I know it seems like the nurses know all their clients and so things just go in a routine manner, but I can assure you that if you are doing intermittent SN visits you will be assigned new clients and have to start the process all over again with every patient. I always call them ahead of time. I try to call the night before, but our office often messes with the scheduling early in the AM and I hate telling patients I am coming then they be removed from my schedule. So I generally call in the morning time and tell them that I am the home health nurse coming out to do xyz today and I will be there at abc time. They usually know to expect a home health nurse as they have been referred by the MD, or the hospital. And our agency uses separate nurses to do the Starts of Care. Then they are assigned a primary nurse. We are computerized and use an interactive scheduler, so while I'm at my first visit I look to see what day they are scheduled for another visit and I try to let them know that "your next nursing visit will be on xyz day, and the nurse will call you before she comes." Just be confident. Do what you are supposed to do based on your orders. Assess your patient, listen to your patient, and report any abnormalities to the MD. Do as much teaching as possible, check medications! Make sure you document properly and soon enough it will become easier to introduce yourself as the home health nurse. And, I just want to add that GPS is a Home Health Nurses guardian angel! Good luck!