Home Health Nursing and Covid - better or worse?

[Peachpit]

There are many posts about nurses working LTC or in hospitals and covid, but I haven't seen any (maybe I missed it or didn't search correctly) in regards to Home Health Nurses and Covid - the concerns, if nurses in home health feel "safer" than in another clinical setting etc. 

I assume most home health nurses are wearing PPE when going into a home (or should be in my humble opinion) but I'm still interested in if nurses feel less stressed/safer in this venue than they would in a hospital/LTC setting.

Has anyone left a home health job because of covid?

Thanks in advance for replies. 

[AdobeRN]

I work PRN for a HH agency - been with one family for 7+ years now.  I am not afraid to go into their home - probably safer there than my regular job as a school nurse.

The parents of my patient are strict with visitors inside their home and where they take their child in public and they have always been honest with me if someone in the house has the flu, been ill etc.  I am not worried about being exposed to Covid while inside their home.  They are not too worried about me exposing them either - they know I work as a school nurse during the week, heck even mom is a teacher so they are well aware of the risk.  

I wear a mask for my entire shift, do my usual of always wearing gloves when warranted and of course frequent handwashing.   I have gowns, face shields etc available to use if needed but it is not required unless doing a procedure that would require wearing full PPE. 

To be honest there are times I am probably more anxious about the possibility of me exposing them to Covid than the other way around where I get it from them.   

 

[caliotter3]

There is a forum section for home health, "visit" nursing, and "private duty", extended care nursing, where you might find input regarding working in the home environment with Covid as a factor.

I have been told by the DPCS that the agency has lost business because some clients refuse to have nurses enter their homes because of where else they "might have been".  Home health nurses that I have spoken to have stated that they refuse to allow the clients to limit their ability to earn a living and they won't limit themselves to only one client.  This, of course, pertains to extended care home health.  Intermittent visit nursing, by virtue of the definition, consists of visits to several homes during the course of the workday.  This would not preclude such clients from also refusing service for the same reason.

[Pat r]

I have done pediatric ICU and adult medsurg.  I have been in home health for 26 years.  I have been confronted with knives, guns, physical assault, vicious dogs, and etc. In the home and hospital settings.  This has not swayed my love of nursing until this past year.  Covid has been difficult in homecare due to unavailable PPE [agencies were turned away from needed supplies by suppliers], no means/testing for covid in the home, and refusal of family to distance or mask.  We have very little control and the state I live in did not place us on the higher priority list for the vaccine.  I went to another state to get it, as my company has offices there.  People come in and out of their home and do not practice precautions.  Despite the trials of the year, I still love my profession and remain optimistic for the future.

[guest1143647]

Worse.

Residents in nursing homes get tested,and of course, by now most have  received the vaccine. Even before vaccination,residents  and staff were tested every week. I cannot say the same for my home care clients. No testing protocol exists for clients nor employees.

I think extended care shifts are worse than skilled visits. At least with skilled visits,my agency tells the clients they have to wear masks while we are there. No such things exists in the two agencies I've worked with.

 

 

[TheReluctantRN]

So I was previously a Home Health Case Manager for many years.  I left to work as a Director of a Home Care Company, which closed at the start of Covid.  I found myself back in my old stomping grounds in Home Health.  Covid changed the dynamic a lot, and every week we were being told to wear something different for PPE.  At one point we were told booties, a gown, a N95 and a face shield.  This was in the middle of Summer last year and I began also having dizzy spells while driving. I feel like it was because of the heat and the combination of all the gear, which yes I stripped most of it between visits.  The final straw for me was that I felt that a bunch of the patients were acting way more entitled than normal.  I asked a patient to put away some dogs that were barking and attempting to bite me, something that has never occurred before-- but I chalk it up to my new mummified nurse look-- and this person was super insulted about it.  I have a hundred more of those stories.  I also had several Covid positive patients, but nothing that worried me.  The attitudes of the people I was assisting was really the most appalling--more than I have ever experienced previously.   So, I left home health for awhile and now I am back.  The PPE wearing has calmed down back to a N95, and now that people are getting vaccinated a lot of the attitudes appear to have shifted a little about me coming in and what I am wearing or not wearing.  I've even had several patients ask me to remove my mask which is a far cry from months ago when people were practically shouting at me if I got near them without a large amount of gear on.  The administration hasn't improved though, and most of them are continuing to alienate their field staff members (by making them unable to come to the office for even things such as supplies without making a "appointment") and they expect that we are working at 110% perfected capacity.  Nevermind the world hasn't yet to return to normal  But hey. Whats new? 

[Missingyou, CNA]

I  only work a few hours a week in home care. The agency I work for does NOT require staff going into a home to wear any mask. I do wear a mask the entire time. I also work in a nursing home that was devastated by covid early on. .....and no, my current facility does not have a policy about working a second job anywhere but, they once did. ...in fact, they are encouraging it now within their own "family" of nursing homes within the state because of a severe shortage of RN & CNA`s.