How to Become a Home Health Care Nurse
Home Health Care Nursing Information and Overview
Home health care is allowing the patient and their family to
maintain dignity and independence. According to the National
Association for Home Care, there are more than 7 million
individuals in the United States in need of home health care
nurse services because of acute illness, long term health
problems, permanent disability or terminal illness.
Home Health Care Basics
Nurses practice in a number of venues: 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
homes. The history of home health care stems from Public Health
Nursing where public health nurses made home visits to promote
health education and provide treatment as part of community
outreach programs. Today academic programs train nurses in home
care and agencies place home health care nurses with ailing
individuals and their families depending on the nurse's
experience and qualifications. In many cases there is a shared
relationship between the agency and the academic institution.
Many changes have taken place in the area of home health care.
These include Medicare and Medicaid, and Long Term Care
insurance reimbursement and documentation. It is important for
the nurse and nursing agency to be aware of the many factors
involved for these rules and regulations resulting from these
organizations. Population and demographic changes are taking
place as well. Baby boomers approaching retirement and will
present new challenges for the home health care industry.
Technology and medical care in hospitals has lead to shorter
inpatient stay and more at-home rehabilitation. Increases in
medical outpatient procedures are also taking place with
follow-up home care. This has resulted in the decrease of
mortality rate from these technologies and medical care has lead
to increases in morbidity and chronic illness that makes the
need for home health care nursing a greater priority.
Home Health Care Nurse Job Description
Through an array of skills and experience, home health care
nurses specialize in a wide range of treatments; emotional
support, education of patients who are recovering from illnesses
and injury for young children and adults, to women who have
experienced recent childbirth, to the elderly who need
palliative care for chronic illness.
A practicing nurse must have the skills to provide care in a
unique setting such as someone's home. The nurse is working with
the patient and the family and must understand the communication
skills for such dynamics. Rapport is evident in all nursing
positions, but working in a patient's own living space needs a
different level of skill and understanding. There is autonomous
decision making as 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 are different for every patient and must be
treated with extreme sensitivity. Other skills include critical
thinking, coordination, assessment, communication, and
documentation.
Home health care nurses also specialize in the care of children
with disabilities that requires additional skills such as
patience and understanding of the needs of the family. Children
are living with disabilities today that would have resulted in
mortality just twenty years ago. Genetic disorders, congenital
physical impairments, and injury are just a few. Many families
are familiar with managing the needs of the child, but still
need expert care that only a home health care nurse can provide.
It is important that a home health care nurse is aware of the
expertise of the family about the child's condition for proper
care of the child. There are many complexities involved, but
most important, a positive attitude and positive reinforcement
is of utmost importance for the development of the child.
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 should
be familiar with pharmacology and taught in training about
different medications used by patients in the clinical setting.
Many advanced practicing nurses are familiar with medication
regiments. 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 practicing nurses can expedite 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 healthcare
occupation, yet many academic and hospital organizations believe
there is a gross shortage in nursing staff. 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. For nursing care facilities, they were the
lowest at $48,200.
Training and continuing education
Most home health care nurses gain their education through
accredited nursing schools throughout the country with an
associate degree in nursing (ADN), a Bachelor of Science degree
in nursing (BSN), or a master's degree in nursing (MSN).
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. The associate
degree program takes 2 to 3 years to complete, while bachelors
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
into administrative positions or research, consulting, and
teaching, a bachelor's degree is often essential. A bachelor's
degree is also important for becoming a clinical nurse
specialist, nurse anesthetists, nurse midwives, and nurse
practitioners (U.S. Department of Labor, 2004).
All home health care nurses have supervised clinical experience
during their training, but as stated earlier advanced practicing
nurses hold master's degrees and unlike bachelor and associate
degrees, they have a minimum of two years of post clinical
experience. Course work includes anatomy, physiology, chemistry,
microbiology, nutrition, psychology, and behavioral sciences and
liberal arts. Many of these programs have training in nursing
homes, public health departments, home health agencies, and
ambulatory clinics. (U.S. Dep. of Labor, 2004).
Whether a nurse is training in a hospital, nursing facility, or
home care, continuing education is necessary. Health care is
changing rapidly and staying abreast with the latest
developments enhances patient care and health procedures.
Universities, continuing education programs, and internet sites,
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).
Conclusion
There are many rewards to becoming a home health care nurse.
Some rewards include the relationship with a patient and their
family, autonomy, independence, and engaging in critical
thinking. The 21st Century brings with it many opportunities and
challenges. We must meet these challenges head on - there is an
aging baby boomer population, a growing morbidity factor due to
increased medical technology and patient care, and the growing
shortage in nursing care.
Becoming a home health care nurse today is exciting and an
opportunity to make a difference one life at a time. With
clinical experience and proper education, a home health care
nurse will lead the future of medical care.
Find more information about becoming a Home Health Care Nurse
including certification and job openings at My Nursing Degree
Online.