“Make a right turn at the cow, follow the dirt road until you see three trees, and make a sharp left into our driveway,” says the family member of your next scheduled patient. Oh, and its foggy out. Like near zero visibility foggy and you have to remove staples from hip surgery and your patient’s family thinks it’s infected, so you can’t reschedule. Yes, these are the adventures in home health care!
Adventures in Home Health Nursing
Let’s face it, you’re out on the open road going from patient to patient in any conditions out there. But the rewards are plenty. Home health care jobs are usually Monday through Friday during daytime hours and some weekends on-call. You won’t be trudging through 12 hour shifts half asleep in the hospital and you’re home for dinner every night.
The benefits to your patient are; they get to recover in the comfort of their own home, they can have physical therapy at home, and include members of their family in their care. Care at home can be for days, weeks, or even months until they are discharged from your care. Here are a few things home health nurses do:
Blood Draws – Since your patient is no longer in the hospital, you get to go out and draw blood and take it to the hospital lab. If this hasn’t been your strong point, you will definitely get lots of practice in home health!
Staple and Suture Removal – After surgery, some surgeons will remove staples and sutures in the hospital. Most will not and you get to do that on a nurses visit to the home. Good reason to pack plenty of removal kits in your medical bag!
Teaching for New Diabetics – You will find in home health care that new diabetics are often sent home with an arsenal of things they need to do, but have no idea what to do with them. Remember back to the hospital how much time your given to do a discharge on a patient, while doing an admit, answering a doctor’s phone call, and giving a pain med. Your usually only able to do some quick basics with new diabetics in the hospital, so plan on doing a few weeks of teaching with your patient as a home health nurse.
Caring for Wounds – Get really good at wound vacs and up-to-date on the latest wound care techniques while you can. In the field you are pretty much on your own and need to know what to ask your doctor when a wound is not healing up properly. Be prepared to see some pretty scary wounds, but some nurses really enjoy a good challenge!
Monitor Vital Signs – At each visit you will check vital signs and report any changes to the doctor. After any medications are added in the hospital, they may need adjustments after discharge.
IV Therapy – Many doctors are opting for home IV therapy for antibiotics and fluids people need. Most patients are trained to hook up their own medications, but you will need to provide care to the site and teaching. If you are concerned about IV therapy, see our IV therapy tips and tricks.
Teaching and Support – One of the most rewarding parts is getting to know your patient and their family. Plan on doing lots of teaching, answering questions, and being there for emotional support.
This is only a tidbit of the many experiences you can have as a home health nurse that will warm your heart, challenge your mind, but it can have its ups and downs!
Some Challenges of Working on the Road
Once you get out on the road and start your busy day, your diet and mind may spin out of control. Here are some helpful tips to keep you healthy and in a good place:
- Pack your lunch and healthy snacks. Commit to only eating out for lunch once a week. All other days keep a packed lunch and healthy snacks in the car. Many home health nurses invest in a good ice chest or refrigerator for their car.
- Have a good playlist. Load your I-Pod/Smartphone with songs that are good for driving. If you are stressed and seeing a good number of patients, keep it relaxing so you can unwind in between stops. Some of the satellite radio providers have great programs during the day so you can switch between music and talk shows.
- Keep your car working. This is a huge priority! Breaking down and not making it to your next patient could be detrimental. Have a spare tire and know how to change it. Get a roadside service account and if you can, have a spare car you can use just in case.
- Check your company policy regarding mileage. Some home health companies pay a flat rate per patient seen, which includes your mileage and some pay an hourly rate and mileage on the side. The flat rate can be an attractive amount, but when you do the math after paying for gas it can average out to about the same as a fast food employee. No joke. Factor in your hours for scheduling your patients before you leave your house, driving time, mileage, the time you spent with your patient, and end of day duties like calling doctors. You may find a company that pays hourly plus mileage is a better way to go.
- Have a good supply box in your car. You never know what will come up on a patient while you’re on your way to their house. You may get a call to draw blood while you’re there, only to go in your car box and find you have no tubes or vacutainers. The doctor may surprise you with a new wound care order and you don’t have the right gauze or dressings.
There are definitely plenty of adventures in home health care; from stormy days to flat tires, missing supplies, and lots of driving. All of it seems to pull together when you see your patients happy and well-cared for, plus more time with your family!