HOME HEALTH and HOSPICE

Ruth Whitehead NUR 210
10/27/08

To do home health the nurse must be able to see the big picture. Clients will not always tell the nurse how they feel or if something is not right. The nurse must go into client’s homes and be able to look at the client and the situation and be able to ask the right questions, to find the answers. During my rotation with home health, I got to do a dressing change on a man that had fallen on his porch and his knee had gotten infected. His would had opened and needed a wound vac; at this point it was closed and almost healed. I did a sterile, wet to dry dressing. I assisted the nurse in flushing his PIC line and did a dressing change on that also. I assisted the nurse with her assessments and did vital signs for her. We did see one terminal client, and the biggest thing with her was pain control. I found out what the level of pain was and where it was and when it occurred and if it woke her at night and if her pain regime was adequate for her. The nurse called the pharmacy to get refills and then called the MD when there were no refills available. With every client that we saw teaching was very important part of the visit. We taught about weighing everyday and writing it done, and eating right, taking medications as directed, taking blood sugars everyday and writing it down so the nurse can see how things have been progressing since she had been there last. The nurse collaborates with the MD, OT, PT and the family in planning care for client. Once a week they have a meeting to see where the client is at and if the plan of care needs to be changed and if the client should be discharged. They all collaborate to provide the best care for the client. Everyone is focused on empowering the client and family to meet their needs, to give the client control of their lives again. The nurse uses the client’s culture and beliefs while planning care. Their culture and belief system is incorporated into the plan of care, which then encourages the client to participate and enables them to have control over their lives and the choices that are made, which promotes healing.