How to Become a Home Health Nurse

Home Health Nurse Overview

• What You Will Do: Provide professional nursing care for patients in their homes, when a patient or the family is unable to provide needed care.
• Where Will You Work: Employers of home health nurses include hospital/medical center systems, retirement communities, insurance agencies, and home health or hospice agencies.
• Employment Projections: Nursing is expected to be the fastest-growing professions, with growth projected at 16% – 26%. Nurses specializing in home health care are in much higher demand as home health employment is projected to grow by 60%.
• How Much Will I Earn: The median annual salary for a home health registered nurse is $79,632, with a range of $72,411 – 87,850.
• Requirements to Become One: To become a home healthcare registered nurse, you must first complete an accredited program to earn either an associate’s degree in nursing (ADN) or a Bachelor of Science degree (BSN), then pass the NCLEX – RN exam to obtain licensure.

Steps to Become a Home Health Nurse

• Earn Your RN: You must earn an RN degree from an accredited associate degree (ADN) or bachelor degree (BSN) program. To further advance in this specialty, a master’s degree (MSN) is recommended. RN vs BSN degree.
• Pass the NCLEX-RN Exam: All RNs must pass the NCLEX-RN exam to obtain licensure to practice nursing.
• Certification: While currently there is no specialty certification related to home health nursing, obtaining other specialty certifications may improve employability and enhance opportunities for advancement.
• Gain Nursing Experience: On obtaining licensure, RNs seeking to specialize in home health care must first gain professional nursing clinical experience. Most employers prefer at least one year of experience, preferably in critical care, or emergency care areas.

What is a Home Health Nurse?

Home health registered nurses provide professional patient care services within the home setting, providing follow-up care following discharge from the hospital. Home health nurses must be able to be self-directed, working autonomously and managing their time and resources effectively. Interaction with both patients and families as well as with referring primary care providers requires strong communication skills.

Home health nurses work closely with patients, doctors, and family members to make sure that they receive the best possible care at home. Home health care is an important service which helps keep people in their homes and out of expensive nursing facilities or hospitals. Home health nurses provide personalized services around the clock to improve patient’s quality of life by providing pain relief, assistance with daily routines such as bathing and dressing, help with medication management. Home health nurses also provide emotional support to patients and their families by listening attentively during difficult times. Home Health Nurses can work for hospitals, private agencies or physician offices in a variety of settings including emergency rooms, long-term care facilities, skilled nursing homes or rehabilitation centers.

Home Health Nurses provide personalized services around the clock to improve patient’s quality of life by providing pain relief, assistance with daily routines such as bathing and dressing, help with medication management. Home health nurses also provide emotional support to patients and their families by listening attentively during difficult times. Home Health Nurses can work for hospitals, private agencies or physician offices in a variety of settings including emergency rooms, long-term care facilities, skilled nursing homes or rehabilitation centers.

The duties performed by registered nurses in home health care may include;

• Develop a plan of care with the referring primary care provider
• Monitor patient’s health and update the care plan as needed
• Instruct patient/family regarding proper home care
• Provide teaching regarding home safety
• Perform head-to-toe assessments
• Detect early symptoms that indicate the need for inpatient care
• Document symptoms and vital signs
• Supervise home health aides
• Wound care/dressing changes
• Intravenous infusions and medication administration
• Obtaining specimens for diagnostic testing
• Assisting with mobility and activities of daily living
• Communicate with other members of the interdisciplinary healthcare team, such as primary care providers, physical therapists or social workers.

To be successful, the home health nurse must be very knowledgeable, organized, detail oriented, and possess effective problem-solving and critical thinking skills.

How Do I Become a Home Health Nurse?

The first step toward becoming a home health nurse is to become a Registered Nurse, earning an associate (ADN) or Bachelor of Science degree (BSN) from an accredited nursing program. It is important to note that many employers prefer at least a BSN. After graduation, you must obtain RN licensure by taking the NCLEX-RN examination in your state. Once you have achieved licensure, you will need to obtain at least one year of clinical experience as a professional nurse before venturing into home health care. Employers prefer experience in areas such as critical care or the emergency department.

While there is no specific certification related to home health nursing, other specialty certifications may be helpful in terms of employment and the potential for advancement. Examples include; certification such as infusion nurse, pediatric nursing, gerontology, psychiatric/mental health nursing, or adult or pediatric critical care.

For further advancement, you may pursue a graduate degree, (masters or doctoral level) to become a home health care nurse practitioner or clinical specialist.

 Where Do Home Health Nurses Typically Work?

Home health nurses provide professional nursing care for patients in the home setting, providing care the patient or family members unable to perform themselves. Employers of home health nurses include hospital/medical center systems, retirement communities, insurance agencies, and home health or hospice agencies.

How Much Do Home Health Nurses Earn?

Nursing, in general, is identified as one of the fastest growing professions in the US in terms of salary, with a projected growth of 16% +, much higher than the national average. The current salary range for home health nurses ranges from $72,411 to $87,850, dependent on factors such as the type of employer, and the geographical area. Salaries are generally higher in urban areas, however, the cost of living is typically higher, as well. In addition, bachelor’s prepared nurses tend to earn higher salaries than nurses with associate degrees, and related specialty certification may also increase salary. According to the Bureau of Labor Statistics the top five states for general nursing salaries are (range $96,470 – $81,380).

• California
• Hawaii
• Alaska
• Oregon
• Massachusetts

Home Health Nurse Programs

At the undergraduate level, specialty-related education consists of continuing education activities, such as conferences or online CEU providers. Topics for continued education include:

• Advanced clinical skills
• Leadership strategies
• Various therapies
• Legislative issues and concerns
• Financial management

Becoming a home health nurse practitioner or clinical specialist requires earning a master’s degree in nursing (MSN), or Doctor of Nursing Practice (DNP) degree. At present there are no specific home health nurse practitioner programs, as this is a very new and expanding specialty discipline. However, most home health nurse practitioners are certified as adult or family nurse practitioners, providing a broad base of knowledge of health care concerns across the lifespan.

The Role of the Home Health Nurse in the Face of Nursing Shortages

 The Bureau of Labor Statistics cites that employment for nurses will increase at a rate of 16% by 2024. There is a national shortage of nurses in general related to the Baby Boomer population entering retirement, and the increased health needs of the growing aging population. It is projected that the South and West will be hardest hit by the nursing shortage. The 12 states expected to have the most acute shortages are: Florida, Georgia, Texas, Virginia, Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada and New Mexico.

In addition to the effect of the aging population, with people living longer with more complex disorders, the increasing costs of inpatient care contributes to the increased importance of home health care. Prospective reimbursement practices have led to patients being discharged earlier than in previous years, often needing follow-up care in the home.  Many states have shifted funding for health care to the home setting, allowing patients needing complex care to receive care in their own homes, rather than in higher-cost settings. Home care is significantly less expensive than inpatient care services.

Benefits to the patient include reduced risk for healthcare errors, and reduced exposure to infectious agents. Patients are able to dress as they please, have visitors they want, maintain their own daily schedule, eat what they want, and have their pets. Many patients with terminal diseases prefer to end life at home, rather than in an inpatient setting.

Home Health Nurse Associations & Resources

• Association of Public Health Nurses – phnurse.org/
• Home Healthcare Now – https://journals.lww.com/homehealthcarenurseonline/pages/default.aspx
• International Home Care Nurses Organization – ihcno.org/
• National Association for Home Care and Hospice – www.nahc.org
• Nursing Certification Boards by Specialty – https://www.nursingcenter.com/career/guideto-certification
• Visiting Nurse Association of America – www.vnaa.org

References

• American Nurse Today – https://www.americannursetoday.com/
• Nurse Journal – https://nursejournal.org/
• Payscale.com – https://www.registerednursing.org/
• Salary.com – https://www1.salary.com/
• Study.com – https://study.com/
• US Department of Labor; Bureau of Labor Statistics – https://www.bls.gov/