I was a hospital-based nurse for nearly a decade, and for the last year have been a home care nurse. One of the best things about the nursing profession is the ability to work in diverse subspecialties, roles, and settings. Home care nursing, however, literally takes nurses to new settings and subspecialties every day. Homes I visit include a trailer in the quaint, quiet 55+ mobile home community, and the house off the beaten path 5 miles into a canyon. Allow me to share four delights I have discovered in home care nursing:
1) Whole Person Caring. Providing care in patients' homes increases the capacity for whole person care. Can we learn more about the giant sea turtle's normal behaviors by placing it in a giant fish tank or by observing it in its natural environment? Seeing patients in their homes allows me to see the stack of empty soda cans, observe the family dynamics, and note rosaries or other religious symbols, helping me to understand them as people.Home care nurses can learn valuable things from their patients. Many patients have admitted to not understanding their hospital discharge instructions, and others acknowledged to me that they do not intend to comply with medical and dietary recommendations. As a home care nurse, it is as if a magic genie has handed the golden telescope to me; through it I can see the lifestyle and family dynamics that pose barriers to the patient's ultimate success.
2) Teaching That Allows Learning. Patients at home typically struggle to manage their illness when it is complex and requires lifestyle adjustments and new skills. Home care nurses are able to provide teaching that truly results in learning that is enhanced by the special rapport with patients. I can focus on the patient-absent the interruptions of beeping monitors and rounding team members.I can also more easily "join" the patient when I learn what is near and dear to them. A patient and I might bond after discussing the kidney stone that Fluffy, the patient's little Yorkie, passed 2 weeks ago. Patients in their own homes seem more comfortable asking me questions, voicing concerns about the plan of care, and verbalizing lack of understanding.
3) Purposefully Living the Future of Healthcare Now. It was through finding that patients learn and heal best at home that I realized how essential home care is to healthcare. Most illuminating was the role of home care in the wake of the recent pandemic. Patients with COVID-19 are often discharged to isolate at home with home healthcare. I have the opportunity to administer their intravenous medications, explain oxygen therapy, and teach them correct inhaler use. I felt a sense of pride knowing the work I did was keeping the community healthy and freeing hospital beds for those who needed them.
4) Enjoying Flexible Scheduling. Being a home care nurse has made a difference in my personal life. Home care schedules can provide more flexibility than acute care. Scheduling flexibility has enabled me to do what I love as nurse while also caring for those that I love at home. I negotiate my appointments with patients and we agree on times that work best for both of us. I can take off my life-saving, healthcare-hero cap and put on my soccer mom cap and get to the game. The work schedule also affords me opportunities to enjoy fresh air, listen to audiobooks while driving, and sing karaoke in the car.
The work of providing nursing care within the home setting is extraordinarily meaningful and fulfilling. Energized and inspired by these four delightful aspects of home healthcare, I continue serving patients in their homes and hope to do so for years to come.