A pair of genuine smiles beam wide as Chelsea Rambo, RN, reads aloud to one of her five regular home health nursing patients. The realities of tracheostomy tubes and medication schedules give way t the colorful adventures of Pete the Cat. The rhyming children’s tale follows the cartoon feline as he befriends Gus the Platypus, who is different than his other friends.

“Don’t be sad,” Chelsea reads. “Don’t be blue. There is something everyone can do.” Her patient listens closely as Chelsea’s voice rise and falls with the rhythm of the story until she reaches the end. Fror start to finish, no more than 10 minutes pass — a brief slice of her typical 12- hour shift.

“Interacting and playing with my patients,” Chelsea describes, “that’s the best part of my day. Anything that involves working together and them being happy.”

Chelsea recently earned her RN while working for a private home health care agency in the Lancaster area. She specializes in pediatric care, which includes nursing within a patient’s home and at school. Her caseload focuses or five patients, with an additional five she fills in for if another nurse cannot. She averages around 40 hours a week, and daytime shifts occupy her current schedule.

“I did nights for a while, and I still pick up night shifts here and there,” the 26-year-old explains. “… My flexibility helps with going on different cases. If they need to switch me, I can do that because I’m trained.”

In addition to her homecare nursing work, Chelsea is studying to earn her Bachelor of Science in Nursing (BSN).

“I’ve always had a passion for it,” Chelsea says. “I knew I wanted to do something in the medical field. My grandmother had dementia, and she lived with us. When I was in high school, I was her caregiver when I came home from school until my parents got home from work. I really loved that.”

Initially, Chelsea pursued a certified nursing assistant (CNA) degree with a focus on dementia and Alzheimer’s ski care. When she went to LPN school, she switched to pediatric care. “I met and interviewed with [pediatric nurses], and I ended up loving it,” she says. “… Just the overall experience with these kids — they are loving, and you get attached to them very easily.”

For Nurses new to home care

Caring for infants, children, and their families during hard times is a meaningful, rewarding, and an important responsibility. Often, those who pursue a career in pediatric nursing feel called to help this age group. The role of a pediatric home health nurse is a bit different from other pediatric jobs because rather than just helping babies and kids when they need hospitalization or routine check-ups, a home health nurse gets the chance to invest in the lives of their patients and help them achieve health milestones.

Successful home care nurses need practical, current clinical experience to care for patients who are being discharged “quicker and sicker”. Physical assessment skills need to be sharp and accurate, especially when immediate decisions regarding patient care must be made. Many agencies today offer classroom and clinical training programs to assist the nurse in the transition from hospital based care to home care. Expertise with new technology is also essential because of the machines, pumps, tubes, and medications that now accompany patients to their homes. To be effective, a home care nurse must be assertive, articulate, and persistent in collaborating with other healthcare professionals. Remember to keep the agency involved of any changes in the client’s condition or plan of care. Hospital nurses making the transition to home care need to realize that patients perceive them as guests rather than authority figures. Hospital-like rules don’t regulate home environments where personal preferences regarding diet, hygiene, lifestyle, and family relationships are important.

Few people are comfortable allowing strange people into the personal space of their homes, and a glance, tone of voice, or attitude of a nurse can build or destroy the patient’s trust in a moment. Flexibility and dependability are important in the home care relationship. A successful home care nurse requires keen adaptability to revise schedules and plans as needed to overcome inclement weather, last minute changes in case load, and staff sick calls that can challenge a well-planned day. They know that showing up on time for shifts demonstrates their respect for the patient and their family’s need to maintain some control over their lives. The flexibility of home care nursing provides nurses with the freedom that they simply cannot find in more structured environments. Nurses typically plan their own schedule and offer their time to the agency based on their needs with respect to their own family, personal and professional commitments.

Although a nurse may have difficulty maintaining a well-defined professional boundary when becoming for a time, a “member of the family”, in the emotion-packed arena of home care, nurses constantly learn valuable lessons about themselves and the people who receive their care. Home health demands are distinctive, presuming maturity and compassion from its practitioners. it also enables nurses to make profound and long-lasting differences in the equality of their patient’s lives. For individuals who choose home care nursing for that reason, the rewards are many.