Home health nurses care for patients in their homes. They may be assigned to one patient all day or they may travel from home to home administering medications, assessing health parameters, and collaborating with patients, families, and the healthcare team. Home health nurses can work in specialties like hospice and infusion, or they may see a wide range of patients. Some home health nurses focus on pediatric patients, some on adults, and some see patients of all ages. Home health nursing requires excellent organizational skills and the ability to work well independently.
Where Do Home Health Nurses Work?
Home health nurses often work from a company hub, where they can meet with other staff, replenish supplies, receive assignments, and chart. But most of a home health nurse’s day will be spent in patients’ homes. Patients can be eligible for home health nursing in many different settings:
Assisted living facilities
Independent senior living facilities
Memory care facilities
Private residences
Part of a home health nurse’s job is to assess whether or not a patient is safe in their current living situation. If a patient needs to move to a higher level of care, the home health nurse communicates and collaborates with the health team, the patient, and their family to make a plan.
Patient care in home health can look a little different than it does in the hospital. In most hospital settings, patients stay in rooms that all look similar to one another, and they spend a lot of their day in a hospital bed that can be adjusted for height and position. In a patient’s home, however, nurses must adjust to whatever situation they find their patient in. They may sit on the floor to change a dressing, or they may sit on a piano bench to record a health history. Home health nurses need to be flexible in their routines and able to think outside the box to take excellent care of patients in their home environment.
What Does a Home Health Nurse Do?
A patient is discharged with home health when they need more medical treatment than they can do themselves, but they are not sick enough to stay in the hospital. Discharge needs requiring home health care can include:
Dressing changes
Frequent lab specimen collection
IV medications and fluids
Once a patient is referred to the agency, the assigned home health nurse obtains that patient’s medical information from the hospital so they can be fully informed on their history, hospital course, and care plan. During or after discharge, they call the patient to schedule their first visit.
A home health nursing visit to a patient’s home can include these tasks:
Activities of daily living (ADL) assessment
Dressing changes
Intravenous infusions (fluids/medications)
Lab specimen collection
Mobility assessment
Physical assessments
Vital signs monitoring
Wound and ostomy care
Some home health care companies also require their nurses to assist with activities of daily living in the home such as feeding, bathing, and dressing. Home health nurses may come upon situations that require collaboration to address, such as an unsafe environment, and they work closely with their providers to ensure their patients are on the road to recovery.
Other home health nurses meet the medical needs of patients who require long-term care. Patients who need long-term care may have medical diagnoses such as:
Cerebral palsy
Chromosomal abnormalities
Gastrointestinal conditions
Paralysis
Recent pediatric organ transplant
Respiratory conditions
Traumatic brain injuries
In long-term home care, a home health nurse may stay with a patient for several hours per day, sometimes five days a week.
How Do I Become a Home Health Nurse?
Aspiring home health nurses have to start by getting their nursing degree from an accredited nursing program. They can graduate with:
A nurse with a BSN has a wider scope of practice than one with an ADN or LPN certificate and may be able to find more opportunities.
Post-graduation, nurses can apply to work as graduate nurses (GNs). Some home care agencies may require some hospital experience first, but others will hire GNs and train them until they take the NCLEX-RN (or NCLEX-PN), their state licensing exam. After they pass the NCLEX, GNs earn the title of LPNs or registered nurses (RNs). After finishing orientation per their unit or agency, new nurses can practice on their own.
No certification is currently offered for home health nurses, but most are required to get certified in basic life support (BLS).
When a home health nurse has worked in their field or acute care for a year or two, they may consider pursuing an advanced practice degree to become a home health clinical nurse specialist or a nurse practitioner. To attain either of these roles, nurses must graduate with a Master of Science in Nursing (MSN). Depending on the specialty chosen, after obtaining their MSN, nurses practice as nurse practitioners (NPs) or clinical nurse specialists. An MSN can be completed in two years, but if working full-time, may be stretched out over a longer period.
How Much Does a Home Health Nurse Make Per Year?
Home health nurses earn slightly less than RNs in a hospital or outpatient setting, with an annual average of $82,920 per year as of 2022, according to the U.S. Bureau of Labor Statistics (BLS). Salaries can change with location and experience, with a low-end average of $61,250 and a high-end of $129,400.
The West Coast, New England states, and Alaska pay their nurses the best, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
Licensed practical nurses may earn a little less than RNs, with an average salary closer to $55,860. Depending on location, an LPN can earn anywhere from $40,490 to $72,650.
The salaries for home health nurse practitioners are higher than RNs, with average annual earnings of $148,960, according to BLS data from 2022. The BLS reports a low-end average of $87,340 and a high-end of $165,240. The location of employment can affect home health nurse practitioners as well, with differences similar to RNs.
The top paying areas for home health nurses and nurse practitioners include:
San Jose-Sunnyvale-Santa Clara, CA
San Francisco-Oakland-Hayward, CA
Napa, CA
Vallejo-Fairfield, CA
New York-Newark-Jersey City, NY-NJ
Yuba City, CA
Sacramento-Roseville-Arden-Arcade, CA
Are Home Health Nurses in High Demand?
The United States is currently facing a nationwide nursing shortage across all specialties according to the U.S. Department of Health and Human Services, which reports 24% of U.S. hospitals have reported critical staffing shortages.
After a decrease and then plateau of hospital admissions from 2009 to 2018, the U.S. has seen an increase in hospital admissions since 2019. Perhaps this is no surprise since the COVID-19 pandemic filled hospitals starting in 2020. But for now, as long as hospital admissions are rising, the need for home health nurses will increase, too.
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