Home health nursing: practices and patient care

¶ … career of Home Health Nursing. With the baby boomer generation aging quickly, there will be an increased need for in home health care and home health nurses. This is a career with a future, since many aging and disabled patients want to remain in their own homes, rather than a nursing or retirement home, for as long as possible.

Home health nurses perform nursing functions inside the patient's home. They can be all the functions of a traditional nurse in a healthcare facility; they are simply performed on site, instead of in the hospital. One real element of the home health nurse is interacting with a variety of patients. They often see several patients each day, and they have to get from one patient's house quickly and effectively, so they need to be organized, efficient, and still compassionate and understanding with each patient. A Web site notes, "Rapport is evident in all nursing positions, but working in a patient's own living space needs a different level of skill and understanding" ("How to become," 2009). These nurses must interact with the family as well as the patient, so communication and empathy are key components of the job.

Specific duties include routine administration of injections, prescriptions, and other prescribed medications. They often help patients with health concerns, help them fill and renew subscriptions, and may even help them with basic issues like balancing a checkbook or getting meals delivered. There is also much paperwork, charting, and information involved, this can take several hours up in an eight-hour day. Nurses also discharge and admit new home health patients, evaluate and report their conditions, help with physical therapy and other issues, and listen to patients' health concerns ("Typical day," 2009). Not all of the patients are elderly, there are many other patients, such as quadriplegics, mentally challenged, those recovering from injuries or surgeries, and many others, to the issues and patients are as varied as they would be in a hospital setting. Two experienced nurses write, "During the last two decades, home health nursing practice has expanded beyond the traditional style of home care to include age-related groups (such as the elderly) and more acutely ill patients." (Korniewicz & El-Masri, 2004, p. 151). Home health nurses need to be ready for any and all healthcare situations, just as they would be in any other healthcare facility.

Education and certification is the same as it would be for any other nursing position. The length of time depends on the certification and type of degree the home health nurse chooses. Simple certification courses from community colleges can take only a few weeks or semesters. An AA degree traditionally takes two years, while a BS takes about four years. A master's program could take six years, and a doctoral program could take eight years. Traditionally, nurses have to update their certificates with continuing education periodically, so that time should also be considered in the overall time spent in education. There is also actual time spent training in health care facilities. Another nursing student notes, "We also work in clinics for our home health nursing and community nursing courses at a shelter for homeless people who are too sick to go out, but not sick enough to be in a hospital" (Sacks, 2003, p. 83). The cost of the education depends on the institution and the degree sought. Certifications might cost less than $1,000, while an eight-year education at a leading university could cost upwards of $100,000 to $200,000 or more.

There are over 30 online institutions offering nursing programs, with literally hundreds of schools across the country offering various nursing programs. Programs can start with a certification or AA degree in nursing from a local community college, all the way to master's degrees that make an RN with a bachelor's degree a MSN. There are also several certification programs in nursing specialties, such as Midwifery and Surgery. Nurses can earn a doctoral degree, as well. A Web site notes, "According to the United States Department of Labor, in 2004 there were 674 BSN nursing programs, 846 ADN programs. Also, in 2004, there were 417 master's degree programs, 93 doctoral programs, and 46 joint BSN-doctoral programs" ("How to become," 2009). Home health nurses would have to be certified, just like any other professional nurse, and they could take specialized courses preparing them for the home health field. There is even a program available for Clinical Specialization (CS) in home health nursing; the candidate must have 1,000 hours of service in home health care, and have a master's degree or higher in nursing (Sacks, 2003, p. 151). There is also a university that specializes in home health nursing, called the Homecare University, a division of the National Association for Home Care & Hospice.

Usually, home health care agencies want a nurse who has experience. A salary Web site notes, "Home health care agencies believe that a nurse should have at least one year of clinical experience before entering home health care. Advanced practicing nurses can expedite that training by helping new nurses understand the home health care market and teaching" ("How to become," 2009). New home health care nurses often shadow nurses for several days or weeks before they take on cases of their own.

Salaries, just as the duties and education, vary with the amount of education, the years of experience, and the number of patients seen. Some home health nurses are paid per diem, while others are paid by the hour. There is a national shortage of nurses, so the job outlook is good. Many of the openings are in large and small cities across America, but there is also a shortage of nurses in rural areas, as well. The Editors of the salary Web site continue, "The shortage of nurses was 6% in 2000 and is expected to be 10% in 2010. The average salary for hospital nursing is $53,450 with 3 out of 5 nursing jobs are in the hospital. For home health care, the salary is $49,000" How to become," 2009). Nurses are also reimbursed a set fee for mileage they accumulate on their private vehicles. Since I have no idea what city the Sunday Herald is located, you will have to supply this information.