Home health care nursing information and overview
Home health care allows the patient and their family to maintain their dignity and independence. According to the National Home Care Association, more than 7 million individuals in the United States need home health care nursing services because of acute illness, long-term health problems, permanent disability, or terminal illness.
Essentials of home health care
Nurses work in a number of settings: hospital settings, nursing homes, assisted living centers, and home health care. Home health care nursing is a growing phenomenon as more patients and their families want to receive care in their own home. The history of home health care stems from public health nursing whereby public health nurses made home visits to promote health education and provide treatment as part of community outreach programs. Today’s academic programs train nurses in home care and agencies place home health care nurses with sick individuals and their families depending on the nurse’s experience and qualifications. In many cases, there is a common relationship between the agency and the academic institution.
Many changes have occurred in the field of home health care. These include Medicare, Medicaid, and Long Term Care Insurance and policies. It is important for the nurse and nursing agency to be aware of the many factors involved in these rules and regulations generated by these organizations. Population and demographic changes are also occurring. Baby boomers are approaching retirement and will present new challenges to the home health care industry. Technology and medical care in hospitals has led to shorter inpatient stays and more rehabilitation at home. Medical outpatient procedures are also being increased with follow-up home care. This has resulted in lower mortality from these technologies and Medicare has led to higher rates of morbidity and chronic illnesses that make the need for home health care nursing a greater priority.
Home health care nurse job description
With a range of skills and experience, home health care nurses specialize in a wide range of treatments; Emotional support, education of patients recovering from illnesses and injuries to young children and adults, to women who have undergone recent childbirth, to the elderly who require palliative care for chronic diseases.
An experienced nurse must have the skills to provide care in a setting as unique as someone’s home. The nurse works with the patient and family and must understand communication skills for these dynamics. Compatibility is evident in all nursing jobs, but working in a patient’s living space requires a different level of skill and understanding. There is an independent decision-making process where the nurse no longer works as a team with other nurses in a structured environment, but now as a member of a ‘family’ team. The host family has important and different cultural values for each patient and must be dealt with very sensitively. Other skills include critical thinking, coordination, evaluation, communication, and documentation.
Home health care nurses also specialize in caring for children with disabilities that require additional skills such as patience and understanding the family’s needs. Children today suffer from disabilities that would have been fatal just twenty years ago. Genetic disorders, congenital physical defects, and injuries are just a few. Many families are familiar with managing a child’s needs, but still need the specialized care that only a home health care nurse can provide. It is important for the home health care nurse to be familiar with the family’s experience about the child’s condition for the appropriate care of the child. There are many complexities involved, but most importantly, a positive attitude and positive reinforcement are of utmost importance to a child’s development.
Medication coordination between the home health care nurse, doctor and pharmacist ensures proper management of the exact science behind giving the patient the correct dose, time of administration and combinations. Home health care nurses must be knowledgeable about pharmacology and have been educated in training on the different medications used by patients in the clinical setting.
Many advanced nurse practitioners are familiar with regimens of medications. They have completed graduate programs. Home health care agencies believe that a nurse should have at least one year of clinical experience before entering home health care. Advanced nurse practitioners can accelerate this training by helping new nurses understand the home health care and education market.
Employment and salary
According to the US Department of Labor, there were 2.4 million nurses in America, the largest healthcare profession, yet many academic institutions and hospitals believe that there is a significant shortage of nursing staff. The nurse shortage was 6% in 2000 and is expected to reach 10% in 2010. The average salary for hospital nursing is $53,450 with 3 out of 5 nursing jobs being in a hospital. For Home Health Care, the salary is $49,000. For nursing care facilities, it was the lowest at $48,200.
Training and continuing education
Most home health care nurses acquire their education through accredited nursing schools across the country with an Associate of Nursing (ADN), Bachelor of Science in Nursing (BSN), or Master of Nursing (MSN) degree. According to the US Department of Labor, in 2004 there were 674 BSN nursing programs and 846 ADN programs. Also, in 2004, there were 417 master’s degree programs, 93 doctoral programs, and 46 joint BSN doctoral programs. An associate degree program takes 2 to 3 years to complete, while a bachelor’s degree takes 4 years to complete. Nurses can also earn specialized professional certifications online in hospice care or life care planning.
In addition, for those nurses who choose to pursue advancement in management or research, consulting, and teaching positions, a bachelor’s degree is often necessary. A bachelor’s degree is also important for becoming a clinical nurse specialist, nurse anesthetist, nurse midwife, and nurse practitioner (US Department of Labor, 2004).
All home health care nurses have supervised clinical experience during their training, but as previously mentioned, advanced nurse practitioners have a master’s degree and, unlike bachelor’s and associate degrees, have a minimum of two years of clinical experience. Course work includes anatomy, physiology, chemistry, microbiology, nutrition, psychology, behavioral sciences, and the liberal arts. Many of these programs have training in nursing homes, public health departments, home health agencies, and mobile clinics. (US Department of Labor, 2004).
Whether the nurse is training in a hospital, nursing facility, or home care, continuing education is essential. Healthcare is changing rapidly, and keeping up with the latest advances enhances patient care and health procedures. Universities, continuing education programs, and websites offer continuing education. One such organization that provides continuing education is the American Nurses Association (ANA) or through the American Nurses Credentialing Center (ANCC).
Conclusion
There are many rewards for becoming a home health care nurse. Some of the rewards include a relationship with the patient and their family, independence and autonomy, and engaging in critical thinking. The twenty-first century brings with it many opportunities and challenges. We must meet these challenges head on – there is an aging baby boomer population, an increasing morbidity factor due to increased medical technology and patient care, and a growing shortage of nursing care.
Becoming a Home Healthcare Nurse today is exciting and an opportunity to make a difference in one life after another. With the appropriate clinical experience and education, the home health care nurse will lead the future of medical care.