Meet a Home Health Nurse
The percentage of people discharged from short-term acute care hospitals to home health nursing care rose dramatically from 11% in 2019 to 19% in 2020. This trend was noted during the COVID-19 pandemic and experts are unsure if it will continue.
However, home health nursing is more cost-effective for insurance companies and families, so the trend may continue to rise. This move also supports seniors who may be fearful of losing their independence and moving into a residential care facility.
Home health nursing is a nontraditional way to make a significant impact in the lives of others. On this page, a home health nurse talks about their experiences. We'll also share the duties of a home health nurse, how much they make, and how to become a home health nurse.
Q&A With Lizbeth Ramirez, a Home Health Nurse
My name is Lizeth Ramirez. I was born in Los Angeles, California. I am the daughter of Guatemalan immigrants Guillermo and Liliana Sabajan and sister to one brother.
Ever since I can remember, I have been drawn to medicine. As a child I remember seeing all the hustle and bustle of the hospital. I remember how much pride everyone took in their jobs and the respect they received for helping people and "fixing them." And so it began.
I decided I wanted to become a pediatrician. When I graduated [from high school], I went on to community college for the registered nurse (RN) program but had to put it on hold. I became pregnant and started my own family with my high school sweetheart. I did not want to give up on my dreams. With the support of my husband and family, I went to private school and graduated with my licensed vocational nurse license in 1996. I had the opportunity to work with children in an outpatient setting. My goal was to work at a children's hospital. I was finally given the opportunity in 2002.
Once my children were older, I went back to college and graduated as an RN in 2018. Unfortunately, I could not continue working at Children Health's of Orange County because it was too heartbreaking for me. I also knew I did not want to work in a hospital setting. I felt like it would be too stressful at my age with the long hours.
I am grateful for the opportunity that was entrusted to me as I started my home health nurse journey. I have learned so much in the last few years and feel truly blessed to be able to do what I enjoy the most.
Why did you choose a career in nursing?
I grew up around hospitals with my grandmother being sick and was always in awe of the work the nurses did and how they took care of everyone.
What led you to pursue home health nursing, specifically?
I had never heard about home health until it was brought up by a former coworker. I did not realize how perfect being a home health nurse would be for me, having the time to spend with a patient, not being rushed, and being able to help them by educating them to prevent rehospitalizations. I was amazed at how much we can offer them from the comfort of their home.
The ability to spend one-on-one time with patients and their families led me to home health nursing. [I have] the satisfaction that we have the ability to provide the patient and their families with the education and tools necessary to improve their overall health to prevent unnecessary rehospitalization.
Many times just being in the hospital alone can be overwhelming. When patients are home, they are in a more comfortable environment and we can continue care at a slower pace where they are more receptive to the information being provided.
How does home health nursing differ from nursing in the hospital setting?
I feel like the hospital setting can be a little stressful and overwhelming. The amount of patients a nurse is given to care for does not allow the time needed sometimes with patient/family members to educate them. It's unfortunate that home health nursing is not as prominent in the nursing field of career pathways.
How has home health nursing changed since the onset of COVID-19?
Unlike hospitals, these patients are not isolated in a special room with all the necessary equipment. We need to take extra precautions because when we visit, we are not only visiting the patient, but the whole family is in the home as well.
The weather can be a challenge for us as well when we have to don and doff our personal protective equipment from the trunk of our car. [In California] we have to deal with heat, the famous Santa Ana winds, and rain.
What are some of the biggest challenges of your work as a home health nurse?
I would say my biggest challenge in the beginning was not having another nurse I could ask for assistance or advice while out on the field. That really made me learn a lot in a short period of time.
Fortunately, I have had the privilege of working with a great team with good communication and assistance when needed. The other challenge is the tedious charting that is required as home health nurses.
And the greatest rewards?
The flexibility of the schedule. I am able to adjust my schedule so I can take my mom to her doctor's appointments. But most importantly, the patients. Many of them are so appreciative of our services that we provide. It amazes me how the education and tools we provide them, whether big or small, are so beneficial.
What advice would you give to those considering a career as a home health nurse?
Do it! We need more home health nurses. If you are passionate about being a nurse and making a difference, this is the way to go. You may have to drive around a lot, but the satisfaction of being able to make a difference in a family's life is worth it.
What Does a Home Health Nurse Do?
A home health nurse attends to a patient's needs in their home. This means they must be self-directed and capable of operating independently. Care often begins with an assessment of the home environment and recommendations for changes to reduce the risk of slip and falls or other dangers for the patient.
The home health nurse is the connection to the patient's physician, therapists, and other healthcare professionals. The nurse's responsibilities include consistent communication with the patient's care team to improve patient outcomes.
The home health nurse also communicates with the patient's family and provides the patient with encouragement and support during their recovery. These are some of the key skills and responsibilities of home health nurses.
- Assess the patient's home for safety issues and recommend changes to the patient and their family
- Consistent assessment of the patient's health needs and develop a plan of care with the patient's healthcare provider
- Pain assessment and pain management recommendations
- Monitor the patient's response to treatment, evaluate the response, and determine if another intervention is needed
- Oversee case management
- Administer medications, intravenous (IV) infusions, and assess the IV site
- Assist with activities of daily living, including grooming, toileting, bathing, and mobility
- Assess wounds, do wound care, and develop a wound care treatment plan
- Take vital signs, draw labs, and start IVs
- Document the physical, psychological, and emotional status of the patient
- Detect early symptoms that could lead to rehospitalization
- Instruct patients and families on proper home care
- Supervise nurse aides
"If you are passionate about being a nurse and making a difference, this is the way to go."
— Lizeth Ramirez, home health nurse
How to Become a Home Health RN
Home health nurses can be nurses with an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). To become a home health nurse, you must graduate from an accredited ADN or BSN program.
To get your RN license, you must pass the National Council Licensure Examination, which is required by all states for your license. The remaining requirements for your state license vary depending on the state.
Home health nursing is a relatively autonomous position. To be successful you must have at least 2-3 years of medical-surgical or critical care nursing. This gives you the opportunity to develop a strong foundation in patient care and confidence in your assessment and intervention skills.
There are no certifications specific to home health nursing. The American Nurses Credentialing Center once offered a home health nursing certification. Currently, they are only renewing the certification every five years.
Home health nurses can choose to earn a certification in a specialty to support their independent practice. This can include getting a certified pediatric nurse credential, wound care certification, an oncology certified nurse credential, or maternal newborn nursing certification.
How Much Do Home Health Nurses Make?
Home health nursing offers greater career flexibility and independence. Nurses can develop long-term relationships with their patients and have a greater impact on their lives over time. Many home health nurses find that their patients have a significant impact on their lives as well.
Most home health nurses work traditional business hours, starting near 8 a.m. and finishing close to 5 p.m.. The average annual salary for a home health nurse is $73,400 as per ZipRecruiter data in June 2022. This is the average salary, which means there is some flexibility in how much you can negotiate for your salary.
There are several factors that can increase your value to a home health agency. Generally, BSN-prepared nurses are paid more than ADN nurses. Nurses with more experience in the hospital or home care can command a higher salary.
Although there is no home health nursing certification, adding optional certifications demonstrates your commitment to quality healthcare and can improve patient outcomes. It also enhances your professional opportunities and can increase your compensation.
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