I've been at my current job for over a year now. Reflecting on the last year, I decided to make a post about how it's going.
First, some background information:
I'm a registered nurse. I left a hospital to try home health nursing:
I was working in a hospital setting full time for several years until our daughter was born. After that I cut back to PRN (as needed), and I was working minimal hours for a couple of years just to keep my license active. I was okay with that. I had an assignment at church that was quite involved, and Aaron also had a busy church assignment. It seemed that me working less was the right thing. It didn't seem like I could manage more. Then last fall I started feeling super antsy, like I needed to make a change. It was a combination of needing to work more hours and needing to change employers altogether. It was a little confusing, since I didn't know how I could work more and still fulfill my responsibilities at home and church. But the prompting felt urgent. It felt like divine guidance, so I started to brainstorm how I could work more hours. With my PRN status, I wasn't guaranteed hours, and signing up for more shifts would just be frustrating because I could work all of them or sit at home on call for each of them. It was really unpredictable whether I would actually work or not when I was scheduled. (If the hospital didn't need all the nurses that day, I was always the first person asked to stay home.) Signing up for more shifts would be challenging. We were trying really hard to arrange my 12-hour work shifts on nights and weekends when Aaron would be home to watch our daughter. But I didn't want to work every weekend. I started looking into other jobs. I applied to several. I ruled them out because the schedule wasn't going to work. I went to a job fair. The job that kept standing out was a home health job on the evening shift: 3-11 pm. I applied and interviewed, and it just felt right. I got the job and had a pretty steep adjustment curve. There were some skills I had not used in my previous job, so I had to review. The orientation process was chaotic and not organized well for the evening staff. I went from working about 16 hours a month to 24 hours a week. My church assignment suffered. It was all very uncomfortable at first. The job was a huge challenge, which was actually pretty invigorating. But I had times when sincerely questioned whether I should stick with it.
However, the thing that kept me going was that I was certain that I had been guided to this position for some reason. I knew that it was a direct prompting that led me on a job search in the first place. And of all the interviews, it was the one that felt right. I made a commitment to myself to stay in the job for at least six months. At that point, I felt more comfortable, and I was inclined to continue working there.
What I love:
Evening hours. The evening schedule is perfect for our family. I was able to move my start time to 5 pm, so I can leave for work after Aaron gets home. This means that - except for on rare occasions - we don't need babysitters when I'm working. (Not that there's anything inherently wrong with a babysitter. We just prefer to not have to rely on others all of the time.) Evening shift is much better than the night shift at the hospital because I can still come home and sleep the rest of the night.
The nature of the beast. Home health is unique in that every patient's environment is different. In the hospital, all the rooms are set up very similarly. There's always a certain bed and a certain table and a certain countertop. The gloves are in the same place, and equipment and supplies are usually where you expect to find them. There's a certain light right over the patient's bed, and the bed can move up to your comfortable height for any procedure. Not in home health. Each home is arranged differently. Sometimes there is so much clutter that I don't have anywhere to place my supplies. Sometimes its a bare rented room in a basement. Sometimes its a little side room in a drug rehab facility. Sometimes it's a motel lobby. Sometimes it's a hotel room. Sometimes it's a mansion. Sometimes it's a penthouse downtown. Sometimes it's an extravagant, old home. Sometimes it's a gated community. Sometimes it's an apartment complex. Sometimes it's a trailer park. Sometimes it smells like cats. Sometimes it smells like smoke. Sometimes they have a chair for me. Sometimes I pull up a box. Sometimes there's a family member who can lend a hand when needed. Sometimes it's just me. Sometimes the room is well-lit. Sometimes I ask the patient to hold my phone flashlight during a procedure. When I go to visit someone for the first time, the environment is a wild card. I have to figure out how to perform a procedure correctly while sometimes improvising on some of the details. I need to maintain my sterile field on top of a pile of books and papers. I'm glaring at their cat who just walked in the room and wants to snuggle (and they were supposed to have locked it out). Now - oops - they ran out of a certain supply. Let me see if I have one in my bag. No? Well, this other thingy will have to work as a substitute for now. I would never recommend home health as a position for a newer nurse. But when I come up with a good solution, I always feel really accomplished.
Audiobooks. I have read many books this year. I drive a lot for work, and I constantly have a book playing while I drive. I read the entire Harry Potter series, and I'm almost finished with Lord of the Rings. I've also listened to some nonfiction books, both thought-provoking and motivational.
Learning the roads better. Since I drive so much for work, I have become a lot more familiar with the roads in this area, specifically the freeways and their entrances. I still rely on my GPS a lot to determine the fastest route, but I'm becoming more confident.
Have a separate phone for work. Not all home health agencies provide a phone. I had the option to pay a small fee each month to have a separate phone provided by the company. It is great to have a phone I can use only at work. It goes both ways: when I'm working, my personal phone is on do not disturb. When I'm not working, the work phone can be on silence. The other good thing is I can use the GPS on one phone and listen to audiobook through the other.
Resources: I work for a large company with lots of resources. When the pandemic hit, we had to conserve PPE, but I have never been denied what I needed. The company has worked with community groups to come up with innovative solutions and provide PPE for employees as well as cloth face masks to patients.
Some regular patients: I don't have a lot of regulars because it's the evening shift. However, I do have some that I see regularly. It is nice to get to know them and their families.
What I don't love:
The nature of the beast. The evening shift is especially challenging in that I mostly see patients I'm unfamiliar with. I'm doing a lot of troubleshooting or evaluating new orders. It can take a while to find the patient's home in the dark - especially at large apartment complexes. It can also be a pain to find all the right supplies in a patient's home. Usually they keep them all in a box, but sometimes patients move stuff around. When it's night time and you go to a home to find that supplies are exhausted or someone delivered the wrong supplies, that's frustrating. It can take a long time to rectify a supply issue. Whether it is going back down the elevator and walking to my car to grab a supply I didn't know I needed, or having the delivery people make a special trip to fix their error, it can be time consuming. Also, patients are usually tired and less patient with little mishaps. Furthermore, some visits at night in unfamiliar areas can feel sketchy.
Less support. During the day, there's a lot more support for nurses compared to my evening shift. There is someone available all day to answer questions. They can easily call a physician's office to clarify an order or report a concern. But in my case I'm inconveniencing anyone I call because it's after hours. If I call a physician, it usually goes to an answering service, and then I have to wait a while for the return call. This is a problem if I'm waiting in the patient's home and I have other patients to see.
Clutter. I have a lot of supplies for this job. I have to keep them with me in the car. But sometimes I need the back of the car on my days off, so I have to move stuff out of the car. It creates a lot of clutter in the house. Especially when our daughter finds interesting things to play with. Like using rubber tourniquets as "scarves". I have to make sure she doesn't compromise the sterility of certain supplies. I was doing a great job at decluttering and organizing my house before this job, but now I feel like I've taken several steps backward. I'm just constantly moving the work supplies back and forth, and they're always in the way.
Sketchier PPE. In the hospital, you usually have a good place to don and doff your PPE and then wash your hands as soon as you leave an infectious patient's room. In home health, I have to be a bit creative to make it safe to don and doff my PPE without drawing attention from neighbors. Then I have to sanitize my hands really well, clean all my equipment, and drive to a good place to wash my hands with soap and water. It just requires more steps and critical thinking to ensure my safety.
No coworker relationships. Home health is unique in that I don't see my coworkers. The COVID-19 pandemic made this worse; when I first started the job, we had staff meetings in person. Now they happen on a video conference from home. I don't even know what most of my coworkers look like. It's not like I don't interact with coworkers at all. I send my fair share of emails. Unfortunately for these people, I have little to go on when trying to remember them and attach meaning to our interactions. Therefore, I catch myself subconsciously forming opinions about them based almost entirely on their documentation and other written communication. Let me introduce you to my unfairly judged coworkers:
Nurse A, who documents wound packing correctly every time: my bosom friend
Case manager B, who always leaves clear orders in the chart: I would take advice from them
Nurse C, who spells "dawn" instead of "don": someone I can't take seriously
Administrator D, who misuses possessive apostrophes: my mortal enemy
Nurse E, who clicks the boxes without filling in any details about the visit: a lazy person
Nurse F, who writes clear, detailed visit notes: a loyal, trustworthy friend
Messes up my hair routine. It's been a couple of years since I stopped washing my hair every time I shower. I worked slowly on spreading out washes over several days. My hair was tolerating about a week of no wash. I just used a little dry shampoo to get by during the week. Thanks to my new job, my hair doesn't know what to think. It's annoying when on a day I wouldn't normally wash my hair, I end up washing it after work because it smells bad (cigarette smoke, essential oils, etc) or because I took care of a patient with COVID-19. Even worse, sometimes consecutive work days fit these characteristics and I end up washing my hair two or three days in a row.
Turnover. There is a lot of turnover on my shift. It is a difficult shift. Most people would rather work days, while I at least have that advantage of evenings fitting my life better. It's harder to get to know my coworkers when they change so much.
Other life things. Everyone tries to schedule stuff in the evening. I still have a church assignment that wants more attention than I give it. And being unavailable some evenings can make it challenging to plan things.
Scheduling. I don't get my patient list until one hour before my start time. After that point, I can still get a phone call if any other patients need to be seen. It is frustrating to me that I can have all my visits planned out and then get asked to see another patient. Since I try to plan my visit order based on the most convenient driving path, added visits after the fact can disrupt all my efforts to be efficient. It's also frustrating when I finish seeing all my assigned patients, and then I head home, only to be asked to go see someone else.
Why I think I was prompted to get this job:
I know I listed a lot of the downsides of home health. But overall, I do enjoy it, and I'm grateful for it.
My old job was fine at the time I started job hunting. But this new job has allowed me to work a lot more hours, which has been great as we have been building up our savings. It became apparent this year why those savings were important for us.
I actually still have connections at my old job, and I'm aware that the morale is low, and many good nurses and physicians have left. These were people who made my job there enjoyable. If I had stayed, my work satisfaction would have been a lot lower.
When the pandemic hit, I would have had a hard time if I had stayed in my old job. I would have been shuffled around to different areas because there was a discrepancy of staffing resources throughout the hospital units. But in my new job, I was able to contribute directly to the increased workload of the pandemic response while not having to work additional shifts outside my work area. It was also very comforting to hold a steady job during a time when many people lost their jobs during the economic turmoil.
I have to remind myself that when I trust in God, things work out. This job has been a blessing and a reminder that I can do hard things. I can push myself through uncomfortable situations.
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| sorting supplies |
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