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Help for New Nurses

Interview with a Homecare & Group Home Nurse

December 23, 2012

Hi Nachama, thank you for taking time out for this interview. Can you describe to us your experience as a new grad in home service? How did you pick up your skills? Tell us about the ins and outs of your job.
Group Home Care
So my first nursing job, I wanted anything because I needed money. I figured I would take any nursing job, continue to look and drop it once I found something else. I met up with a friend who said that the place that she works (a group home), needed nurses. I Told her I was interested (although I at the time was intimidated with G-tubes), and she got me an interview. It turns out that the home where she worked didn’t need nurses, but another home did. I appeared confident and said that I had no problems with traches (yea right, hoped I would figure it out during orientation)….and that’s how I got my first job and skills. Luckily the one orienting me was great, she taught me everything, suctioning, flushing meds, changing the trache, and the head nurse was really nice too. If there were any questions, she was always there for you.

I thought I would stay till I would find a job that I wanted, a hospital position, but I learned the hard way that I really needed a bachelor’s degree and hospital experience. I began volunteering in an ER, but that didn’t help. So I started to do my bachelor’s degree online, and decided that homecare would be the best kind of experience to help me get a hospital position. I heard of a local homecare agency that took new grads, and applied. They took me right away and loved the fact that I had experience with G-tubes, and traches..and found me cases. So the homecare is mostly pediatrics, and I find it to be babysitting that pays well and looks good on your resume. Some cases are more complex than others. Often it’s monitoring their o2 stats, oxygen PRN, suctioning, meds, and giving them tube feedings. They are great at teaching you new skills and will orient you to vents, IVs, etc. if you want. I love the agency that I work for now, very straight, honest, there for you if you have questions, easy to talk to, etc. However, I do find homecare boring, because you only have one patient. Basically, I’m doing it for now as I’m hoping it will help get me to the position that I want.

Thank you for all the info. Let me just ask you some practical questions that the readers might be interested in.

1. What is the salary like in your kind of job? In a group home it’s LPN salary :( . For home care it depends on the case. For an RN it ranges from $27 – $45/hr. Most cases I guess are $27/hr, vents are $35/hr. IVs I believe are $45/hr.

2. Who do you ask when you have questions? In the group there is a head nurse – who is really sweet and is there for you should questions arise. She guided me through inserting my first G-tube and stayed on the phone till it was in place. Should questions arise on home care, they encourage you to call the office, and a nurse will get back to you for nursing questions. Questions are encouraged, as they’d rather you ask ‘stupid’ questions than do something wrong.

3. Is it possible to turn your current job into a career? I feel like nursing itself is a career. If the salary is enough for you from those jobs then it can be a career. You can work f/t or p/t. From a woman’s perspective, I think it’s great because the hours are very practical, you pick when you want to work, as well as the shifts. It’s great hours for those who are moms, and want to be home, as you pick your shifts, and decide how often you want to work. Some days I work 9am-3pm. However, for a guy, they may want to be doing more. Many people do this as their second job. For example, working 3 hospital shifts and then working another 2 or 3 half/full days doing homecare.

4. Are there growth opportunities there? In a group home there is some growth, if you are good and they like you. For example, a new group home opened and they needed another head nurse. However, not much hands on care doing administrative work, and not many positions available. With homecare I find the growth is basically with skills. You can tag along with another nurse and learn whatever skills you want. It’s a small agency, so they basically just need nurses to go to people’s houses. Not much growth.

5. Do you have any contact with other nurses? Not much contact with other nurses in either job. In homecare, contact can be when coming on or leaving via report, if the next shift has a nurse. Group home as well. You are basically the only nurse there.

6. Will it be hard to leave if you get an offer at a hospital? For me, I don’t think leaving my jobs for a hospital position will be hard, because of my mindset. I want more experience, and a hospital can give me that. I am not scared of saying, “I found another position, would still love to work here, but will need to re-arrange my schedule starting in …” Of course they won’t like it, but…too bad! For those that think differently, my advice is… it’s your life, you are free to do what you want and live it how you want. If it’s uncomfortable to let your boss know your leaving, it will only be uncomfortable for a few minutes, and then you’ll be doing what you’re really happy with.

7. Did you have to sign any kind of agreement when you took this job for either a minimum commitment or a non-compete clause? No.

8. What’s the hardest part of your job? In homecare – being bored. I hate it. I need to be busy and love action. In a group home – too much to do, and no time to sit (I know it’s the exact opposite, I guess there is no happy medium with nursing). 8 patients all need meds, and other nursing care, all at the same time. Everyone has questions for you, because your the nurse…while the pharmacy is on the phone etc. I like getting my work done, and being free, but you never get your work done with nursing. Also I dislike that the work is so repetitive, and I don’t use my brain. I need to think.

9. Tell me of a bad situation in your job and how you dealt with it. Bad situation…hmmm. Ok. My first patient I had doing homecare. This patient desats often. His mom wanted to go to the city for a Dr.’s appointment with him. She had no oxygen left in the portable oxygen tank and was rushing me the second I came to leave with her. I refused! I needed to first find out when his last albuterol was given…. and then decided I needed to give him a nebulizer treatment before going. She was mad. I gave her the choice of either going without me, in a non-safe way, without o2, nebulizer, or suction machine. Or, going with me, in accordance with my decisions which included, waiting, getting portable equipment first, or I was not going! She scrambled around and brought this huge o2 tank and got his brother’s suction machine. Had she not listened, I would have called the agency, and let her go herself….. LOL when in the city the patient needed the oxygen, as well as the suction machine. (I still can’t get over it. She kept saying “don’t worry, nothing will happen. G-d will help, we have no oxygen and we’re gonna be late, just come. G-d will help”. I was appalled! I wanted to say ‘why should G-d help if you act stupid? But I kept my mouth closed.)

10. Finally, tell me about your most rewarding experience at your current job. It’s very rewarding when I come in and the patient starts smiling and getting very excited that I’m there. It also feels rewarding when I nip problems in the bud.

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