difference between home health and public health nurse?

[tinderbox]

I currently work in home health and am thinking of making a change. I had considered wound care and even going back to acute care (temporary bout of insanity on my part!), but neither really hold an appeal to me now, especially not acute care. I really like educating my patients and the one-on-one interaction I get to have with them, but I'm getting really tired of doing hours of paperwork at home, after having seen my patients and also getting wary of constantly having to drive into bad neighborhoods alone. I also hate the amount of paperwork involved in home health. I mean, it is really ridiculous!

Other than that, I actually do enjoy the work, and I thought public health nursing might be a good option. From what I understand, it seems to entail a lot of patient education and preventative care, both of which pique my interest, but not as much crazy paperwork and charting on your own time? Am I right?

But it also sounds like some phn's go to people's homes, and that is where I get confused. I do see the major differences between home health and phn, but are there any phn's out there who can elaborate, especially on the home visits? Do you have to spend hours charting after seeing your patients? How much travel time exactly is there in ph nursing? I'd like to kind of steer away from traveling so much as well...

[exnavygirl-RN]

Some public health nurses do home visits depending on the area they are working in. Our TB nurse and high risk maternity/infant nurse do home visits. I work in child health and occasionaly have to make a home visit. The paperwork, to me, is nothing like home health or working inpatient. I work 8-5, off weekends and holidays. The pay isn't that great but I enjoy what I do.

[mariebailey, MSN, RN]

How much travel time? I provide TB case management, and my time spent on home visits varies drastically from month to month depending on caseload. Overall probably 5-10% of my work month is spent in the home and traveling to visit my TB clients.

How much time charting? It’s probably minimal compared to what’s required for home health. It takes a couple of hours to chart on a new client, but daily charting averages about 5-10 minutes of my time.

A note on direct client services…Public health services are population-based, a lot of it is not direct patient care (depends on the position). In fact, I probably spend a/b 75% of my time at my desk (5-10% home visits, 10% STI clinics, 5-10% immunization, international travel, & TB testing services). For example, disease investigations/surveillance to control and prevent the spread of communicable diseases is a huge function of public health; we may interview clients, but we are not their provider of care.

Last thoughts… Public health could REALLY benefit from someone like you with a home health background. If you’re not into desk jobs, there are plenty of positions out there that involve more frequent client interaction. You may like the balance; I do. I love public health, so it’s great to see nurses from different backgrounds interested in the field. Best of luck!

[tinderbox]

Thank you for your replies!

That does clear things up for me, especially regarding travel time. It seems to me that public health nurses seem more satisfied with their jobs than HH nurses do. There is a lot to love in HH, but I constantly hear and read comments from HH nurses expressing burnout with the hordes of paperwork, unpaid overtime, charting well into the night at home, and wear and tear on our cars. It's all true, and I've had the same issues! LOL! Whereas in public health, it seems the common complaint is lower pay. I think I would enjoy public health, though, as I do enjoy promoting wellness and preventative care. I went back to full-time in HH, and we still have to work a weekend a month and some holidays (depending on who wants what off, according to seniority). The hours and the work of public health sound very appealing to me!