For nurses who don’t — or no longer — want to work in a hospital or medical office setting, there’s home health care nursing to consider. While the required degrees and licensures are essentially the same (more on this shortly), the daily work or home health nurses, as well as the preferred experience, differs quite a bit from more traditional nurse settings.
“Home health nurses offer at-home care to newborns, children and adults, as well as individuals needing end-of-life care,” explains Yuko Bautista, a registered nurse and associate professor at Arizona College of Nursing. “They also provide hands-on care to individuals who may be homebound or unable to leave their homes for various reasons and are typically the liaison between the patient and physician.”
Wondering how to become a home health nurse? Here, Bautista and other experts share how to take your career down this track, along with insight as to what you can expect from this important role.
What is a home health nurse?
A home health nurse is a licensed nurse who provides care for a person inside their home. They offer care to folks of all different ages for both acute and chronic issues.
“This type of nursing is designed to help individuals who need ongoing medical care but prefer to stay in a familiar environment rather than being hospitalized or staying in long-term care facilities,” explains Dawna Cato, a registered nurse and director of nurse residency programs at OpusVi.
The care can be ordered by a physician or it can be obtained directly by a person who hires a nurse privately, adds Jasmine Bhatti, a registered nurse and the founder and CEO of Navi Nurses, a private duty nursing company that specializes in home nursing care in Phoenix.
Home health nurse duties
The duties of home health nurses vary depending on the patient and degree scope, but here are possible daily duties, per Bautista, Bhatti and Cato:
- Continuous assessment of the client’s care needs/track changes.
- Intravenous therapy for antibiotic administration.
- Care/management of PICC lines and ports.
- Wound care, including negative pressure therapy (wound vac).
- Care/management of indwelling catheters.
- Physical assessments.
- Collection of vital signs, such as blood pressure and heartbeats per minute.
- Diabetes care/management.
- Communication with the patient’s care team.
- Care/management of issues such as hypertension, congestive heart failure and renal disease.
- Hospice care.
- Medication administration as prescribed by the physician.
- Immunization administration.
- Data entry into computer systems.
- Patient and family education on release instructions.
- Observation of patient reactions to medications.
- Observation of patient mental health status.
- Assistance with daily needs such as bathing and dressing.
- Monitoring fluid/food intake and output.
- Safe patient moves and transfers.
Another thing to keep in mind, Bhatti notes, is that duties can vary based on the patient’s insurance status.
“If the duties are covered by insurance, the care that is provided is outlined by the order from the physician prescribing it,” she explains. “This means if a patient has insurance covering home health nursing care because of, for example, a wound, the primary responsibility is to provide wound care and address issues that may impact it.”
If a patient hires a home health nurse independent of insurance, “the nurse can provide any service that falls within their scope of practice,” notes Bhatti. “This can include advocacy, care coordination, assessments, wound care, medication administration and more.”
What education is required to become a home health nurse?
In order to become a home health nurse, you need to complete one of the following educational requirements:
- Licensed practical nurse (LPN). LPNs usually complete a practical nursing program that’s 1-2 years.
- Licensed vocational nurse (LVP – California and Texas). This program is typically about one year.
- Registered nurse (RN). RNs typically need either an associate degree in Nursing (2-3 years) and a bachelor of science in nursing (four years).
“Individual state practice acts require that the LPN/LVN must work under the supervision of a registered nurse, advanced practice nurse or physician,” notes Cato, adding: “Registered nurses (RNs) can also become board certified as a Home Health Nursing Certification (RN-BC) through the American Nurses Credentialing Center (ANCC).”
To that point, Cato continues, LVNs/LPNs cannot perform the initial comprehensive assessment, as this is strictly an RN duty.
“While LPNs are valuable in home health, their ability to assess is typically restricted to focused, task-specific assessments,” she says. “Comprehensive initial assessments, ongoing evaluations that inform changes to care plans and any form of diagnostic assessment remain the responsibility of an RN or higher-level practitioner.”
“LPNs gather data, provide essential care and collaborate with RNs and other healthcare professionals to ensure the patient’s needs are met,” she says.
Home health nurse requirements
In addition to their degree, home health nurses need to earn their nursing license by passing the National Council Licensure Examination (NCLEX-RN for RNs, NCLEX-PN for LPNs).
Additional trainings and certifications may be:
- Clinical experience. “Most home health agencies prefer nurses with at least one to two years of clinical experience, often in medical-surgical nursing or critical care,” Bhatti explains.
- Specialized training. Some nurses pursue additional certifications in areas like pediatrics, wound care or infusion therapy.
- Home Healthcare Nursing Certification. This isn’t a requirement, but it’s offered by the American Nurses Credentialing Center for nurses wanting extra certification, says Bhatti.
- Continuing education. “Ongoing education is typically required to maintain licensure and stay current with best practices,” notes Bhatti, “but doesn’t have to be specific for home health.”
How much do home health nurses make
According to the U.S. Bureau of Labor Statistics, the median annual salary for registered nurses is $86,070. Nurses in home health care settings have the third highest level of employment in the nursing industry, behind folks working in hospitals and doctors’ offices.
How to become a home health nurse
While the right degree and proper licensure is required to become a home health nurse, experience is key in this field — particularly since home health nurses are, essentially, alone.
“Home health nursing offers a unique and intimate perspective on patient care, as it involves providing medical services in a patient’s home,” Cato says. “Nurses should have one to two years of experience prior to working in a home health setting. Nurses must practice autonomously and have strong communication and critical thinking skills.”
“New nurses starting out, no matter where, still have a lot of learning to do, and this comes from shared experiences from other nurses who help guide them,” notes Bhatti.
The bottom line
Home health nursing is a rewarding field that comes with a number of benefits, according to Cato, including close relationships with patients, autonomy and flexibility and a relatively stable field. However, experience is important in this arena, so gaining time in a hospital or doctor’s office setting is advisable before heading down this path.
