“Keeping an open mind” is probably one of the most clichéd expressions within the English lexicon. Yet, when I placed that phrase into action, it sparked my nursing career. I hope that my message will allow others, especially new graduate, millennial registered nurses like myself, to consider a growing yet still relatively small aspect of nursing: home care/visiting nursing.

Like countless other children and teenagers, I had many different career aspirations. However, in retrospect, my becoming a RN is not an extreme surprise. Being the son of Afro-Trinidadian immigrants and growing up in the predominately African American/Caribbean neighborhoods of Central Brooklyn in New York City, I had decent exposure to the health care industry. While it is a generalization, it is common to see many Afro-Caribbeans (e.g., Haitians, Jamaicans, and Trinidadians) in New York City working within health care, ranging from nursing assistants to LPNs, RNs, and so forth. With that assertion, I indeed have family members and friends of my parents who are active in these occupations.

After I finished high school, I did more research on health careers, specifically nursing. Of course, I was not ignorant of the fact that nursing is a profession dominated by women and that, unfortunately, there are myths and stereotypes about men who enter into the profession. Being a man, especially a young African American man, I knew that I was not the image that most people would think of in regards to being a nurse. Nevertheless, I kept an open mind. I enrolled at New York City College of Technology in Brooklyn, and I was eventually accepted into the nursing program.

Without a doubt, nursing school was the hardest academic endeavor that I have experienced thus far in my life. It took me time to adjust from a standard memorization model of learning to the analytical and critical-thinking process that is the essence of nursing school. There were times when I wondered if I could ever get that cognitive skill. Of course, despite the fact that I was in school, the process of life still went on. From my anxieties about my future to dealing with illness and death in my family (two of my relatives passed away in roughly a three-month span), nursing school was not easy for me. However, with perseverance, I graduated with my associate’s degree in nursing in January 2011 and passed the NCLEX later that year. I returned to New York City College of Technology to complete the RN-to-BSN program and received my BSN in 2013.

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Despite holding my BSN degree, I still found it challenging to find employment with the hospitals in New York City. While I obviously had the degree requirement, I lacked the RN experience that was specified for a majority of the jobs. Also, by speaking with some of my colleagues who were also having issues with nursing employment, I knew that I was not suffering from random bad luck. There were indeed structural issues—things beyond my control—that were affecting the nursing job market. While I was never depressed during this time, it did hurt to some extent to have a viable degree yet no tangible evidence (e.g., a nursing job) to show for it.

To quote the late R&B singer Marvin Gaye, I “heard it through the grapevine” from some of my colleagues about visiting nursing with home health agencies. While it is true that some home health organizations want an experienced nurse (hospital or otherwise), I heard that some organizations were willing to take new graduates and train them as needed for their nursing duties. Even though the thought of going into clients’ homes did not seem overly appealing, given my limited employment options, I once again kept an open mind and did my research. I found organizations within my district of New York City  that were willing to take recent graduates.

Currently, I work with three different Licensed Home Care Services Agencies (LHCSA): ValuCare, PellaCare, and The Royal Care, all of which are based in Brooklyn. The crux of my duties as a LHCSA RN includes making a full physical assessment of the client, inspecting their home environment, and viewing their active medications for compliance and side effects. In addition to those tasks, I contact their respective physicians to get pertinent data and give current information. Then, I craft a care plan for the home health aide to follow to assist clients with their needs, from helping them with activities of daily living to calling the EMT/paramedics for emergencies.

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Like any subdivision of nursing, there are pros and cons with being a LHCSA RN. For cons, you never know what you might encounter in a client’s home, and being a New Yorker, I do go to some districts that suffer from urban decay. However, the benefits definitely outweigh the negatives. I am able to create my own schedule. If you live in a city with a decent mass transit system like my hometown, you can use the bus, subway, or tram instead of a car. And due to New York’s diversity, I get to see clients of all backgrounds. As minority nurses, being in this role allows us to give back to our respective communities by being agents of preventive care and health advocacy that will hopefully alleviate some of the ailments that afflict minority populations. Finally, with national health care reform, this area of nursing is growing.

Obviously, being a LHCSA RN is not for everybody. If you love the hospital, nursing home, or another clinical setting, then do what is right for you. Nevertheless, given the somewhat tough job market for new nurses, let life be a lesson as it unfolds and keep an open mind.

Brandon Archer, RN, BSN, graduated from New York City College of Technology in 2013 and currently works as a LHCSA RN. He lives in the New York City borough of Brooklyn.

Brandon C. Archer
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