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How to Become a Home Health Care Nurse
Home Health Care Nursing Information and Overview
Home health care allows the patient and their family to maintain dignity and independence. According to the National Home Care Association, there are more than 7 million individuals in the United States who require home care nursing services due to acute illnesses, long-term health problems, permanent disability or terminal illness.
Basics of Home Health Care
Nurses practice in many places: 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 desire to receive care in their own homes. The history of home health care stems from Public Health Nursing where public health nurses visited homes to promote health education and provide treatment as part of community outreach programs. Today academic programs train nurses in home care and agencies place health care nurses at home with sick individuals and their families according to the experience and qualifications of the nurse. In many cases, there is a joint relationship between the agency and the academic institution.
Many changes have occurred in the area of home health care. These include Medicare and Medicaid, and Long Term Care insurance reimbursement and documentation. It is important for nurses and nursing agencies to be aware of the many factors involved for these rules and regulations resulting from these organizations. Population and demographic changes are also taking place. Baby boomers are approaching retirement and presenting new challenges for the home health care industry. Technology and medical care in hospitals has led to shorter inpatient stays and more rehabilitation at home. The increase in outpatient medical procedures also occurred with follow-up home care. This has resulted in the decrease in the mortality rate from these technologies and medical care has led to the increase in morbidity and chronic diseases that make the need for home health care nurses a priority bigger.
Home health care nurse job description
Through a variety 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 for children and adults, to women who have experienced a recent childbirth, to the elderly who need palliative care for chronic illness.
A nurse practitioner must have the skills to provide care in a unique setting such as someone’s home. The nurse works with the patient and family and must understand the communication skills for such dynamics. Rapport is evident in all nursing positions, but work in the patient’s life space requires a different level of competence and intelligence. There is an autonomous decision that the nurse is no longer working as a team with other nurses in a structured environment, but is now as a member of the “family” team. The host family has cultural values that are important and different for each patient and must be treated with extreme sensitivity. 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 of family needs. Children today live with disabilities that would have resulted in mortality just twenty years ago. Genetic disorders, congenital physical disorders and injuries are just a few. Many families are familiar with managing a child’s needs, but they still need expert care that only a home care nurse can provide. It is important that a home care nurse is aware of the family’s expertise on the child’s condition for the correct care of the child. There are many complexities involved, but most importantly, a positive attitude and positive reinforcement is of the greatest importance for the child’s development.
Medication coordination between the home health care nurse, the doctor and the pharmacist, ensures proper management of the exact science that gives the patient the correct dose, time of administration and combinations. Home health care nurses must be familiar with pharmacology and trained in the various medications used by patients in the clinical setting.
Many advanced practice nurses are familiar with medication regimens. They have completed graduate level 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 that training by helping new nurses understand the home health care market and teaching.
Employment and Salary
According to the United States Department of Labor, there were 2.4 million nurses in America, the largest occupation of health care, but many academic and hospital organizations believe that there is a large shortage of nursing staff. The nursing shortage was 6% in 2000 and is expected to be 10% in 2010. The average salary for a hospital nurse is $53,450 with 3 out of 5 nursing jobs being in the hospital. For home health care, the salary is $49,000. For nursing care facilities, they were the lowest at $48,200.
Training and continuing education
Most home health care nurses earn their education through accredited nursing schools across the country with an associate degree in nursing (ADN), a Bachelor of Science in Nursing (BSN) degree, or a master’s degree in nursing (MSN). According to the US Department of Labor, in 2004 there were 674 BSN nursing programs, 846 ADN programs. In addition, in 2004, there were 417 master’s programs, 93 doctoral programs, and 46 joint BSN-doctoral programs. The associate degree program takes 2 to 3 years to complete, while bachelor’s degrees take 4 years to complete. Nurses can also earn specialized professional certificates online in Geriatric Care or Life Care Planning.
In addition, for those nurses who choose to pursue advancement in administrative positions or research, consulting and teaching, a bachelor’s degree is often essential. A bachelor’s degree is also important to become 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 stated earlier, advanced practice nurses have a master’s degree and, unlike bachelor’s and associate’s degrees , have a minimum of two years of post-clinical experience. Course work includes anatomy, physiology, chemistry, microbiology, nutrition, psychology, behavioral sciences, and liberal arts. Many of these programs have training in nursing homes, public health departments, home health agencies, and outpatient clinics. (US Dep. of Labor, 2004).
Whether a nurse is training in a hospital, nursing facility, or home care, continuing education is necessary. Healthcare is changing rapidly and staying abreast of the latest developments enhances patient care and healthcare procedures. Universities, continuing education programs, and websites all offer continuing education. One such organization that provides continuing education is the American Nurses Association (ANA) or through the American Nurses Credentialing Center (ANCC).
There are many rewards to becoming a home health care nurse. Some rewards include relationship with a patient and their family, autonomy, independence and engagement in critical thinking. The 21st century brings with it many opportunities and challenges. We have to meet these challenges head-on – there is an aging baby boomer population, a growing morbidity factor due to the increase in medical technology and patient care, and the growing shortage of nursing care.
Becoming a home health care nurse today is exciting and an opportunity to make a difference one life at a time. With the clinical experience and proper education, a home health care nurse will lead the future of medical care.
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