Home Healthcare Nurse Careers and Salary Outlook

Americans enjoy longer lives than prior generations, with more than 46 million adults over the age of 65 in the country who may need help managing their healthcare. A report from the Home Care Association of America reports that 9 out of 10 seniors prefer to stay in their homes as long as possible. Home healthcare nurses make this possible for millions of patients. Our guide explains the important duties of a home healthcare nurse, the education and training required, and salary and career growth expectations.

What is a Home Healthcare Nurse?

Home healthcare nurses are registered nurses (RNs) who provide care in a patient's home. They may assist someone following an injury or hospitalization, ensuring the patient's recovery progress while keeping an eye out for complications. They may also offer specialized services in pain management or hospice care. These nurses typically provide care for each patient, carrying out physicians' orders and documenting the patient's condition. They may direct other members of the care team, such as nursing assistants or non-medical home care providers.

What Do Home Healthcare Nurses Do?

A home healthcare nurse works closely with patients within their own homes or nursing home environments. This includes bathing and feeding patients, along with providing other medical support, such as massage, medication, and wound treatment.

Home healthcare nurses work long hours and typically spend most of their time in the home of a patient. While some work during the day, others work only overnight with their patients in case there is trouble while they sleep. Other home healthcare nurses live with their patients and care for them until they are no longer needed.

Home healthcare nurses use their medical training to track their patients' progress. They check each patient's vital signs, such as their pulse rate, blood pressure, and blood oxygen. They also carry out physician orders for lab tests by drawing blood or other biological samples. They must keep detailed records of their tasks and their patient's health, communicating regularly with the patient and their families.

The patient's needs drive the nurse's specific duties. Nurses may occasionally need to make meal plans or teach caregivers how to use certain medical equipment. They must always ensure the safety of their patients and report any changes in health quickly to the supervising doctor.

Where Do Home Healthcare Nurses Work?

Home healthcare nurses work primarily in the homes of their patients. They may have a central office where they keep patient records and complete administrative tasks while traveling to multiple patients each day.

Home healthcare nurses work in comprehensive medical teams that may include personal patient aides, nurse practitioners, and doctors. They fill the gap in care between hospitalization or long-term care facilities and independent living. RNs often direct the activities of the patient aides, who may assist patients with mobility needs or tasks of daily life.

Skills That Could Affect Home Healthcare Nurse Salaries

PayScale reports nurses with training or experience in telemetry or critical care units can earn up to 5% more than other home healthcare nurses. Other skills that positively affect home healthcare nurse salaries include acute care and intensive care unit experience or prior work in an emergency room, surgical unit, cardiology, or psychiatric nursing.

Home healthcare nurses also need strong organizational skills. Due to the amount of traveling from home to home, they must possess time management abilities, as well. The home healthcare nurse acts as the eyes and ears of the physician to provide detailed care notes and keen observation of each patient's condition. They must also communicate clearly in writing and verbally with other members of the care team. Nurses also must exhibit compassion for their patients and their families.


How to Become a Home Healthcare Nurse

Many patients rely on home healthcare nurses to help them recover from injuries or illnesses in the comfort of their homes at a lower cost than the 24/7 care of a hospital. Home healthcare nurse requirements include training in many different patient care needs, such as medication management, wound care, and home medical equipment operation.

Becoming a home healthcare nurse requires each aspiring professional to earn a minimum of an associate degree in nursing (ADN) and an accredited RN training program. Some home healthcare nurse degrees require only two years to complete. Before beginning work as a nurse, many states require passing an exam and a background check.

Education

When exploring how to become a home healthcare nurse, consider the type of degree you wish to earn. A two-year associate degree program meets the RN licensing requirements in most states. The curriculum focuses on nursing skills and clinical care with some general education courses.

A bachelor's degree in nursing requires at least four years to complete. This undergraduate degree includes clinical training but incorporates research, management, and leadership training, as well. Many schools offer ADN-to-BSN bridge programs that allow RNs to streamline their education, gain additional skills, and qualify for promotions or leadership positions.

Training and Certification

Every state requires nurses to demonstrate their nursing knowledge and clinical competency through its licensing program. Requirements vary by state, so check with your board of nursing to ensure you qualify for licensing. Most states require prospective nurses to pass the national council licensure examination for RNs (NCLEX-RN).

The exam uses multiple-choice, multiple-response, and fill-in-the-blank questions covering care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. Licensing also typically includes a background check, including criminal background and fingerprints, and payment of a licensing fee.

Home healthcare nurses often work alone or in the supervision of nurse assistants, so many health organizations prefer to hire nurses with experience. Experience may include an internship in a specialization, such as acute or critical care or emergency care, or work experience demonstrating increasing responsibility. Several nursing organizations also offer nursing credentials or certifications in various specializations, such as adult-gerontology clinical nurse specialist or nursing case management.


Home Healthcare Nurse Salaries and Job Growth

The demand for RNs continues to grow across all industries, with the BLS projecting 14.8% growth in employment through 2026. The aging population requires nursing assistance with managing chronic illnesses, such as diabetes or dementia. States anticipating the largest employment growth through 2026 include Arizona (37.3%), Colorado (35.7%), Idaho (29.4%), Nevada (27.3%), and Utah (36%).

Home healthcare nurses command competitive salaries across the country, with the BLS reporting a 2018 median salary of $71,850 for RNs. Salaries vary by location and experience, however. PayScale reports that entry-level home healthcare nurses earn $53,600, while late-career nurses take home an average of $64,270 each year. The highest RN salaries go to nurses working in government or hospitals, but home healthcare nurses often do not provide 24-hour care and tend to work more regular business hours.

Highest Salary Locations for Home Healthcare Nurses
National Median $64,313
Chicago, Illinois $65,000
Houston, Texas $69,473

Source: PayScale


Median Salary for Home Healthcare Nurses by Career Experience

  • Entry Level: $53,600 yearly
  • Early Career: $56,350 yearly
  • Mid Career: $60,570 yearly
  • Experienced: $63,460 yearly
  • Late Career: $64,270 yearly

Source: PayScale


Related Job Salaries
Registered Nurse Certified Nurse Assistant Licensed Practical Nurse Office Manager Medical Assistant
$63,393 yearly $27,891 yearly $43,528 yearly $47,349 yearly $32,840 yearly

Source: PayScale


Home Healthcare Nurse Resources

  • International Home Care Nurses Organization IHCNO supports home healthcare nurses around the world. Members can enjoy networking through conferences and webinars, in addition to providing input on international guidelines for home health nursing. The organization also provides research grants, and members can submit articles to the association's journals. Committees allow members to take active roles in issues that interest them, such as outreach, education, and research.
  • National Association for Home Care and Hospice This trade association supports more than 33,000 home care organizations and dedicated professionals caring for chronically ill or disabled patients. It advocates for legislation aimed at improving Medicare reimbursements and increased access to home care services. Its website includes an agency locator, career center, and business marketplace for member agencies.
  • Visiting Nurse Association of America ElevatingHOME formed VNAA to advocate for caregivers working in home health, palliative, and hospice care. Members can receive access to professional development education, networking through in-person and virtual events, and discounts on products and services. The VNAA Clinical Procedure Manual helps providers ensure high-quality care with more than 300 clinical procedures included.
  • Nurse.com Job Search The Nurse.com job search function allows RNs to search for jobs by location and specialty. Members can upload their resumes and sign up for job alerts that match their search criteria. The site also includes articles on career development, nursing employment trends, and job search guidance. Healthcare organizations can post jobs and target their recruitment campaigns with email and social media tools.
  • Home Care Association of America This trade association sets high professional standards for home healthcare and advocates for legislative support at the state and federal levels. The organization's Safe Home Care Initiative educates consumers on the financial implications of hiring in-home care, such as wages and taxes. Members can access association healthcare, dental, and vision programs, inclusion on the Find a Provider website, and discounts on educational programs.