Home healthcare is visiting and caring for the patient and his or her family within the comfort of their own home. The nursing care could be for the patient of any age. The home healthcare nurse has many duties. Some of the duties are dependent on the needs of the patient. Is the patient confused, does the patient needs assistance with activities of daily living (ADLs), or is the patient terminally ill? Does the patient have wounds, tubes, or life support?
Most healthcare nurse duties involve assessing the patient, writing and following a plan of care, responding to the needs of the patient, consulting with a physician or other staff members, emotional, physical, and educational support, and documentation.
PALLIATIVE NURSING CARE
According to Web MD, palliative nursing care is specialized nursing care for the patient with serious and long-lasting illnesses. The goal of palliative nursing care is to improve the quality of life for both the patient and the family. It helps the patient by providing relief from the symptoms, pain, and stress of his or her illness, whatever the diagnosis. Some of the diagnoses of serious and chronic illnesses may include cancer, heart diseases, such as CHF, COPD, kidney failure, Alzheimer’s, Parkinson’s, Amyotrophic Lateral Sclerosis (ALS) and many more. Some of the symptoms palliative nursing care help to relieve are pain, SOB, fatigue, nausea, loss of appetite, constipation, difficulty sleeping, depression, and many more. The palliative nurse is also responsible for counseling, spiritual comfort, and education.
HOSPICE NURSING CARE
Hospice nursing care is specifically for the terminally ill patient and his or her family members. The goal of hospice care is maintaining the patient’s quality of life and providing patient comfort and relief of symptoms, rather than providing a cure. Hospice care provides medical, spiritual and emotional support for the patient and his or her family. Hospice care ensures that the patient is free of pain and discomfort and assists the patient to live his or her last months, weeks, and days to the fullest with peace, comfort, and dignity.
ASSESSMENT OF THE PATIENT
According to National Institutes of Health, assessment of the patient includes taking vital signs, listening to heart and lung sounds, checking for pain or discomfort, and checking the skin for any wounds. If the patient has any tubes, such as an IV, a nasogastric tube, trach, or foley, the nurse checks the tubes for proper placement and patency. If there are any problems during the assessment, the nurse will respond to them as needed.
THE PLAN OF CARE
The purpose of the care plan is to identify patient problems and find solutions to the problems. There are five steps to do this: assessment, diagnosis, planning, intervention, and evaluation. After assessing the patient, the nurse writes any noted problem into a nursing diagnosis. For example, acute pain in the RUE (right upper extremity). The plan or goal is to what extent the nurse wants to reduce the problem, such as that the patient’s pain will be reduced to five out of ten. Interventions are the procedures the nurse uses to relieve the problem, for example, to elevate the RUE. Re-assess the pain, and to give pain medication. Evaluation involves evaluating how well each intervention relieved the problem and whether the goal was reached.
MEETING THE PATIENT’S NEEDS
According to the World Health Organization, responding to the needs of the patient is the most important duty for the home healthcare nurse. Whether the patient is uncomfortable, needs to eat, needs a dressing change or needs a bath, a home healthcare nurse meeting the needs of the patient is crucial.
CONSULTATION WITH THE PHYSICIAN OR OTHER TEAM MEMBERS
According to the Rehabilitation Institute of Chicago, home healthcare is a team effort. There is a physician, nurses, and maybe physical, occupational, respiratory, and psychosocial therapists. Sometimes the nurse is responsible for any physical, occupational, respiratory, and psychosocial therapists’ duties. When the home health nurse has a problem with meeting a patient’s need then the nurse will consult with other team members.
SUPPORT FOR THE PATIENT AND FAMILY MEMBERS
According to the National Cancer Institute, providing emotional, physical, and educational support is also crucial. Emotional support may be just listening to the problems of the patient or family or making an appointment with a psychologist. Physical assistance might include helping a patient ambulate or turning and repositioning him or her in the bed. Educational support might be teaching the patient about his or her medications or teaching him or her to use a walker.
Chart documentation includes everything the nurse done for the patient and the response of the patient. It is essential to write legibly and to use correct abbreviations in the documentation, as the chart is a legal document. The documentation facilitates communication among the team members. It is also a source of data for government programs, such as Medicare and Medicaid.
Related Resource: Advanced Practice Nursing
As described above, the home health nurse has many duties. It may be a very difficult job, but it is also very rewarding. To be able to put a smile on a patient’s face makes the nurse feel happy.