Nursing student interested in home health

[kcdavin]

I am currently enrolled in an RN program and i have been interested in home health. The problem is that i have heard many different things about how you are employed as one. People have said that you are kind of employed through a company but self contracted in a way. But then others say that its the same as a hospital as in you are assigned these patients and you care for them and are not actually independent. Sorry if this seems stupid i am still naive about nursing specialties.

[paradiseboundRN]

I think its great that your interested in home health. I have been in Medicare Certified home health for 11 years and in my experience I have always been an employee. Medicare Certified is when you make short visits at patient's home a few times a week. Unless you work for a staffing agency, you are an employee of the home care agency and either get paid by the visit or by the hour, full time, part time or contingent. You are not a private contractor. If you work for a staffing company, you are their employee. Basically, you get assigned to a number of patients and see them about 2 times a week for 2-4 weeks to teach them about their medications, disease and provide skills like wound care, Foley changes etc. Sometimes you see them longer and more often when they require a lot of nursing. You are independent in that you can see them any day/anytime that you agree on following medicare regulations. Medicare regulations are very complex and are a big part of the job. Home Health care is its own specialty for this reason. A lot of nurses like this work because you have flexibility and independence. However, you have to have good assessment and clinical skills because its just you in the home. If this is something that interests you I recommend that when you graduate, you get a job on a medical floor in the hospital for at least a year, preferably more. Then you can explore this specialty. Home Care is growing rapidly and will continue to do so. At least in Michigan, there are many openings for nurses and this isn't going to change. Good luck!

[nursejay04]

I think it's great that you are interested in home health. I also work as an RN for a CHHA (Certified Home Health Agency). I have been there for 2.5 years and I am currently pursuing my master's degree. I would echo the advice to get a job on a medical floor and be there for a minimum of 1 year. That is our agency's minimum experience per policy, but you really have to have solid assessment skills, a solid understanding of the meaning of all of the numbers and symptoms that you will see on a daily basis, and confidence in yourself.

As an example on the "numbers" point, I oriented a mature individual that had just barely reached his one year of experience before going in to home care. He was very nervous in home care if people had an SBP >130, morning blood sugar of >120. He wanted to call the doctors for every little sniffle because in the hospital you have the control to do things like that. However, with thousands upon thousands more people receiving home care than being in the hospital, an agency would soon find themselves out of business if they called doctors for minute variances like that. You really have to have the "real-life" nursing experience to know what a BP of 140/90 means. Sure, they should get better control, but is it urgent for today?

Just my thoughts. Good luck with school and the boards. Stay positive and don't let stress and negativity get you down. You can do this!