Very unexpected job opportunity - need feedback please

[CFitzRN]

I apologize if this is the wrong place to post this - I know they will move it if it is inappropriate here. I just need some feedback on a very unexpected job opportunity that fell into my lap a few days ago.

Background - I graduated with ADN April '08. Started on L&D, 6 weeks' orientation on days, then went to nights (I was hired for nights). Crashed and burned after realizing I could not sleep during the day no matter what I did or how exhausted I was. Forced to leave my dream job. Started working PRN in an Endo unit at a GI practice, post-anesthesia/recovery nurse, still doing that. Also picked up PRN jobs at 2 family practices. As other PRNs know, it is feast or famine. The zero benes work out okay as I am on my husband's through his job. I enjoy doing all jobs, though the fam practices pay little (one pays 16/hr, one 14 - not much). The Endo pays $20.

Saw an acquaintance Thurs night - she is the executive director of a home health agency here in town. It is a nationally owned franchise. She mentioned that she was in serious need of an RN supervisor to do "sup visits" 16 to 20 hours a week and couldn't find anyone because everyone she interviewed wanted full-time. I do NOT want full-time as I need some flexibility for kids appts, etc.

The job pays $23 an hour (more than I made bedside in L&D and obviously more than the other jobs). No benes. The hours are totally flexible - I can work when I want, no weekends or holidays - so long as I get my sup visits in and get the paperwork in. I can work 2 8-hr days a week or any combination of hours/days I choose to, so long as it is 16-20 hours (I can choose how many). The job would entail visiting pt homes and "overseeing" the CNA or Nurse, checking the plan of care and determining if it is being followed, having the CNA or Nurse do one demonstration of care for me (accu check, in & out cath, G-tube feed, etc), speaking with the client about whether they feel they are getting appropriate care, then moving on to the next home. I would have up to 10 pts to visit in one day but the visits average 15-20 mins each. Then back to the office to enter the documentation into a computer, file paperwork, etc. Oh, and .45 cents per mile reimbursement. She kept calling it a "cream puff" job. Does anyone have actual experience with this kind of job? I would do patient visits one of the 2 days, then paperwork in the office the other day. For the 3rd day (half-day) I could visit any pts I didn't get to see the 1st day or finish paperwork.

It would entail very little (almost no) hands-on nursing work or skills. I could (and would) choose to participate in all their in-service training sessions for vent/trach, wound care, G tube, PICC flush, etc. Though I wouldn't be actually using these skills very often if ever. I learned early on that bedside nursing isn't my ultimate goal, so I feel that this could be a great opportunity to learn case management, which I'd like to do full-time eventually, once the kids are older. Am I skipping a necessary step here in not working med-surg first? Or would this be a good move seeing as case management is what I plan to do anyway? Have I mentioned I hate the hospital and would rather never work in one again?

I guess I'd just like to hear what other nurses' thoughts are about something like this, and also, I would love to hear from home health nurses who have experience either doing this, or dealing with RN supervisors in the home health setting.

Thanks so much in advance.

C Fitz

ETA that I love being out "in the field" and enjoy driving a lot, especially when it is only 1 day or 1 and a half days a week.

[CFitzRN, ADN]

be sure it don't entail filling in if someone call in sick ect.. sometimes being a supervisor means cover if no one else can.

They have a PRN pool they would pull from. I wouldn't be in a bedside position with this job. Honestly, I don't think I would mind it, so long as I had the proper training for the patient's acuity. But I would not be asked to do fill-in in this position.

[CFitzRN, ADN]

I work home health care and it is pretty simple to only do sup visits. It is really easy money. The down side...not all homes are clean and appropriate. There is often little that can be done about that. You do fall in love with some of your clients while becoming frustrated with others. It is a good job and I dont regret leaving a poorly managed med/surg floor for hhc.

Shannon

Shannon, thanks for the input. I did Meals on Wheels for years on a volunteer basis and found exactly what you're describing. Some homes were beautiful and clean, others were filthy and bug-ridden. The truth is, it never bothered me. I am super adaptable and am very able to set aside stuff like that and do my job. I love people and get along very well with everyone. I know not everyone lives the same way. I think I will adapt pretty well to whatever comes my way. Thanks again for you input (and thanks everyone!!).

[CFitzRN, ADN]

I can guess which company this is. The pay offered is too low. In other parts of the country they offer their supervisors $28 to $30 an hour. That is only one dollar an hour more than they were paying RNs to do shift care out of my old office. I think it is too low pay, but if you are comfortable with it. If it really is the company that I am thinking of, I cannot recommend that you work for them.

Surprisingly, $23 an hour is considered pretty good pay for a fairly new nurse where I live. There are nurses on floors at the hospital killing themselves for far less (our local hospitals start new nurses at $19). I'm very curious which agency you're talking about. This is Intrepid USA.

[CFitzRN, ADN]

Could you keep your PRN jobs for a bit while you start this home health supervisor gig? That way, if the home health job ends up not being a good fit for you, you could quit and essentially just be back in the position you are now with your PRN jobs. Another thought is that if you like the home health job, maybe you could work PRN every once in awhile on a med/surg unit to keep your skills up if that is concerning to you.

April, that is exactly my plan. I just started PRN at a family practice last week. I will probably give that one up because it's the newest and it only pays $14/hr, which, after doing the job a couple of times, I've decided is absurdly low. The practice is huge and I do tons of peds - lots of baby immunizations, tons of physicals, paps, hearing and vision, you name it. I am hopping from the time I come in until time to leave. It's a ton of work for the pay. I hate to leave the job after only a week but I sure wasn't planning on this coming my way. So I will keep my two PRN jobs that I've been doing for over a year each, and will probably tell the 3rd one that if they really are in a bind, I would be willing to cover occasionally. Thanks for the feedback!

[caliotter3]

No, never heard of Intrepid. The agency that I recommend nurses stay away from is Maxim Healthcare. RNs at $19 an hour? Horrid. I have seen where CNAs are paid $18 to $20 an hour. That is insulting to RNs, no matter where in the country. The least I would expect to see an RN make doing clinical supervisor in home health would be, at the bottom, $25/hour. If this is better for you in terms of wages and other benefits, then go for it. Hope that you like home health and the job in general.

[CFitzRN, ADN]

I just want to say thanks to everyone who has offered feedback, and thanks in advance for any further feedback.

[CFitzRN, ADN]

No, never heard of Intrepid. The agency that I recommend nurses stay away from is Maxim Healthcare. RNs at $19 an hour? Horrid. I have seen where CNAs are paid $18 to $20 an hour. That is insulting to RNs, no matter where in the country. The least I would expect to see an RN make doing clinical supervisor in home health would be, at the bottom, $25/hour. If this is better for you in terms of wages and other benefits, then go for it. Hope that you like home health and the job in general.

I know, it is ridiculously low. But unfortunately it's the going rate all over where I live. If I lived an hour south, in the closest big city, I could make $25 as a new nurse, but the cost of living is higher too. So this is what we must accept... I'm just excited to get to start working toward case management.

CNAs make about $13/hour here. Not kidding.

[caliotter3]

CNA at $13/hr and RN at $19/hr. Not quite right. For the most part, $13/hr for CNA is excellent. The jobs I saw for CNAs at $18-$20/hr are not the norm. But I can't get over $19/hr for RN. Taken advantage of, is all I can say to that. (One of my last employers paid me that for LVN, and I felt taken advantage of.)

[CFitzRN, ADN]

I'm guessing from your name you're in California. The cost of living there (in all of Cali) and here can't be compared. We have a 3,000 sq ft 5-bdrm home and it was 200,000. The cost of living here is pretty low. So of course the pay will be lower too. I am in NC.

[caliotter3]

Well, employers are lowering our pay in CA also. It is unrealistic to expect nurses, even those who are not RNs, to work for as low as $14 an hour in CA. One home health agency actually had the audacity to advertise a position for $14 an hour for LVNs here awhile back. If they want to lower the wages, which they are doing, then it would be nice if the cost of living were going down also. My apartment has had the rent raised each year that I have lived here and the roach infestations get no better for the increased rent. Yet I am not working at all, much less at $14 an hour.

[DirtyBlackSocks]

Caliotter.

I live in Los Angeles and have supported a family of 3 on $12 an hour.

Yes it sucks - and wage should be adjusted accordingly to where you live.

Personally I think having work at any price is better than no work at all.

[caliotter3]

Dirty

You aren't a nurse? That is bad but at least you have a job. I worked a couple of shifts as a caregiver for $12 an hour and was happy to get it. But when they cut my pay rate for LVN work, I get angry. I did not spend all that time and money on an education to work for the same wages someone coming out of high school can make. My daughter gets more money than I do and does not have a college diploma. With her shift differentials, she is doing fairly well.