Dorothy had it right when she clicked her ruby-red slippers and uttered: “There’s no place like home.” Those now-famous words are certainly true for the 7.6 million Americans receiving their health care services in a home environment each year — a trend that continues to spur the demand for well-trained registered nurses.

Home health nursing is at center stage of the aging baby-boomer population, a group continuing to exercise its influence by choosing to receive care at home. But this trend extends further than this group. Patients of all ages and backgrounds suffering from acute illness, long-term health problems, disability or terminal illness are finding respite through the home-care services offered by nonprofits, hospitals, and other providers. Research shows that patients tend to recuperate sooner when their healing occurs in a home setting.

According to the U.S. Bureau of Labor Statistics, home health will be one of the fastest-growing health care fields between now and 2014 — driven largely by an aging population, technological advancements and the continued decline in hospital stays. Nursing job opportunities in home health are plentiful through private home-health agencies and hospitals. Some nurses open their own home health businesses, or become Nurse Practitioners and address home-care issues through their own private practices.

Minimum requirements for this profession include an RN degree and several years of solid experience in an acute hospital setting; the latter is critical for developing patient assessment skills to effectively address complex home health issues. A master’s in nursing, including specialized coursework in areas such as diabetes, geriatrics or rehabilitation, is fast becoming the degree of choice for those seeking careers as a nurse practitioner, clinical nurse specialist or a home health administrator.

The duties of a home health nurse vary and may involve interdisciplinary collaboration with home health aides, social workers, and physical and occupational therapists. Basic competencies in checking vital signs, skin color, and other areas of assessment are par for the course. Critical skill sets include intravenous administration and management of medicines, as well as the insertion and removal of sterile catheters and IV lines. Specialty home health care can also include caring for pediatric and adult patients on ventilators, setting up apnea monitoring for newborns at risk for SIDS, and teaching significant others to assess and monitor changes as well.

Home health nurses must also possess a great deal of compassion and diplomacy, as they may be called upon to resolve conflicts that inevitably arise between patients and family members and even their primary care provider. It is also a field where unexpected changes in a patient’s condition can suddenly occur, requiring urgent interventions like accompanying a patient being transported to the hospital.

Success in the home health nursing profession requires a temperament calibrated to deal with the daily challenges facing patients. Unlike acute hospital settings where the support of other professionals is readily available, home health nurses often function with latitude and independence, requiring them to rely more heavily on their own knowledge and experience to develop care plans and interventions. The ability to function “solo” is in fact one of the reasons why many nurses are drawn to home health. Confidence in one’s own independent judgment and decision-making is paramount to the delivery of high-quality home-based care.

Patient education is another area where home health nurses must display a level of comfort and willingness. This requires addressing various education, socioeconomic and cultural and language barriers that their clients may have. Expect this area in particular to grow in importance as health reform efforts seek to address disparities that impede the delivery of high-quality, affordable health care.

Future opportunities abound for those possessing a passion toward the home health care movement. For the well-educated nurse, the specialty offers autonomy, variety and flexibility — values often elusive in acute-care hospital settings.

Home is where the heart is, and there may be no better time than now to explore the advantages of pursuing a career in home health nursing.

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