It seems when new grads are lamenting the difficulties of finding acute care (hospital) nursing jobs, the suggestion is to try SNFs or home health, that they might be more willing to hire a new grad.
To me, home health seems like a more difficult area of nursing, requiring more experience and strong assessment skills. Thus, wholly inappropriate for a new grad nurse. Am I wrong?
My husband is a manager for a home health hospice company, and he says they would never consider hiring a new grad. Likewise, I've been looking around for jobs outside of the hospital that offer more sane hours, and every home health agency I've applied to has not been interested in me, due to not having home health experience. Yet, they're a viable option for a new grad? Doesn't seem to make sense.
New grad: I'm having such a hard time finding a job. I've applied to 18 different hospitals and nobody wants to hire a new grad.
Helpful ANer: Have you tried applying to SNFs or home health agencies? You might have better luck finding employment.
I saw it suggested twice just yesterday.
There is no implication here that hh is lesser. There is an implication that hh has problems getting enough nurses to fill the needed positions, so there is a chance to get a job. That is the only implication I read in this scenario.
I started off in a home health agency, I have been there for a year. Yes it is hard sometimes but it is doable,next week I will be working for two agencies.
Well, I wouldn't pay any mind, the same as with threads about ADNs being "lesser" than BSNs, LPNs being "lesser" than RNS, SNF being "lesser" than acute, LTC being even MORE "lesser" and on and on into which specialites are "lesser" than others.
Just make the most of the opportunities you have. I had a family member come out of the hospital and go on home health and I was seriously impressed by the care he got. It was a life-saver to know that we could get him better care at home than he would have gotten in any facility -- whether it be acute OR long term.
So just remember that. Your job is very important and it has some very special challenges of it's own -- I think it requires a person to be much more adept at handling the psych/soc aspects of medical care than in-patient. It also requires you to be able to make better critical thinking decisions as you are working with minimal supervision and making constant assessments and decisions about your patient's medical issues.
ETA: If I could, I would change the title from "lesser" to "beginner's". That's more what I was trying to convey.
It seems when new grads are lamenting the difficulties of finding acute care (hospital) nursing jobs, the suggestion is to try SNFs or home health, that they might be more willing to hire a new grad.
To me, home health seems like a more difficult area of nursing, requiring more experience and strong assessment skills. Thus, wholly inappropriate for a new grad nurse. Am I wrong?
My husband is a manager for a home health hospice company, and he says they would never consider hiring a new grad. Likewise, I've been looking around for jobs outside of the hospital that offer more sane hours, and every home health agency I've applied to has not been interested in me, due to not having home health experience. Yet, they're a viable option for a new grad? Doesn't seem to make sense.
Home Health covers a very, very wide spectrum of patients, so it depends on the needs of the agency. It is a challenging area of nursing, but new grads can rise to that challenge with proper training. It is not like they just cut you loose on your own your first day with complex patients.
My classmates who have taken home health jobs as new grads are getting the training and preceptorship required for their specific positions (vents, trachs, GTube, special needs, assessments, documentation...) - just as they would as a new grad at a hospital.
I think your husbands's home health company policy is stupid. I worked as a Hospice Aide in facilities and Home Health as a nursing student and I was damn good at that job. The nurses and families I worked with were very thankful I was there to assist with the treatments, support the family, and report pertinent data.
As a new grad right now, I would make a fantastic Hospice Nurse and I applied for some jobs in that area. It is shameful and definitely the loss of companies like your husbands that they won't even consider new grads.
I got a great offer for a new grad residency as a hospital, so I'm not bitter because I can't find a job. But I do question the policy of refusing to train capable new grads.
Under no circumstances should a new grad work in home health; you need strong assessment skills which means experience and a fairly good knowledge of the healthcare system as you will need to facilitate a lot of care for your patients. I'm disappointed to hear that there are new grads working in HH; what were those hiring managers thinking?
As Caliotter mentioned, I think what you're seeing is a reflection that some HH agencies are not good employers and they have a hard time keeping staff. New grads might be so desperate for a job and so unaware of what they're getting themselves into that they are happy to sign on. Gradually, the light dawns, that they are in over their heads and that the reasons more seasoned nurses left the agency are still in play (crummy hours, inadequate training, inadequate supplies, nit-picking on every expense, refusing to pay for legitimate claims, etc.). Some will stay and learn the ropes in spite of their employer, but many others will jump ship and make way for a new crop.
I've seen this model in action. I was hired fresh out of school by a large nursing home to work on a hospice unit with approx. 35 patients. We had end-stage cancer, renal, hepatic, HIV, etc. along with stage 3 and 4 decubiti and MRSA and c-diff patients. The infectious right there with the immuno-compromised. I had no idea what I was signing on for. My orientation lasted a week, and then I was on my own with just two CNAs. In other words, I was in way over my head. I quit after six months, but that was fine with them. A new class had just graduated, and they would just hire a fresh pigeon and burn her out.
So, the suggestion that new grads try HH is related more to the fact that agencies (especially the bad ones) have holes in their staffing than to the idea that HH is a good place for a newbie with budding assessment skills.
Home Health covers a very, very wide spectrum of patients, so it depends on the needs of the agency. It is a challenging area of nursing, but new grads can rise to that challenge with proper training. It is not like they just cut you loose on your own your first day with complex patients.
My classmates who have taken home health jobs as new grads are getting the training and preceptorship required for their specific positions (vents, trachs, GTube, special needs, assessments, documentation...) - just as they would as a new grad at a hospital.
HH also covers a wide spectrum of agencies. Most are good and would not expect a new person to handle complex patients without a proper orientation, but judging by the horror stories on this very site, some would do exactly that.
Not every agency has the manpower to give a lengthy orientation. Many want experienced nurses who can orient to that specific employer and then hit the ground running medically.
It isn't stupid to hire what works for your agency. And it isn't shameful for companies to recognize that they aren't set up to be new-grad friendly. IMO, it's far more shameful for a company that really isn't equipped or motivated to work with new grads to hire them anyway just to fill staffing holes and regard them as disposable when they quit or get fired.
Under no circumstances should a new grad work in home health; you need strong assessment skills which means experience and a fairly good knowledge of the healthcare system as you will need to facilitate a lot of care for your patients. I'm disappointed to hear that there are new grads working in HH; what were those hiring managers thinking?
Have you ever worked in home health?
The hiring managers probably thought the new grads would get training and preceptors. They also figured they could match up patient needs with capabilities of the aforementioned new hires.
The hiring managers probably thought the new grads would get training and preceptors. They also figured they could match up patient needs with capabilities of the aforementioned new hires.
This isn't that big of a deal.
Yes I have so I speak from experience.
As for matching up patient needs, as I stated before HH nurses need solid assessment skills and the ability to problem-solve that comes with experience. Recently I have been seeing some very poor quality from HH, so you have provided another piece to the puzzle. Just today, I had to follow-up on a patient with HH in the home who has not had her medications reconciled from her hospitalization 1 month ago including a PO antifungal that her husband never bothered to fill because the hubby didn't understand why it was needed. Where was the HH nurse in all of this?
I have 20 years of experience in home health care. I second the very strong belief that new grads are not appropriate for skilled home health care. Long term care with stable patients (shift work or private duty), absolutely. But not skilled home care. Very few agencies have the budget to give an extensive orientation to teach a new nurse how to be a nurse. We expect them to know nursing and are happy to orient to home care for someone with a good skill set already in place.
I see nurses with years of experience flounder and get in over their heads with home care. They can't deal with the mind shift of case management, the brutal paperwork, and the never-ending aspects of home care. They have difficulties setting boundaries with patients and families, and they are unable to manage their time effectively without someone giving them guidance.
Add all that to a new nurse who is maybe struggling with assessment skills, when to call the doc instead of the clinical supervisor, little experience with phlebotomy or wound care, and it's a disaster waiting to happen. In all my time, I've seen exactly one new grad thrive in home care, and even she had 6 months of SNF experience. I'm not sure what it is about her that makes her unique, but she just is and she outshines nurses with a decade of experience. She's one in a million. Would I have hired her if I had been doing the hiring? Probably not. But I'm glad someone else did. And I still won't consider a new grad for home care. Too dangerous for the nurse and the patient.
Well, home health and hospice and dialysis (believe it or not) are often considered last ditch new grad jobs.
In Illinois/Wisconsin you can get employment in these as a NG. Training? sometimes non-existent. Too bad because there are a lot of excellent new nurses who give everything they have in these jobs, the only jobs available. They buy books take classes on their own dollar hoping to make up for the lack of edu/clinical orientation from their employers. Most end up quitting when they realize that often, they were hired to be worked up until the point they realized that they were risking their licenses. I think some of these home health and hospice privately owned employers would rather hire Bambi, it makes it easier to rake in the money because eager new nurses are not likely to know what's what for a while.
Well, home health and hospice and dialysis (believe it or not) are often considered last ditch new grad jobs.
In Illinois/Wisconsin you can get employment in these as a NG. Training? sometimes non-existent. Too bad because there are a lot of excellent new nurses who give everything they have in these jobs, the only jobs available. They buy books take classes on their own dollar hoping to make up for the lack of edu/clinical orientation from their employers. Most end up quitting when they realize that often, they were hired to be worked up until the point they realized that they were risking their licenses. I think some of these home health and hospice privately owned employers would rather hire Bambi, it makes it easier to rake in the money because eager new nurses are not likely to know what's what for a while.
That's exactly right. Disposable nurses who are too wet behind the ears to know what they subjecting themselves to. They start out with the best of intentions and by the time they quit or get fired, they're just thankful they still have their licenses.
I would much rather see an agency refuse to hire new grads than send them out unprepared and disoriented. To me it is unconscionable to risk the well being of the patients and the hard-earned licenses of the new nurses, but there are still places who do this and nurses who don't realize what they're getting into. It's a bad situation for them and for their patients.
"Lesser" area of nursing - I've heard this my entire career.
Started as an LPN - "less" of a nurse.
Worked in LTC, "less" of a job -and yep it was because I quickly realized I would not ever get into a hospital as a new LPN.
SNF - "lesser" unit of hospital -- and the most stressful, difficult, taxing job so far, which pushed my assessment, clinical, and time management skills to the limit almost daily
Now an RN in home health.. the other day at the gas station the cashier saw my uniform shirt with my HH agency's name on it and made the comment, "oh, you work in home health?" Me: "yeah, I really like it." Her: "My daughter did that for a while, but now she's trying to get out of it - she's studying to become a nurse."
caliotter3
38,333 Posts
There is no implication here that hh is lesser. There is an implication that hh has problems getting enough nurses to fill the needed positions, so there is a chance to get a job. That is the only implication I read in this scenario.