Career Story: Licensed Home Health Care Nurse

Licensed Home Health Care Nurse

Job Title: Licensed Home Health Care Nurse

Education: Chemeketa Nursing College, Salem, Oregon-/ Pacific Lutheran University, upper post grad continuing education, specialty nursing, Tacoma, WA. Nursing Education with 2 years prerequisite education, then two years Nursing Education classroom and clinical exposure. Chosen specialty, Med-Surgical, Triage, Operating Room, Emergency Room Triage and Intervention, and OB/GYN.

Focus on all areas of hospital and home health care interventions of discharged post operative patients not needing further hospitalization with acuity factors of 1 to 5. 5 being most intensive/ skilled nursing care. Skills require abillity to make skilled , exacting professional decisions based on patient health care changes, and at times, cell phone direct to doctor orders for life saving in home telephone intervention orders by MD.

Home Health Nurses are the Doctors front line defensive eyes and ears for their patients, reporting critical information changes up to three and four times daily with visits at the patient's home. Requires extensive skills and driving over great distances during work day.

Previous Experience: Six years Army and Air Force Nursing, Dover AFB, Delaware/ Also Reynolds Army Hosp, Fort Sill, Lawton, Oklahoma. Includes many temporary duty stations in United States and other countries. Primary AFSC 97501, secondary AFSC, mortuary.

Primary MOS Army = 91B10, 91C10 (nurse) Combat Field Medic, Secondary= Infantry. Each position with military includes extremely varied job description requirements. Excellent learning foundation for those interested in nursing/ healthcare, as well as leadership positions, including Commissioned Officer positions with Military.

Job Tasks: The primary requirements of my position mandates me to check in with the Hospital Home Care Manager for the Med-Surgical Team, for the day's caseload, any additions, or changes in my patient caseload, and any new updates or new patient admissions I need to perform, which would include an in-depth patient medical history, and also a head to toe examination of the new patient. This includes a written documented patient log of details to include such things as current medical condition and current diagnosis, treatments, medications, allergies, past surgeries, creating a new patient care plan specifically tailored to the patients needs, and also includes patient teaching, such as self-medication administration, teaching wound care and sterile dressing changes as well as involving significant others in the health care plan to optimize and expedite healing and overal patient progress to the end that their acuity of care level drops from a high of 5 to a low of at least 2 prior to discharge from home care, or maintainance visits.

This profession requires the nurse to be skilled with intravenous administration of medications, and supplemental parenteral fluids, sterile technique involving many invasive procedures including intra-eurethral sterile technique, catheterization, maintainance of patency, removal, and re-insertion of new sterile catheters and intravenous lines. Many of the in home care nurse's duties are challenging, with unexpected changes in patient status requiring urgent intervention in home, or transport back to the hospital. The nurse must be well versed in noting such things as changes in vital signs, skin color changes, neurological assesments, signs of infection, and much much more. The work is challenging, yet rewarding.

Some shifts are relatively routine visits, while some shifts, you may have four out of 10 patients with critical or urgent interventions mandated according to your in-home assesment of their stability, which is taught in depth in college, and learned more perfectly in the home or hospital environment.

Nurses in any spercialty must know how to assess each type of patient, adjust for changes and be ready for the unexpected at all times. A good/excellent nurse will be within a year of post clinical practice and be able to determine problems at a glance before any scientific interventions have even begun to assess the patient's condition. This ability continues to develop in the excellent nurse throughhout their career. This inate quick assessment ability continues to develop in the nurse with great compassion, and dedication to the well being of the patient and a love for their work and mankind.

It is my humble opinion after 21 years of nursing, that we are indeed special, but not haughty. We bring to the doctor, family, and the community a special respect for our kowledge, skills, and our dedication to life and well being of all we are charged to care for. Once a nurse, always a nurse. Good luck in your advancement in medicine. Be advised: The job is demanding, and many times thankless. However, for the most part, we are the front line heroes in the medical care administration. Without us, the public health chain of care would completely fail.

Best and Worst Parts of the Job: Best: The patient continues to improve according to the written and updated care plan to the end that self care is achieved, or total healing has occured. You have achieved excellence in nursing care.

Worst: The patient declines despite medical science's best efforts and your application of knowledge in your daily care for the patient. The patient you have cared for may die, or become unresponsive for lengthy amounts of time. You talk to the person unresponsive in a caring manner as if they were concious, always caring, always respectful. Hearing is the last sensory perception to leave the dying patient. So everything you say should be supportive and positive. The patient may improve, or the patient may expire. Often we have become emotionally close to our patients. We may ouselves need time to grieve, as well as be there for the significant others that they may be helped during the grieving process for the loss of their loved one.

Job Tips:
1. Know in your heart, that you want to serve the sick and injured, in spite of their often rotten dispositions. Remember that they are suffering and may not mean the hurtful things they often say and do.

2. You are their sounding board. Patients will first tell you before a family member or doctor what is bothering them. Be open minded and compassionate no matter what has been said. Build a relationship of trust. Be consistent and on time. Never mislead a patient or lie. Always keep in confidence that which you hear. To do otherwise would sabbotage the healing process psychologically, and they may decide to not confide further in you.

3. Remember to take care of yourself at least as good as you would your patients. If your care becomes sloppy or inneffective, take note of it and request time off to rest and seek answers to personal issues that may impair your ability to perform your duties to the level of excellence you normally would. We are strong, but not made of titanium. Seek for yourself optimum self awareness and care so that you may be ready to heal others in the highest levels of performance you are able. To do less is to compromise your patient, and your good reputation.

Additional Thoughts: Know that we nurses are in great demand. Don't settle for just any job. You may want to try working with a travelling nurse agency, working in Hawaii for a few months on contract. Or, you may want to work with a world relief society for cultural knowledge and humanitarian reasons. The world is now an open book for you to write your story on. You will impact many thousands of lives and their friends, and loved ones. Remember always to do no harm. If you feel stressed out, you must take a break and nurture yourself. There is always another time and place to leave your beautiful healing mark on the hearts and minds of the worlds sick and injured. Walk forward into the world boldly and with confidence, knowing your skills mean the difference between life and death for countless souls. Many persons wear the title of NURSE, but limited numbers of us truly know our part in that designation. Be dedicated and true. Be strong and caring. Remember what it was like when you may have been seriously ill or injured, frightened and perhaps alone. Nurses make the difference by anticipating the pain of the suffering, and responding in a loving and compassionate manner. We do not need more "Nurse Ratchetts" in our profession. Love yourself. Love others. Love healing. If you cannot, please leave the medical profession.

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