Beyond the hospital: what it’s like working as a home health nurse

Stories - Home HealthOver a cup of coffee, I asked my friend, “What does a home health nurse do?”

I had just retired from the Army and she was starting a home health agency. She needed nurses and made it sound so easy. I said I would be glad to help but I only want to work part-time, a couple of days a week.

We agreed, I filled out the paperwork and was set to get the ball rolling on a Monday.

On my first day, I gathered all of my nurse gear and a lab coat and went to work only to be swept up into a whirlwind of activity.

The agency was very busy.

I ended up working six days that week and, just like that, had found a new profession I enjoyed very much.

Step inside as a home health nurse.

When patients are discharged from the hospital, they arrive home with a lot of paperwork, bottles of pills and instructions. They may have heard what the doctors and nurses in the hospital said but for a variety of reasons, it does not always translate when they get back home to a familiar environment. Someone needs to follow up.

1. On the first visit, within a day or two of hospital discharge, the home health nurse goes to the patient’s home, does a physical assessment, checks the patient’s understanding of medications and treatments and his or her disease process, and does any teaching necessary.

2. The nurse then assesses for mobility and physical environment problems such as throw rugs a patient could trip on or any obstacles that should be cleared.

3. A care plan is created to address any issues needed on the next visits. If there are mobility problems, a physical therapist will be needed.

4. Admission paperwork takes a couple of hours to do unless it is computerized.

5. On each subsequent visit, an assessment is done and progress is checked especially with the medication regimen.

6. Most patients are compliant and can be discharged after a few visits.

Over time, you learn there are a few key things to watch for.

  • Older people tend to have vision, hearing, and memory problems. Sometimes they will not tell you if they can’t see the pill bottle label or did not hear what you said.
  • Some patients have to be watched more closely like a forgetful person with diabetes or a person with a questionable caregiver.
  • Caregiver problems may require a social work referral.

Home health is a challenging and rewarding field especially now that patients are discharged after only a few days in the hospital with a need for a higher level of care at home. I have been welcomed by many frantic spouses who were trying to figure out “what the doctor wrote” or “which medication bottle was which.” Care doesn’t always stop with a hospital discharge and for that, I am glad to be a home health nurse.

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