Internships key to future for home care nurses

Homecare exposure builds good relations

The home care environment is more than a little daunting for nursing students, and it often continues to be a more intimidating work environment to nurses who work in hospital settings.

Suppose then, that a home care agency had the opportunity to give fledgling nurses a brief exposure to the benefits and importance of home care nursing. It possibly could plant seeds that will come to fruition sometime within the next five to 10 years, and as the medical field faces severe nursing shortages in coming decades, this could be just the advantage a home care agency needs.

At least that’s a potential side benefit to a program called HealthLink that uses student nurses to make visits to certain clients of the Visiting Nurses Association (VNA) Inc. of New Orleans. The program is free to clients who have already received home care services and no longer qualify and to other clients who do not qualify for home care services but need additional support and guidance.

"When we first get the student nurses, they are scared and afraid to do a visit, even though they travel in pairs," says Katherine France, RN, MN, executive director. "To the students, these clients are strangers and they don’t know anything about them. Of course, we teach them that safety comes first, but when they visit patients’ homes, they are hit with the reality that people are living on $500 a month and have trouble paying their rent or that their home may not be immaculately clean."

While the home visits may be shocking at first, students soon learn that this also is an exhilarating way to provide nursing services. The home care nurse has the opportunity to help patients in ways that a hospital nurse never could.

For example, one of the VNA’s student nurses visited a multiple sclerosis patient for whom the student could do little to aid medically. However, the student had been taught to ask the patient an open-ended question of "What is it you would like me to do for you?" This patient had a very specific request: "She told her that she’d like the student to help her get a high school diploma," France recalls. "The student made phone calls and then referred the client to where she could attend a community college to receive her GED."

The student also asked the Tulane University engineering department for a special engineering device that would enable the patient to get into and out of bed on her own, and the student obtained a free computer for the woman.

Not only was the experience helpful to the patient, who worked for her GED and then continued with taking community college courses, but it was extremely gratifying to the student nurse who made it all possible.

"This gives nursing students an introduction to home care, which in view of our nursing shortage is a good idea," France says. "It gets them used to the idea of being independent and making decisions and analyzing problems on their own."

France says she hopes these student nurses will remember their home care experiences after they graduate and begin to work in hospitals, so that they might one day decide to return to the home care environment.