Home Health Nurse Training Prepares Nurses for Autonomy of Role

The training and orientation period varies in length, depending on experience and skill set.

The role of a nurse comes with significant responsibilities, regardless of the area of healthcare in which they work.

In home health, while a nurse has greater autonomy in completing tasks, they’re also regularly interacting with their patient’s family and caregivers in their homes and must know how to knowledgeably navigate complex situations surrounding them.

“We get nurses from a wide variety of care settings with varying levels of experience, and we’ve developed a standardized training program that extended or accelerated based on each of those nurses’ needs,” Sheila Guither, manager of clinical practice and staff development for OSF Health, said.

Previously, Guither said, there had been a requirement for nurses wanting to come into the home care setting to have previous experience in nursing. However, they’ve found that some nurses who come to them as new graduates  perform well in their roles.

The system’s training for home health nurses varies according to their skill and experience level, beginning with an initial three-week period. For those coming from other care settings, they split the orientation period to allow them more time to get acclimated with the more complex responsibilities. Nurses must also complete the OASIS assessment, which ensures that the nurse can properly assess and provide care to their patient.

“A nurse who has experience with wounds or IVs in the inpatient setting is going to translate really quickly into certain aspects of home health,” J. J. Guedet, vice president of business development and strategy for OSF Health, said. “We’ve had clinicians come over who’ve had really strong cardiovascular experience or pulmonology and when they’re on patients they’re familiar with, they’re going to be rock stars. But you never really know what you’re going to get because the geography of that we cover is so great that you’re going to have a smattering of others who just fall into the general category.”

The training includes wound identification, assessment, and care; in-home IV therapy; pediatrics; and components of case management, such as  patient family engagement and  navigating  socio-economic challenges that arise.

To assess the nurse’s performance, their productivity is measured (how many visits they do within a certain period), as well as quality of care using OASIS to see how the patient progresses over the course of their care. Occasionally, leadership will join nurses on their visits with patients and assess their performance by observing their work and asking the patient and their caregivers questions.

“We like to say, we’re about 1%  of their healthcare, because we go out and teach them what they need to do to provide their own self-care, and then they and their caregivers provide the other 99%,” Guither said. “So our nurses have to be well-trained to prepare our patients and caregivers to provide that self-care and they have to be skilled in identifying when they need to bring in other care team members, like a social worker or physical therapist.”

The metric of success for their training is reflected in staff retention, Guedet said.

“We really want to make sure that the nurses that we onboard are here a year from now, given the staffing crisis we find ourselves in with nurses in healthcare in general,” he said. “The emphasis is less on rushing someone out to see a patient, and a lot more intensive on building that experience where clinicians feel they’re set up to succeed.”