Home health nursing is a specialty available to registered nurses (RNs) as well as licensed vocational nurses (LVNs), and nurse assistants. A home health nurse is responsible for caring for patients in their homes, performing various tasks if patients and/or their families are unable to care for themselves. Skills from many different specialties are necessary in the field of home health:
Medical-surgical
Mental health
Gerontology
Pediatrics
Community/public health
Integrating these skills as well as performing task-based services are part of home health nursing.
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There are certain levels of home health nursing. Regardless of the level, home health nurses must value autonomy, individualized care, and family-centered care. The first step in becoming a home health nurse is to decide whether to pursue a career as an RN, LVN, or nurse assistant.
What Are the Educational Requirements for a Home Health Nurse?
Registered nurses must complete an accredited nursing program and obtain either an associate’s degree in nursing (ADN) or a Bachelor of Science degree (BSN). They must also pass the NCLEX exam for licensure.
Licensed Vocational Nurses (LVNs) or Licensed Practical Nurses (LPNs) must also complete an accredited nursing program and test for licensure. LVNs are skilled in performing task-based nursing care, which is a large part of home health care.
Certified Nurse Assistants (CNAs) are unlicensed staff who perform task-based care, excluding medication administration. Certain nurse assistants can obtain certification.
Are Any Certifications or Credentials Needed?
While additional education is not required, registered nurses can advance their practice by becoming a home health clinical nurse specialist by obtaining their master’s degree in nursing (MSN). Additionally, they can pursue advanced practice nursing (APN) by their state board of registered nursing. Some home health positions require 1-2 years of prior acute care experience.
Home health nursing staff work within patients’ homes. They usually have a facility in which they report to receive their assignment. After receiving their assignment, they drive to patients’ home to perform the specified nursing care as ordered by the physician.
Based on their credentials, home health nursing staff perform a variety of tasks.
Registered nurses perform the following duties:
Medication administration, including intravenous infusions
Wound care/ dressing changes
Taking vital signs
Performing head-to-toe physical assessments
Drawing labs
Assisting with activities of daily living (ADLs) such as bathing, toileting, grooming
Assisting with mobility
Developing a plan of care with the physician
Licensed Vocational Nurses perform the following duties:
Medication administration, excluding intravenous infusions
Wound care/ dressing changes
Taking vital signs
Reporting to the supervising RN any concerns the patient may have
Assisting with ADLs
Assisting with mobility
Nurse Assistants perform the following duties:
Taking vital signs
Report to the supervising RN any concerns the patient may have
Assisting with ADLs
Assisting with mobility
What Are the Roles and Duties of the Home Health Nurse?
The roles and duties of home health nurses are dependent upon their individual credentials.
Registered nurses are responsible for:
Assessing the patient’s needs
Developing a plan of care based on individual patient needs
Collaborate with the patient, family, physician, and additional support staff to provide individualized care
Direct LVNs and nurse assistants, and provide oversight to their care
Evaluate patient’s response to treatment
Monitor progress of healing/ mobilization
Case management
Direct nursing care
Licensed Vocational Nurses are responsible for:
Collecting data and presenting findings to the RN
Direct task-based nursing care
Nursing assistants are responsible for:
Task-based nursing care
Report concerns/ findings to registered nurse
What Are the Challenges Home Health Nurses Face?
There are many uncontrollable factors in a patient’s home that can give rise to challenges that home health nurses must overcome.
Navigating an unkempt home isn’t unusual for this type of nurse. The layout or structure of the home can present challenges as well. Some patients with mobility issues may not have the appropriate safety equipment installed. For example, a bathroom that cannot fit a wheelchair. This can be a safety risk, as improper transfer techniques may be used and result in injury to the staff and/or the patient.
Many patients require home injections or IV infusion. Without a sharps container nearby, the nurse may have to administer a medication and then walk a distance to dispose of the needle in another room. He or she may not even have disposal access at all, causing them to recap the needle, which results in most needle stick injuries.
Confused or angry patients, such as those with dementia or Alzheimer’s, can become agitated or violent with a stranger in their home. The risk increases if the nurse must do something that will cause pain, such as injections or lab draws. A Home Health Nurse does not have access to additional staff for assistance in case a patient confrontation escalates. Home Health Nurses must be diligent to check their safety and surroundings, remain calm, and report any suspicious activity or safety concerns when appropriate.
Home Health Nurse Salary & Employment
Medically stable patients who still need nursing care can qualify for home health care. Certain patients with mobility challenges and those who have difficulty traveling to a health care facility can also qualify for home health. As the aging population increases and hospitals strive to reduce costs by reducing the number of unnecessary lengthy hospital stays, home health nurses (RNs, LVNs, and NAs) are in high demand. According to salary.com, the median income for a home health RN is $75,871 annually. An LVN/LPN can earn $47,546, while a home health assistant can earn $25,952. These values can vary depending on the state or city of employment, as well as experience.
