Home Care: Moving Beyond the Hospital (Podcast)

When patients are discharged from the hospital, undergo an outpatient procedure or live with a chronic condition, they may require skilled nursing at home. Home care nurses provide the same services as their inpatient peers, ranging from IV and tracheotomy care to medication education.

“It’s those things that we’re doing inside the hospital setting but doing them in the comfort of the patient’s home, helping them age in place, helping them be in the comfort of an environment that they’re most familiar with and helping them be successful in that environment,” says Heather Woodard, MBA, MSN, RN, director of nursing at Cleveland Clinic’s Center for Connected Care.

In a recent episode of Cleveland Clinic’s Nurse Essentials podcast, Woodard and Suzanne Blankemeier, BSN, RN, assistant director of Cleveland Clinic Home Care, share insights on the home care nursing specialty. They discuss:

• The benefits of home nursing for patients and caregivers
• Signs that a patient may be a good referral for home care
• What a typical home care visit looks like
• Skills required for home care nurses and the training process
• Support for nurses, including mentors and Cleveland Clinic Home Care’s Virtualist Program

Click the podcast player above to listen to the episode now, or read on for a short, edited excerpt. Check out more Nurse Essentials episodes at my.clevelandclinic.org/podcasts/nurse-essentials or wherever you get your podcasts.

Podcast excerpt

Podcast host Carol Pehotsky, DNP, RN, NEA-BC:We spent a lot of time talking about what home care can do. What are some things that either one of you would say, a referral comes in and somebody needs a higher level of care than what we can provide in a home care setting?

Woodard: Our intake department definitely reviews the referrals that are coming in just to make sure that they're appropriate for the home care setting. There are certain times that we have to have some challenging conversations with some of the referrals that are coming in just to say, "Hey, you know, this patient's going to require more care than what our home care agency can provide." Or this patient's expectations are not realistic for what our home care services can do as well.

Even just making sure that the family understands that home care is not there 24/7 in the home. That we're just doing a 45-minute to an hour visit, one, two, three times a week. And that we're not going to be there from the time that they wake up in the morning till the time that they're going to bed. That we're not helping them use the restroom, helping them get cleaned up in the morning. You know, that we're really there for those skilled needs in the home – to help them with that dressing change, to help teach the caregiver or themselves to learn the skill with the goal of eventually helping them be independent and discharged from the agency, the short term aspects of care.

Blankemeier: I agree with that, Heather. Sometimes we can work together with patients and families for other resources that are available. So, there's non-medical home care.We're skilled at home care, but there is non-medical that provides aides in the home, and we work with agencies that do provide those services to help keep our patients at home. But if that isn't an option, oftentimes we're having the conversation around skilled nursing facilities and even hospice for some of our patients.