For those of you who do/did homecare, please advice

Flare, ASN, BSN · Dec 5, 2008

I did home care for a short while. It was a part time job for me where I worked a few weekends each month and occasionally during the week. Because of the schedule I worked, I was not considered a primary nurse in patient care which pretty much just meant that i could not do admissions nor could i do hospice pronouncements. They also did not use me for all-day shifts, like attending to someone needing rtc care. Mostly I went out to see patients to change dressings - everything from simple wet to drys to vacuums to ostomies. I also did a lot of catheter changes and a lot of medication education (diabetes, hypertension). I was given a brief orientation, but was also expected to have a fairly good base knowledge of what i was walking into. There were a few times that i made a visit and ended up calling for an ambulance as the patient had taken a turn for the worst and needed a higher level of care.

CheyRN · Dec 6, 2008

The greatest challange is the condition of the homes. You were taught that sanitary conditions are to be expected in the workplace, but most of the homes that I worked in were far from that. I even worked one place that was so nasty that I had to clean the kitchen before I could wash my hands to do the dressing change. You must also be able to follow agency policies to the letter. You will find family members that expect you to work for them as well ("Can you take my BP while you are here?", "Does this look infected?", "What cold medicine can I give to my kids?"). Lastly, if you have allergies to dust, pet hair, smoke, etc. rethink working in homecare. Good luck, I loved it, but it's not for everyone.

Itshamrtym · Dec 6, 2008

hi everyone,
i am a new rn graduate and just joined this site. i graduated in may with my bsn and also currently am in adult/geriatric (non acute) np program. i got a part time position at the hospital affiliated with my university, at the general medicine floor. i really wanted to work at the general medicine unit, but they only had a pt position when i applied. because i work pt, the hospital only pays pt classes. so now i am working pt and going to school pt. i feel like i could work another day or two for experience and money. i was thinking about doing home care, maybe in a few months. could you please advise me what skills do i need to master for home care. of course, i need to be able to do a good assessment and teaching, but how about hands on? wound care, catheters, ivs? i know it differs from one patient to another, but i just want to have a general idea. what kind of challenges should i expect? do the agencies usually provide an orientation? thank you! :redpinkhe

welcome to allnurses:yeah::yeah:and congrats to you... good luck:saint::heartbeat:saint:

female12233 · Dec 6, 2008

it depends on the type of in home care that we're talking about here. There is the traveling aspect of it. This is pretty much were you drive from house to house seeing a couple of clients a day. Or there is the type of in home care were you provide care to that client for your entire shift. I have done just a few shift of the "traveling" in home care. During these shifts I would have to have a wide variety of nursing skills. Big time assessment, it doesn't matter if you don't know what the odd finding is as much as being able to detect that it's odd. If you don't know what it is there always someone else at a higher level of care or another nurse who may have seen that pt. to help you through whatever your unfamiliar with. I mostly did medication education, dressing changes, assessed or change IV, Bandages around devices or insertion sites, Foleys. But the biggest challenge on both fronts is going to be the family and their home in general. I worked home health for almost two years, I was sent to a variety of cases. I mostly did actual full shift taking care of patients in the home. Be prepared to take care of a lot of peds cases this way though. CP was the big one that I would manage in kids. Those two main kids that I took care of will always have a piece of my heart. I think after caring for a child for so long and learning their ticks and loving them for it despite of how hard you try you become so much more than just there nurse. I was the mother and father to both of my patients. I learned really fast that the moms i delt with wanted to be called "mom" but didn't want to do any of the motherly duties. And even when I would offer to do something extra with one of patient. I wanted to take her swimming and go for walks both of which she absolutely loved. Her mother put a end to both and didn't really have a reason. The lil boy that I fell for also had CP and I found in that house that I also had become the nurse and caretaker to the whole family. That means the mentally handicapped uncle, the two grandmas that lived there, the yr. old baby, the eight yr. old and my pt. the parents would rather go out and never come home on time for me to go rather then take care of the family. Which is why I say that you have to have a strong sense of what role you play and stick to it!! Otherwise it'll start out by you being friendly and helping just this once to you doing it all........