Today’s Home Healthcare Nurse: A Truly Patient-Centered Career Path

Home healthcare is one of the fastest growing industries in the U.S. According to the Bureau of Labor Statistics, home healthcare is projected to grow by 60 percent from 2012 to 2022. With this tremendous growth, the role of the home healthcare nurse has dramatically evolved – giving this profession a unique and transformative facelift.

In Northern Ohio, for example, Cleveland Clinic’s home healthcare nurses serve more than 1,000 new patients monthly across 14 counties. Kristine Weiss Adams, MSN, CNP, is the Associate Chief Nursing Officer of Care Management and Ambulatory Services for Cleveland Clinic health system. In this Q&A, she talks about the many advantages and opportunities available in today’s new age of home healthcare nursing.

Q: As the executive leader of nursing practice in Cleveland Clinic’s homecare areas, how would you describe the role of today’s home healthcare nurse?

A: At Cleveland Clinic, our home healthcare nurses work with patients one-on-one in the home setting, making individualized care plans, delivering specialized services that include wound care, medication management and IV therapy, and offering disease/condition education and teaching disease management skills. For example, homecare nurses teach patients with diabetes how to regulate insulin levels, they show patients with wounds how to properly change dressings, and they monitor vital signs and oversee home treatment care plans.

Today’s home healthcare nurse is much more than a clinician. They are an admitting nurse, decision-maker, hands-on care provider, safety regulator and care instructor. They continually work to meet care plan goals, coordinate care services and collaborate with physicians, acute care nurses and other caregivers to avoid patient readmission, encourage compliance, positively impact patient satisfaction and improve overall health and wellness.

Q: How has home healthcare changed in recent years?

A: It’s radically different. In the last decade especially as the complexity of patients has increased so has the complexity of care required in the home setting. Due to financial pressure, patients are discharged from the hospital sooner than they were in the past, requiring more acute care at home than ever before. In some instances, it’s like home healthcare nurses are running small-scale ICUs out of a patient’s home. I like to call it “acute care at home” versus homecare.

Additionally, Americans are living longer with chronic diseases and complex disorders; and as the baby boomer generation continues to age, the number of geriatric patients who desire care that allows them to remain in their homes continues to rise. Coupled with the fact that industry data shows that patients have better recovery rates at home as opposed to a care facility – home healthcare is said by many to be the healthcare setting of the future.

Q: What do home healthcare nurses often say they like most about their jobs?

A: For most, it’s having complete autonomy in their practice. Their attitude and environment are self-determined. They like that they can take charge, manage patients and find personal independence in the workplace. However, they also appreciate that they have a nursing management team just a phone call away for advice or help.

Additionally, they enjoy working one-on-one with patients and building close, trusting relationships with them and their family members in an incredibly personalized setting. Not to mention, in home healthcare, there’s great opportunity for nurses to create more flexible work schedules and achieve salary increases by picking up extra home visits as desired.

Cleveland Clinic Homecare Nurse Susan Kurcz, RN, WTA, recently said, “I’ve been a registered nurse since 1998 and spent most of my career working in the ICU setting. I became a homecare nurse 6 years ago and I love it! I decided to make the change to homecare primarily because I wanted something with more flexibility. I also wanted a setting where I could build strong patient relationships and make a difference by educating patients and their families. With homecare, I knew I would get it all.”

Q: What does it take to excel in a home healthcare nursing career?

A: First and foremost, because of the complexity, home healthcare nurses must have at least two years of inpatient nursing experience prior to working in the homecare setting. At Cleveland Clinic, we also require registered nurses to obtain their Bachelor of Science in nursing degree within 3 years of hire, for which we offer tuition reimbursement.

Aside from the proper training, nursing skills and education, to excel in home healthcare nursing, you must have strong interpersonal skills, possessing compassion, empathy and kindness. Home health nursing is one of the most holistic and patient-centered care environments in our industry and nurses need to be warm and open, recognizing that they are guests in their patients’ homes. A smile goes a long way.

Additionally, it’s important to understand that the home environment can be unpredictable so successful nurses are those who are organized, detail oriented, effective communicators and superior problem solvers.