Factors that help nurses stay in long-term home healthcare

In my previous column, I discussed how nurses are recruited and hired by a home health agency, as well as the interview and training processes necessary to work on my case. In this column, I’d like to explore what it takes for a nurse to remain in this role, both in my case and in the field of home care in general.

As someone who has lived with spinal muscular atrophy (SMA) for 43 years, I’ve had numerous licensed practical nurses and registered nurses working in my home, and the topic is near and dear to my heart. Several factors contribute to why some nurses may stay just a few weeks, while others remain for decades. I’d like to highlight two of these factors.

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Wearing different hats

As one of my nurses said a couple of days ago, home care requires adaptability. Accepting this can lead to experiences that truly make a difference in your patient’s life.

Recently, I acquired a new wheelchair after two challenging months, during which my previous chair had been falling apart. The armrest, essential for maneuvering my chair, kept coming off. Although the wheelchair repair company came to fix it, the chair was old and in poor condition, and the repairs didn’t hold.

I recommend that people with wheelchairs call their repair company whenever issues arise. However, in my case, it wasn’t feasible to keep calling them each time the armrest fell off, which was often multiple times a week.

During this time, my nurses had to adapt to the new situation. In addition to their medical responsibilities, they occasionally needed to step into a “fix-it” role, making temporary repairs to keep my chair operational until the new one arrived.

I’ve seen many nurses wear multiple hats. If you just want to be a nurse in home care, that’s acceptable. However, be prepared for the possibility of needing to improvise and take on additional responsibilities outside your usual role.

Taking care of all your patient’s needs

Someone might be interested in home health nursing because they think it involves less work than in a hospital or nursing facility. While it’s true that you focus on one patient at a time, don’t expect to relax; home care can still be quite demanding.

This is because you are responsible for every aspect of your patient’s care during your shift. For instance, if your patient experiences diarrhea, you can’t call another nurse for help; it’s entirely on you.

My nurses often perceive themselves as respiratory nurses, as they frequently take on tasks that a respiratory therapist would typically perform in a hospital. For example, while you may not be allowed to change settings on a ventilator, you will be expected to understand its basic function.

I’ve known many nurses who are reluctant to take on home health patients who use a ventilator because they find it intimidating. However, I can assure you that, as someone who depends on a ventilator, it is a valuable tool. It provides a lifesaving airway in emergencies. When used properly, the ventilator can actually provide more security for nurses, as it serves as a safety net for patients who may need assistance with breathing.

Expectations

It’s crucial to be clear about the expectations discussed above, both for home healthcare in general and my specific case. My mom and I always say that it’s better to determine early in the interview or training process if a nurse is not a good fit, rather than discovering this weeks into their employment.

My mom, my nurses, and I invest a significant amount of energy into training new nurses, and we hope they will stay for at least six months to a year. A few nurses have remained with us for up to 20 years. If you are a nurse reading this, I believe there’s a chance you could be one of those who lasts that long. If you are, let’s soar together in the world of home healthcare!

Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.