Maryland resident Dawn Silverthorn-Cerra, RN, BSN, has been a nurse for more than 30 years. For about the last five, she’s worked in home health care. She currently works for BAYADA Home Health Care. “I have to say it’s the best company I’ve ever worked for,” says Silverthorn-Cerra. So what’s it like to work as a home health care nurse? Silverthorn-Cerra took time to let us know. What follows is an edited version of our interview.
As a home health care nurse, about how many patients do you see each day, on average?
On average, I see 4 to 5 patients a day. That number can change, though.
Describe for me a typical day in the life of a home health care nurse?
The day of a home care nurse actually begins the day before. Home care nurses organize their day according to a variety of factors—geography of their patients, etc. Once the day is organized, each patient gets a phone call to confirm the approximate appointment time; I usually give them a 1- to 2-hour window regarding my arrival time.
I am blessed by this job to have flexibility. I drop my daughter off at school and then I head off to see my first patient. Each patient is unique. Some have wounds that need a skilled nurse assessment and wound care, i.e. if they have a wound vac. Many of our patients have just been discharged from the hospital because they have a chronic disease, such as congestive heart failure. These patients often require a lot of education regarding their disease process and medications in order to stop the cycle of them going in and out of the hospital. All of our patients receive education regarding their disease process, their medications, and how to live safely and independently in their homes, among other topics. Our teaching not only involves the patient, but also any family or caregivers that are involved with assisting the patient.
What are the challenges to this type of nursing?
There are always challenges with any type of nursing. Our care of patients is directed by their physician(s), physician orders, and, of course, insurance.
One challenge is communication with a physician. If the patient needs something or if there is a change in their condition, I am responsible for communicating with their physician. Sometimes, it may take a few days before they return my call. Thankfully, this is very infrequently an issue. I am fortunate that I feel like I have a lot of support from my clinical manager and office staff. They are always available to advise me when I am facing a challenging situation. In home care, you never know what you could face when you enter a patient’s home, so it’s good to know you have support when you need it.
Another challenge is the amount of time that documentation of your visits take. Although I have to say that BAYADA is diligently working on this. Every week, I get emails about how the documentation system is being modified to make it more user-friendly. I think this is pretty impressive that BAYADA listens to their clinicians regarding problems we find in the documentation program.
What skills do you need to have for this particular type of nursing?
Organizational skills are important as are strong interpersonal skills. You will come in contact with a lot of personalities, and you need to be kind, caring, and respectful regardless of your patients’ moods or attitudes. Patients are generally very nice and grateful for your help.
You must be able to function independently and have confidence in yourself. You should have excellent physical assessment skills. Venipuncture skills and IV therapy skills are necessary because many of our patients are able to come home and receive their IV antibiotics because of our presence and care. Patience and flexibility are on the list, also.
What kinds of people would do well here?
People who are enthusiastic about nursing and caring for patients, and nurses who like autonomy.
What do you love most about what you do?
Without a doubt, it’s my patients. You develop a relationship with them, and a mutual trust develops. They know you are there to help them, and they appreciate your efforts. We serve a lot of elderly patients, and many of them are on the verge of not being able to live independently any longer. Nurses teach patients about their medications, the purpose and action of them, and what possible side effects may affect their safety. We can make recommendations for assistive equipment that will make them safer in their home and also for other disciplines like physical and occupational therapy.
What do you wish more people knew about your job?
I wish people knew how great it is to be a home care nurse!