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10 Tips for Home Health Nursing

Home Health Article   (100,810 Views 40 Comments 732 Words)
by homehealth20 homehealth20 (New Member) New Member

1 Article; 3,444 Visitors; 5 Posts

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As a Registered Nurse, this year marks my 20th year in home health nursing. It has been a wonderful ride and I have met some interesting patients and co-workers along the way. I have worked in the field and in the office. I have done private duty and Medicare intermittent visits. I have cared for patients in mansions on the ocean, and intercity homes with holes in the floors and roaches so big that they almost carried my nursing bag off. I have collected my own and fellow nurses' stories and str

10 Tips for Home Health Nursing

The following are some tips I have learned from experience and my peers:

1. Have a good sense of humor.

You have to learn to laugh at yourself. This is a good practice for most aspects of your life. But if you take yourself too seriously, no career will be enjoyable.

2. Be open minded.

Toto, we are not in the hospital anymore. In the patient's home, you are no longer in a controlled environment like a hospital or doctor office. You still have to follow your agency's policies, safety rules and perform procedures correctly, but if the patient requests you enter their home and take your shoes off because of religious reasons, you do. The beautiful woman that presents as your patient, turns out to be a man. (You learn this without warning when they drop their drawers for the dressing change you came to perform. The scheduler thought it would be funny if you were surprised.) Diversity is one of the wonderful aspects of home care, you learn how other people really live. Learn to appreciate different cultures.

3. Learn to modify.

You have to hang an IV. It's after hours and the pharmacy forgot to send the IV pole. The hanger over the door may work, or the broom handle strapped on the upright vacuum suddenly creates a wheeled IV pole. But always make sure that your modifications are safe and appropriate, otherwise, it will come back to bite you in the ....

4. Be flexible.

The day you planned will change, guaranteed. There is an accident on the freeway, now you are late. The patient has a doctor's appointment they forgot to tell you about and now they aren't home. Someone called in sick so now you have 5 extra visits. If you can't be flexible, home care may not be your bag.

5. Be prepared.

Sure enough, the dog ate the patient's box of dressings, or the patient has a bed sore that did not show up on the hospital discharge information. Your car trunk should look like a supply closet.

6. Be organized.

For those home health nurses that drive a car between patient visits, your car is your office. It should contain supplies, paperwork, computer and cell phone battery chargers, pens, marketing flyers, etc., etc., etc. Learn to plot your visit route. With the cost of gas nowadays, you don't want to have to drive needless miles.

7. Have basic computer skills.

If you don't have them, learn them. Many home health agencies have already gone to field staff carrying laptop computers into the patient's homes. It is the way of the future.

8. Be alert and be safe.

You may be presented with many new dangers that you won't see in the hospital. Take a self-defense class. Learn what areas are the "unsafe neighborhoods" in your territory. Visit those places early in the morning. Always be alert to your surroundings. Don't talk on your cell phone while driving. Follow safety rules.

9. Don't be afraid of paperwork.

If you work for a home health agency that performs Medicare visits, YIKES, what paperwork (thanks in part to the Medicare Paperwork Reduction Act?)!! An OASIS is not a desert paradise. Those agencies that have laptops for their field staff have part of this licked. However, the questions still need to be asked and documented. Practice does help speed up the documentation process.

10. Keep your skills up.

Take continuing education classes online. Attend seminars. Read articles. Knowledge is power. You are very autonomous in the patient's home and good skills and quick thinking are mandatory to survive.

In closing, home health is a wonderful way to care for patients. You are able to interact with the family and really do one-to-one education. Whether it be with a Medicare agency, Hospice, private duty or other home care venue, it is an enjoyable and full-filling division of nursing. Remember, many home health nurses believe:

A bad day in home health is better than a good day in the hospital.

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RN Home Health with over 20 years of experience

1 Article; 3,444 Visitors; 5 Posts

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imanedrn has 7 years experience and works as a Registered Nurse.

7,858 Visitors; 547 Posts

Thanks for the tips! A lot of this seems like common sense, but it always helps to have a veteran bring it all to light.

In a few weeks, I will be starting a part time home health job. The company is small and doesn't need a lot right now, so the DON was willing to take me on part time -- and as a new grad! She said she'd like to pair me with a great mentor, so they can "mold" me for their needs. Then she said, "Who knows? Maybe you'll come on full time in the future..." That was a hopeful prospect!

I got into nursing because I love caring for people. While I enjoy working in acute care, I find there are so many limits to the "care" I WANT to provide. Home health seems like a better fit for me, so I can't wait to step into those shoes and give it a run!

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1 Article; 3,444 Visitors; 5 Posts

Glad to hear they are pairing you with a mentor, especially since you are a new grad. Sounds like you will fit nicely into home health. I always liked home health because you get the opportunity to teach much more than you do in the hospital as patients are so acutely ill at that point. Enjoy and good luck!

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imanedrn has 7 years experience and works as a Registered Nurse.

7,858 Visitors; 547 Posts

The teaching is the part I actually look forward to most. I LOVE one-on-one teaching. That's the part that breaks my heart in the hospital setting, actually. I feel like my patients would be so much better off if I could just sit them for an extra hour (even a half hour!) and explain their illness in detail, why certain meds are prescribed, what THEY can do, etc. I really look forward to being there for people AFTER the acute incident. I know they all won't abide by my teaching, but I like knowing that at least I've tried. That's why I wanted to be a nurse so bad in the first place!

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1,226 Visitors; 4 Posts

I enjoyed reading your article . I am an ER nurse 28yrs and have been looking for a drastic change in my career. I have been thinking seriously of home health care. I enjoy being flexible . So all the tips are great . keep them coming. I respent the veterans

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1 Article; 3,444 Visitors; 5 Posts

Good luck. The flexiblity is a huge draw, especially for parents that have to see their kids in a play or pick them up from school. You should have no problem finding the agency that's right for you, especially if you live in a large urban area. Can you tell, I love home care? Hope you will too.

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1,226 Visitors; 4 Posts

Thank you for the response . I do love teaching patients and family . I will keep you updated on my home care experience. Once I get out there and apply to agencies.I plan on starting per diem to get a feel. Can I use you as a resouce for your knowledge in home health care

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1,080 Visitors; 3 Posts

Thank you, thank you, thank you,

I am new to home health nursing and your tips are very helpful.

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mimi81 has 1 years experience.

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Thanks for the tips, I am into my 3rd week of home health and loving it so far.

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2,207 Visitors; 60 Posts

loved it. i've been doing home health for two years and you confirm a lot of what i've found. especially the part about keeping flexible.

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1,091 Visitors; 4 Posts

I agree, I have never worked in a hospital setting but did HH for about 8 years, including hospice and private duty. It is very rewarding and I loved it. Got out because of having to go to the bad side of town at dusk repeatedly and had no other way to go any other time. Had the males in the house making inappropriate sexual remarks and decided it wasn't safe anymore, plus lots of drive by shootings at the time back in the 1990's in that area, still loved that one on one pt contact though and would love to go back. :up:

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all_dressed_in_white works as a New Graduate RN.

1,550 Visitors; 31 Posts

Thanks for this posting. Its so inspiring to hear nurses talk about loving their job, and the fact that they (you) are so good at what you do just comes shining through.

I'm still at uni doing my BN, but I'm working with DADCH HomeCare while I'm studying. I am constantly honored by the priveledges of caring for people in their own homes, by the smiles on their faces when I arrive and by the information they so willingly share. Of course, every job has its challenges, and sometimes one hour in one persons home can feel like an entire night shift in an aged care facility, but still, they are the people who i will want to tell first when i do graduate. As hard as it is at the moment, i know the tough love is preparing me for the years ahead as an RN.

Its the first job I've ever had where I have total trust in my workmates, and learn more from them everyday. I believe it takes a special kind of person to stick at home health for so long. You seem to have learnt all the secrets.

Thankyou so much for sharing them.

I'll be sure to revisit this post after many a difficult day.

Love your work!!!

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