Visiting nurses, also called homecare nurses, meet patients in their homes to provide nursing care including medication administration, treatment and other nursing interventions. They may work for a hospital, an independent visiting nurse service, or another community facility such as hospice. The specific responsibilities of a visiting nurse vary from job to job, but some general responsibilities are the same for nearly all homecare nurses.
Patient assessment is one of the first responsibilities of visiting nurses. Patients who are receiving care in the community are usually not as sick as those in the hospital, but they are less likely to have safeguards in place. It's important to assess not only just the effectiveness of the intervention you are in charge of, but also all the patient's body systems. It's also important to look at the physical environment as part of your assessment and identify any potential hazards for the patient.
Treatment tasks are, generally speaking, the reason the patient is receiving homecare nursing. This might include administering intravenous drugs, changing dressings, maintaining a ventilation system, assessing wound development or changes, and other treatment, as provided through physician orders or established office protocols. As a homecare nurse you will work more autonomously, but you should still have access to a continual medical supervisor as well as full set of standing orders, policy and procedures.
Patient teaching is a very important part of homecare nursing, since family members are more frequently involved in patient care in the home than they are in the hospital. If the patient consents and it seems appropriate, involve the whole family in any needed teaching. Make sure the family and patient understand the treatment, why they are getting the treatment, and what type of results they should expect. Since extended family caregiving can often negatively impact the health of the caregiver, you should also be prepared to make referrals for the family as needed. For example, you may need to make referrals for specific medical complaints, for mental health counseling, or to a caregivers' support group.
A visiting nurse will often have the responsibility of coordinating communication with other care professionals. Depending on the patient's diagnosis, he may already have a care manager or case manager in place. In addition, you may have care management provided through your facility or as secondary function of the division of social work. However, if you are the professional who is most frequently in the home, you may need to coordinate care with the patient's doctors, family therapist, and any unlicensed assistive personnel who are also involved in the patient's care.
- Jupiterimages/Comstock/Getty Images