How to Become a Home Health Care Nurse


Home care Nursing Information and Overview

Home care allows the patient and his family to maintain dignity and independence. According to the National Association for Home Care, more than 7 million people in the United States require home care due to acute illness, long-term health problems, permanent disability or terminal illness.

Home Care Basics

Nurses practice in a number of locations: hospital settings, nursing homes, assisted living centers, and home care. Home care nursing is a growing phenomenon as more and more patients and their families wish to receive home care. The history of home health care stems from Public Health Nursing, where public health nurses have made home visits to promote health education and provide treatment as part of community programs. Today, academic programs train nurses in home care and home care nurses place home care nurses with sick individuals and their families, depending on the nurse's experience and qualifications. In majority of cases, there is alays a shared relationship between the agency and the academic institution.

Many changes have taken place in the field of home care. These include Medicare and Medicaid, and long-term care insurance reimbursements and documentation. It is important that the nurse and care agency is aware of the many factors that play a role in these rules and regulations that arise from these organizations. Population and demographic changes are also taking place. Baby boomers are approaching retirement and will pose new challenges for the home health care industry. Technology and medical care in hospitals have led to shorter hospital stays and more home rehabilitation. There is also an increase in the number of outpatient treatments in the aftercare of home care. This has led to a decrease in the death rate from these technologies and medical care has led to an increase in morbidity and chronic diseases, making the need for home care a higher priority. 

Job Description Home Care Nurse

Through a range of skills and experience, home care nurses specialize in a wide variety of treatments; emotional support, education of patients recovering from illness and injury for young children and adults, for women who have recently given birth, for the elderly who require palliative care for chronic diseases.

A practicing nurse must have the skills to provide care in a unique environment, such as in someone's home. The nurse works with the patient and family and must understand the communication skills for such a dynamic. Rapport is visible in all nursing positions, but working in a patient's own living space requires a different level of skill and understanding. There is autonomous decision-making because the nurse no longer works in a team with other nurses in a structured environment, but as a member of the "family" team. The host family has cultural values   that are important and different for each patient and should be treated with extreme sensitivity. Other skills include critical thinking, coordination, assessment, communication and documentation.

Home care nurses also specialize in caring for children with disabilities that require additional skills, such as patience and understanding of the needs of the family. Children today live with a disability that would have led to death twenty years ago. Genetic disorders, congenital physical disabilities and injury are just a few. Many families are familiar with managing the child's needs, but still require expert care that only a home nurse can provide. For proper care of the child, it is important that a home nurse is aware of the expertise of the family about the condition of the child. There are many complications involved, but most importantly, a positive attitude and positive reinforcement are paramount to the child's development.

Medication coordination between the home nurse, physician and pharmacist ensures proper management of the exact science behind giving the patient the correct dose, time of administration and combinations. Home health nurses should be familiar with pharmacology and be trained in the various medications used by patients in the clinical setting.

Many advanced practicing nurses are familiar with medication regiments. They have completed higher education courses. Home care facilities believe that a nurse should have at least one year of clinical experience before entering home care. Advanced practicing nurses can accelerate that training by helping new nurses understand the home care and education market.

Work and Salary

According to the US Department of Labor, there were 2.4 million nurses in America, the largest health care profession, but many academic and hospital organizations believe there is a serious shortage of nursing staff. The nurse shortage was 6% in 2000 and is expected to be 10% in 2010. The median hospital nursing salary is $53,450 with 3 out of 5 nurse jobs in the hospital. For home care, the salary is $49,000. For nursing care facilities, they were lowest at $48,200.

Training and Continuing Education

Most home health nurses are trained through accredited nursing schools across the country with an associate degree in nursing (ADN), a bachelor of science degree in nursing (BSN), or a master's degree in nursing (MSN). According to the U.S.Meanwhile the  Department of Labor, in 2004 there were 674 BSN nursing programs, 846 ADN programs. In the year 2004 there were also 417 master's programmes, 93 doctoral programs and 46 joint BSN doctoral programmes. The associate degree program takes 2 to 3 years to complete, while bachelor's degrees take 4 years to complete. Nurses can also earn specialized professional certificates online in geriatric care or life care planning.

In addition, a bachelor's degree is often essential for those nurses who choose to advance into administrative positions or research, counseling, and teaching. A bachelor's degree is also important to become a clinical nurse practitioner, nurse anesthetist, nurse midwife, and nurse practitioner (U.S. Department of Labor, 2004).

All home health nurses have had supervised clinical experience during their training, but as previously mentioned, advanced practicing nurses have master's degrees and, unlike bachelor's and associate degrees, have a minimum of two years of post-clinical experience.Most of the Course work that they includes are anatomy, physiology, chemistry, microbiology, nutrition, psychology and behavioral sciences and liberal arts. Many of these programs have training in nursing homes, public health departments, home health facilities, and outpatient clinics. (U.S. Dep. of Labor, 2004).

Therefor, it doesn't matter i a nurse is training in a hospital, nursing facility, or home care, continuing education is necessary. Healthcare is changing rapidly and keeping abreast of the latest developments improves patient care and health procedures. Universities, continuing of education programs and the Internet sites all offer continuing education. One of a kind organization that have decide to provide continuing education is the American Nurses Association (ANA) or through the American Nurses Credentialing Center (ANCC).


There are many rewards for becoming a home care nurse. Some rewards include the relationship with a patient and their family, autonomy, independence, and critical thinking. In this very 21st century, it do brings many opportunities and as well more of challenges too. We must face these challenges - there is an aging baby boomer population, a growing morbidity factor due to increased medical technology and patient care, and the growing shortage of nursing care.

Becoming a home nurse today is exciting and an opportunity to make a difference, life for life. With clinical experience and good education, a home nurse will lead the future of medical care.

By Michael V. Gruber, MPH is a contributing author to My Nursing Degree Online, providing articles and resources for nurses seeking continuing education online. With ones good performance  Masters in Public Health and two years of medical training, Michael offers a unique perspective on the current nursing shortage crisis on the Nursing Career Blog, as well as extensive articles on nurse education and progress.

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