10.02.2008

Home care interview

Another interview today, this time at a home care agency. Despite the stern warning from a VNA nurse that entering into practice in home care would be "one of the biggest disservices to yourself that you can do"; I balanced that against the experiences of the home care nurses who came to speak in our last semester of RN preparation, who held the opposite opinion.

The office is within walking distance of my current residence, in the same building as one of the anchor stores in a nearby shopping mall. The office was one large open space with four computers clustered around the center. There were cardboard boxes stacked against one of the walls, and a lonely looking couch off in the distance. The space had a "just-moved-in" feel to it.

I was greeted by two young, attractive women, an HR agent and the recruiter I had spoken to on the phone. The recruiter reminded me of someone..she had a Norwegian lilt that placed her somewhere near Wisconsin.

I was expecting an interview, but one didn't take place. After filling out the usual employment paperwork, I was given four tests to take. Metrology, pediatric vents, pediatric tracheostomy care and pediatric G-tube feedings. The tests themselves were easy, and I was provided with learning modules to get through all of the tests except metrology (which was easy, even compared to the easy metrology tests I took in nursing school).

The two employees in the office were...overtly friendly. They acted like I had the job already, pending my background check. The HR agent complimented me on my driver's license picture (in which I looked more than a little sullen and disheveled, due to the circumstances surrounding the capture of the image). After a little less than an hour, most of which was spent filling out forms, the recruiter told me what great feedback she got about me, even from the then-absent administrator, who I spent all of 3 seconds talking on the phone with yesterday.

Next I was told about the assignment they had in mind for me, which they all thought I would be a "perfect match" for. At this point I feel I should point out that I haven't met anyone in this company besides administrative types so far, no RNs, clinicians, etc.

Alarm bells started going off in my head, loud and clear like a ventilator klaxon. The assignment was an 8 to 4 shift on weekdays, getting a three-year-old client ready for school, staying at school with them, then staying with them at home for four hours. The client has a tracheostomy and a gastrostomy. When I asked about the orientation process, I was told I would accompany the nurse currently assigned to the client for "a couple of weeks" before taking the assignment over myself.

There's a couple of issues with this: The practice act in my state suggests that RNs taking care of pediatric clients have a four-year education, and I have two. Granted, the shortage here and everywhere else results in ADNs finding work on pediatric units, but that's generally in hospitals with comprehensive clinical support and supervision. Tracheostomy care, although something I've been trained to do in my clinical rotations, is also somewhat advanced, especially for pediatric clients. I'm confident I could pick up the skills with one-to-one instruction, but just the thought has me scrambling to earmark my old nursing textbooks for relevant information. Gastrostomy care, at least, is something I'm confident I can do with minimal further training, since I got a lot of experience with that in clinicals.

That said, I'll accept the position if they offer it to me. It's a risk, to be sure, but a risk I'm willing to take. I'd have the weekends off, so I'd still be able to take the bailer shift at the skilled nursing facility I mentioned in the previous post. The home care job pays 25USD/hr, slightly more than I'd make in the hospital. Maybe risk-taking behavior is just a feature of my gender, but I think I could make it work. I've always enjoyed taking care of children, and the consistency of the one-patient assignment may ameliorate some of the inherent risk-factors of the assignment.

If I get offered the positions, I'll visit the family and the client for a "meet-and-greet", and if both the family and myself find the arrangement acceptable, I'll start the orientation process. Otherwise, they'll select a different assignment for me and the process will start over with a new "meet-and-greet" with a different household.

What do you think? Bad idea? Acceptable risk threshold? If I pull it off, it will be a good resume builder, I think, especially for someone who would like to eventually get into emergency and/or pediatrics.

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