Im a new grad RN who started working part time in pediatric home heatlh. I accepted a full time cardoac SD job at a hospital and start in august. I love working with my client and not sure if I want to work in a hospital. Any advice for a new grad?

Hi! Congrats on the job! I would say as a new grad this cardiac SD job will be a great opportunity to get experience which in my opinion will serve as a better foundation than a home health pediatric job. It will definitely be a learning curve but don’t be afraid to ask questions! There’s no such thing as a stupid question. Utilize your charge nurse if you feel overwhelmed, and don’t be afraid to speak up. A hospital can’t fire you bc you ask too many questions lol and if you need more time for orientation don’t be afraid to ask.
I actually preferred working at a hospital as opposed to outpatient bc after you clock out your DONE. When I was a new grad I would always go in early bc I wanted to get to know my patient and review the chart. The 10 minute report from the previous nurse was quick and I wasn’t ever able to make a task list unless I came in early. I like to make a list of what I need to do for the shift and check things off. I would suggest doing that. Know your patients vitals. Lastly my best advice is prioritise. Cardiac meds are priority- a dressing change can always be passed on to the next shift, but MAKE SURE YOU ALWAYS ASSESS your patient in the beginning of the shift. If they have a dressing- take a look and make sure it’s intact with no drainage.I always look at my patients sacrums too if they aren’t ambulating. A pressure sore can happen quick- especially if they’ve spent some time in the ICU and now are on the step down unit.

Having at least 2 yrs. of hospital experience will be an asset to you in performing clinical procedures and will help with nursing judgement in Home Health situations.

Give yourself a chance to experience the hospital, stay on at your hh job PRN of you can if you dont like it just transition back into it FT. Good luck.

I would get the hospital experience, home health will always be there. I did the pediatric home health route after school and found it hard to get in the hospital years later. Sadly lots of places don't respect your home health experience.

Welcome to this amazing community and congratulations on becoming a nurse! I’ve been a hiring manager for years and especially now, your options are so many, even as a new grad. Nurses have so many options and while the old advice was to always start in the hospital, if you’re interested in another field or, you’d like to work in another type of nursing position, you have the leverage (again, even as a new grad). You can always go back to the hospital or anywhere else in nursing if you decide to do so. Happy to answer more questions about this but in the meantime, please check out Kelsey @wholelifenurse on instagram https://instagram.com/wholelifenurse?igshid=YmMyMTA2M2Y=
She has many free resources and valuable insights to ensure you mainly our health and self-value. Good luck with your next move, you got this! 💜

I personally would continue working with your current client(s) and keep building up patient care experience. You will be better prepared to care for hospitalized patients and have empathy for your fellow nurses =) you might not want to switch, or maybe even, you'll want to try new branches of home health. I wish you the best of luck in both ventures, you're strong and you've got this.

I love my cardiac floor, been there for a few years now, and I started during the pandemic. The type of culture of your unit often makes or breaks a unit, no matter where you are! Encourage teamwork, learn from nurses who are willing to share, and learn all you can. Even if you don't stay on the unit for the rest of your career, you will learn a great deal and what you learn on a cardiac unit will serve you well for the rest of your career. From one cardiac RN to another...:)

I’ve only ever worked in LTC and Home Health & Hospice. I only did clinicals in the hospital setting and I hated it. You don’t have to work in a hospital to be an excellent nurse. You have so much more autonomy in LTC and HHH and I think that’s why I have never liked hospital. But that’s just me! I’m the director for a rural home health & hospice but make time to go see patients when I can. They help me remember my why….

I think the cardiac SD job would be great experience. It may seem a little overwhelming at first but hang in there because you will learn so much and gain strong clinical knowledge. Try to stay at least one year for a solid foundation. You may love it and never want to leave 🤷‍♀️. But if it’s not your niche you can always go back to pediatric home health, if you leave on good terms

I agree with everyone. Take the hospital job for experience. You will probably dislike the hospital because it is not one on one snd do different from HH. That’s the best part of nursing—you can change and accept different positions throughout your career.

Hello Dear . . . if your heart and passion are in the idea of helping others in times of vulnerability, you chose the right profession of study . . . don't give up an opportunity to learn about life and from others . . . you need to know that you are special in that you chose a science of caring to demonstrate your life force . . . stay the course and know that I support you . . . give yourself the opportunity to become even more open-minded through and by learning from unconditional illness experiences of others . . . You will never be the same if you should choose to do so . . . No matter which area of nursing in which you choose to practice . . . Yours, Dr. Brian Mendyka, PhD, RNC

Hello,
Working in hospital on a cardiac unit will be a valuable learning experience for you. The skills you learn there will help you in all your future endeavors. Working in a hospital will be much different. You have to get used to the longer shifts and being on your feet longer. There are also many different personality types that you may have to deal with. As a recent grad do not let anyone bully or make you feel bad if you dont understand something or need help with something. No question is a stupid one when it comes to patient safety.with

Follow what your heart desires, the cardiac floor in a hospital setting can be tough for new grads. You need to condition your mind and body if you are willing to commit, although they will train you it is all gonna boil down to your passion it is a rewarding experience in a fast pace environment.

I have loved the autonomy of Home Care for Peds and Adults because I had a breadth of knowledge and decision making skills gained by working in hospitals.
You can do both at the same time, but diligence in caring for yourself is essential for providing the best compassionate and problem solving care. It's never just "the patient" you are working with, but their support system and medical team plus community resources. You are the key person in the home to identify where the individual or family may benefit from outside resources with which you are familiar. Social Workers and Discharge Planners have merit as resources, but the nurse working with an individual sees the needs better, usually. So, my advise is to work hospitals - even on a variety of units, or a rural setting where you get a wide amount of experience for at least 2 years.

As a new grad I would say get the hospital experience first and then keeep the HH job PRN that way you will have some diversity in your education and you will gain valuable hands on training in the hospital. I understand your desire to stay out of the hospital as it is not my cup of tea either. However having had hospital experience you will be more well rounded in your knowledge. I love home care but you kind of our on your own and while you might get some support you will have to wait which might not be feasible but while you are learning in the hospital you have access to many years of experience with your peers helping to build your knowledge.
PNewton, ADN

Susan Hamel, FNP, BSN

I highly recommend a solid two years on a medical-surgical floor. This is most needed! After doing almost two years on the med-surg floor, I chose a a position in a home health care department. I also did private duty caring for chronically/terminally ill children. At the age of 45, I went back full time to pursue my MSN. I chose to be a Family Nurse Practitioner as I loved caring for the individual members of a family unit.

I say you should try to get the experience the hospital gives you. Your critical thinking skills will be tested and you will learn a ton of new skills. You can always keep your patient

Perhaps you could get on a 3 days 22 hrs a day rotation and still work a few days in the peds home. It’s always good to have hospital experience under your belt. It’s usually a must for most jobs. They want to see that you can multi task handle all kinds of pts and not fall apart. Also it teaches you a variety of skills. It sounds like Peds is your passion so try and work in a pediatric hospital. Best of luck !!!

Don’t work in a hospital if you already think you won’t like it.

EXPLORE YOUR NEW OPTIONS, OTHERWISE YOU WOULD NEVER KNOW YOUR PASSION FOR THE JOB.

Very true

Definitely get enough experience at the hospital.

be a team player, care for each patient like you would a loved one, and attempt to involve parents and convince them that they are in charge of their children, and you are a part of their family who cares as much as they do
CONGRATULATIONS

The choice of where you want to work is yours. But giving the best care to your patients is a standard for all nurses. Home care is not comparable to Cardiac SD. Be informed that the patients depend on you to provide the best care with evidence based practices. As a new grad, you may need more experience even before working in a home care setting. Be aware that your expertise is beyond your comfort.

Do both until you’re ready to choose one!

Hi congratulations on being a recent graduate and on the new job offer. I always suggest hospital experience as a foundation for your career. Sometimes when nurses are brand new, we start something, and this becomes our comfort zone. There is nothing wrong with this, but it is always great to have a broad knowledge base to build your nursing practice foundation. I do not think home health provides the best support and guidance for a new graduate nurse to develop a strong nursing practice.

Congratulations. the more diverse experience you have the better. As a new grad, you have a lot to see, and then you will be more successful in home health. I did home health for over 30 years, but I had CCU, med surg. background first. It helped with the transition. I loved HH.

Home care is a very rewarding career choice. It is like a hospital without walls. I have recently retired as VP of Nursing Services for a major home care company. Patient care is pretty standard however Medicare has imposed so much oversight that working within the guidelines is very good for patient safety but the documentation is the drawback for clinicians. Documentation often takes longer than patient care. Many clinicians leave homecare because of the documentation. Home care does offer some degree of flexibility because you make your own schedule. My biggest words of wisdom for a new graduate are these:
You need to be independent with good assessment skills because there is no other clinician there to verify your findings and you have to report the patient status to the physician. It could be life or death and you need to be confident in what you encounter. Also you will be doing wound care, IV management, lab draws, trach care, a lot of teaching, med monitoring. You will be required to see at least 6 patients a day and there is also an oncall element. You need a good reliable car and be comfortable going into patient homes, many with different cultural backgrounds. Often you will find yourself in the worse house in the neighborhood. Are you comfortable going into the city? A lot to consider but all in all a great field. Hope this helps.

1) Keep your home health part time job. They took you as a new grad which the hospitals would not. There’s a world of difference in hospital work and home health work. I did both.
2) Try the hospital job that is full time and will give you benefits. It is difficult to juggle the two jobs and both employers will deliberately throw obstacles at you to make you quit the other job.
3) Now tell me is SD step down? We didn’t use that abbreviation when I worked. They take away the standard abbreviations and just make up new ones. I won’t elaborate on that….

try rehabilitation services

First bit- learn the basic rythms and how to interpret telemetry strips. Then learn the treatment/medications for them. Be sure to have the lethal rythms down cold. Get ACLS certification.

Take the hospital experience while you have the opportunity. You can always transfer back into HH but you need the skills and experience that they always require from hospital setting. Good luck

Hi,
How about working part time and co to ur to work with your client?

As always…it depends. It’s great to love what you’re doing; that seems tough to find in this field without some trial and error. Hospital life is a grind like no other but it’ll build a good foundation of basic nurse/med surg/time management skills. Not that you don’t do that with HH jobs, but juggling multiple pt’s with all their tasks and interventions is different.

Just depends on what kind of base you want to build. I think going from HH to hospital will be a gut punch later in your career, so I’d get the hospital experience out of the way early before you get used to being on your own in the field.

When your a new as an RN or an NP, working in a mobile health setting will be very challenging. You are alone in that moment of time with no resource or mentor readily available to assist you in moments of the questions that will arise etc. Expect challenges as mobile in home care who is a new clinician of any kind, is challenging. And I speak as a seasoned 40 yr RN who has been in many executive roles to see the outcomes of many clinicians growth

In my opinion you need to have a minimum of one year of experience prior to working in home health.

I also recommend the hospital job but be on top of your game patients are critical and Heparin drips need to be adjusted according to protocol . Cardiac Rhythm course/critical care course probably needed since everyone will probably be in telemetry. I did it as one of my first jobs and it was def a challenge.

As a retired nurse of 50 yrs, my advise is keep hospital job …best way to earn experience.

I can totally relate. After being an LPN for 17 years I finally bridged over and got my RN this past March. I have worked in geriatrics and am currently still employed with a Home Health working with pediatric patients.
The decision is ultimately yours to make. You're going to get "experience" anywhere you work. I have great clinical managers that I can call anytime with questions. It's a matter of wanting one on one with a patient or working with several like in a hospital setting.
Don't feel like you're less of a nurse if you decide to stay with home care.