, LTC is functioning at capacity with waiting lists. Used to be, back in "the day" :D sick folks stayed home with the family and did their healing there, tended by family. Well, there's no family at home anymore because Sonny and his wife both work to pay a mortgage and the lease on 2 new cars. The thing that has changed as well, and thank goodness for it, has been the move to decentralize hospitals and making care more home centered. Since the care level has increased in those wanting to stay at home, that's where the home health nurse comes in. So, by having made the strides we have in medicine, we inadvertently created a niche for a new breed of nursing! Well, one that's been around for a long time, but one that will become more and more evident in the community as our aged population increases. I did a paper on this very subject in school 20 years ago - on the need for community health care for the increasingly aged population in the new millennium. Wish I could put my hands on it! :typing Just my :twocents:

Sue

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Specializes in OB, M/S, HH, Medical Imaging RN.

to the op, did you respond to the e-mail? hear anything else from this person? i'm just nosey.

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Specializes in oncology, trauma, home health.
to the op, did you respond to the e-mail? hear anything else from this person? i'm just nosey.

hoi dutch:

yes, i replied back with my reasons and probably a bit too harshly. she responded with apologies and wished me luck.

i am really looking forward to the changes this will bring, both good & bad. i am so tired of med surg & nights, but more than that i am looking for a career not just a paycheck. right now i feel like my job is drudgery and i envy people who love or at least don't mind their jobs. thanks for letting me in on your best kept secret of nursing!

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Specializes in OR, ICU, Tele, Psych, LTC, Palliative.

"I am really looking forward to the changes this will bring, both good & bad. I am so tired of med surg & nights, but more than that I am looking for a career not just a paycheck. Right now I feel like my job is drudgery and I envy people who love or at least don't mind their jobs. Thanks for letting me in on your best kept secret of nursing!

Boy, am I with you there! Just starting (after my bout with flu) a HH career after 20 years in hospital, clinic and what have you. It'll be interesting what we have to say in 5 years, eh? :cheers:

Sue

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