Home Health Nursing

Mrs.Rollins, ASN, RN · Aug 21, 2009

I did an extended rotation in nursing school, and I saw it as being a kind of jack-of-all-trades. We did A LOT of wound care; as a matter of fact, the majority of our visits were for ongoing wound care. You'll also have to perform the head-to-toe assessments on all new admissions to home health (much of the care provided by home health can in fact be done by LPN's or aides, but as you know only an RN can assess), fill out tons and tons of paperwork required by Medicare and private insurance for reimbursement (not really that different from the hospital's amount of paperwork, IMO), draw labs and/or attend to PICC/CVC lines etc, and spend as much time as you possibly can per visit teaching patients and their families. It was my experience that almost to the letter these clients needed a lot of teaching about their disease process and healthy living.

The reason you won't catch me dead working in home health is the ick factor: many of the homes I went into were simply disgusting. Unless your clients all live in Beverly Hills (and even then nothing would surprise me), you're going to encounter some people who live in absolutely wretched conditions. While they may come into the hospital smelling the same way, at least there I can leave the room. I would literally bring a change of clothes and a big plastic bag with me on my route: I would stip my uniform off and put it, along with my shoes, in the plastic bag and take it directly into "decontamination" when I got home. Uggggh! Bear in mind, however, that the area I was in was a very underserved community, most of whom lived below the poverty line. This might not be the norm for experience elsewhere.

I was always under the impression that you needed some experience as an RN before you could go into home health. However, several of the people I graduated with in May went directly into home health. To be honest, they've all since told me they want to leave but I don't know if that has to do with the job itself or just the agencies they're working for. Home health is truly a very necessary aspect of healthcare and one that can always use good, qualified professionals. I just could never be one of them. :)

caliotter3 · Aug 21, 2009

You can get an idea of what home health is about if you do some reading in the home health forum. A lot of job satisfaction depends upon what type of job you take and how your home health agency is run. Good luck with your decision.

SummerGarden, BSN, MSN, RN · Aug 22, 2009

most local facilities in my area will not hire new grads because they do not want to train them (their words) and it takes experience to become comfortable nursing alone. for example, if you do not draw blood by the second stick you need to wait for another nurse who is visiting his/her own patients to travel to where you are located to draw blood. also, new grads have a lot of questions regarding health conditions etc. and these questions are not easily answered by other nurses. within home health setting you do not have another nurse standing right next to you to answer questions after observing your patient. you also will not have experience to rely on instinct to guide you when something goes wrong. i could go on... but after working in the hospital as a rn i am ok with not having started out in home health because home health nurses do not have the same kind of support as facility nurses. :twocents: maybe after a few more years acute care nursing i will work home health prn.?

to answer your other question, i know of a few home health nurses. their tasks are similar to the hospital: assessments, lab draws, patient teaching on disease process and equipment, medication administration, dressing changes, cath and central line access, documentation, calling docs for orders, coordinating care, etc.... no call lights, one patient at a time, and time management with some room to run personal errands (shhh…. the last part is a secret…)