The discussion of differences in places to work comes up from time-to-time on the board. I worked in an ambulatory clinic, then hospital, then LTC.
First, I would definitely NOT do home health UNTIL you've worked a solid year in the biz. Why? Simply because you'll find out how the job is really done, tips, methods, etc. by working with a lot of different people (both coworkers and patients/residents). As is true for all professions, what you learn in school and how it's done in the 'real world' are not the same. It will be a real help to you to work in a facility where you will ambulate, toilet, change, bathe, feed, etc. a whole lot of different people with varying health conditions. You'll get much better at handling someone that weighs twice what you do, or is bedridden.
As far as hospital versus nursing home, very different except that of course, basic CNA skills are used in both.
I'll generalize (there are always exceptions).
LTC, the most common area for CNA's, will basically be working with 12-15 residents doing primarily transfers --- to/from chair/bed --> on/off toilet.
Then, bathing, feeding, and bed changing with vitals from time-to-time. Rather a set of limited tasks, but a whole lot of work doing them. The MAIN thing about LTC is that you work with the same residents day-after-day and get to know them, their habits, and how to handle them along with family members.
In hospital, there is far more training as there are far more tasks (not more overall work) to do. Hospital is a whole lot of vitals (I used to spend at least 1.5 hours a shift doing them), doing EKG's, running things to the lab, taking samples of fluid and properly bottling them and labeling them, setting up new patients and discharges, fetching machinery (IV's, putting on SCD's, setting up suctioning, and yes, post-mortem care (and a whole lot of computer input). Very little toileting, but a lot of ambulation (post surgery), bathing, bed making, etc. You're also always exposed to TB, C-DIFF, and other fluids. There is some of that in LTC, but nowhere near the extent as in hospital.
Unlike LTC, you DON'T get to know most patients. Or if you get to know a couple of them, they're still gone in a short time. Patients are there for 1-5 days (for the most part -- depends on what unit you're in). So, there is no 'routine'. In LTC, you know who you're going to work with and can better organize your day. In hospital, NEVER routine --- patients change every day and you'll get all different types (post surgery, pre-surgery, detox, in for testing and right out of the ER, TB and other respiratory, etc.
Those are the basic differences --- routine and patient/resident relations. Some people cannot handle constant change (hospital) and need LTC routine. Others may be able to handle change, but prefer LTC because it's nice to get to know your residents and families (well, sometimes not).
Hospital is more 'impersonal'.
I won't get started on this topic, but your interactiin with nursing staff between hospital and LTC is totally different. I would work with at least 2-3 nurses a shift in hospital, and work WITH them in most cases. In LTC, I hardly saw the nurse. Totally different -- hospital is more like you see on TV with constant change to conditions of patients. LTC's have a lot of work for the CNA, but residents don't constantly have changes in their health conditions.
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