Home Health Nurse

Home health nurses coordinate and deliver care to a broad range of patients in the home environment. Patients are often concerned about how they will manage once they leave the safety of the hospital. It is the job of the home health nurse to organize, support, and provide care to assure them that life outside is safe and achievable.

Home health nurses deliver care to both adults and children. A patient could be recovering from surgery, an injury, a stroke, cancer, or other chronic illness. Some patients are pregnant mothers unable to eat and need IV nutritional support. Others are children who are ventilator dependent and need family teaching to learn how to manage their care at home.

Home health nurses can fill a variety of opportunities, giving them more flexibility and autonomy. They can choose to work with one patient for the entire day or visit multiple patients. Home health nurses can deliver care to a single patient population such as gerontology, pediatrics, medical, surgical, or home IV patients. There are plenty of part-time or full-time positions, making home care nursing attractive in balancing with one’s lifestyle.

Home health nurses spend much time teaching patients and families what to expect and how to manage their illness during their daily lives. Therefore, these nurses must be skilled, empathetic communicators to gently introduce the changes people must make and allow time for patients to learn.

Home health nurses often receive advanced training to improve their skills. Some become advanced practice nurses (APNs) who specialize in an area relevant to home care, clinical nurse specialists (CNSs), or as nursing administrators.

Home health nurses perform some of the same activities as hospital nurses, but they provide them in a person’s residence. Home health nurses coordinate and manage the plan of care since physicians will not see patients as frequently as they would in the hospital.

General activities may include:

• Taking patient histories
• Recording vital signs and blood sugars
• Administering medications or teaching patients how to self-administer
• Providing wound care, IV therapy, and ordering of supplies
• Doing physical exams and monitoring for skin breakdown
• Monitoring lab results and response to therapy
• Alerting the physician to any significant changes that need attention

Home health nurses offer recommendations to the physician since they see the patient more often. For example, they recommend and arrange for ancillary health visits such as physical or respiratory therapy, home x-rays, and LVN or CNA visits.

Home health nurses must have sharp assessment skills to anticipate patient risks and monitor changes between visits. They need strong leadership skills to delegate to LVNs and CNAs how to carry out their care.

Home health nurses function as the physician's eyes and ears, so they are responsible for communicating the patient’s status.

In addition, home health nurses need strong communication and teaching skills to instruct families and patients on delivering medications and treatments at home and how to reduce complications.

Home health nurses often work in patients’ or their family’s homes or assisted living places. Others work for insurance companies or a government public health service.

Home health nurses care for

• Dementia/Alzheimer’s disease‍
• Stroke, hypertension, and cardiac disease‍
• Traumatic brain injury (TBI)‍
• Spinal cord injury (SCI)‍
• Diabetes‍
• COPD or other respiratory complications‍
• Cancer and other chronic conditions‍
• Neurological conditions: Multiple sclerosis (MS), Muscular dystrophy (MD)‍
• Home IV therapy

There is no requirement that home health nurses obtain certifications though it may help with advancement. The Home Health Nursing Certification (RN-BC) was phased out so cannot be pursued.

An alternative option is: Wound, Ostomy and Continence Care Certification

Home health nurses must be BCLS certified. The Home Health Nurse certification was retired by the ANCC. Other certifications you might consider are:

Wound, Ostomy, and Continence Certification Board has four options with differing CE/CME requirements.

Gerontological Nursing Certification (GERO-BC)

Pediatric Nursing Certification (PED-BC)

1. Complete an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree: takes two-to-four-years based on the program
2. Pass the NCLEX-RN exam and apply for your RN license after graduation
3. Work for one to two years in the hospital or skilled nursing facility to gain experience.
4. Apply to your county Visiting Nurse Service (VNS) or contact a local home health nursing agency.

You can advance your career by getting a master’s or doctoral degree focusing on an area relevant to home care, such as gerontology, pediatrics, or nursing administration.

Alternatively, you can become an Adult-Gerontology Primary Care Nurse Practitioner (AG-PCNP), Pediatric Primary Care Nurse Practitioner (PPCNP), Clinical Nurse Specialist (CNS), or become an educator or manager.

Home health nurses typically make between $65,137 - $102,290, with a median salary of $80,302, according to Salary.com.

The May 2021 Bureau of Labor and Statistics report shows which states have the highest and lowest wages for nurses. They do not list by nurse specialty, but home health nurse salaries would likely follow suit. The highest-paid states are California, Hawaii, and Oregon. The lowest-paid states are South Dakota, Alabama, and Mississippi.

National Association for Home Care & Hospice

Visiting Nurse Association of America

Association of Public Health Nurses