Rosa Aguiar, RN, has two reasons to love working in home care: the variety of work experiences and the personal relationships.
As a case manager with HopeHealth Visiting Nurse, Rosa cares for about a half-dozen patients every day. No two days are alike.
“We see a little bit of everything in home care, believe it or not,” she explains. “I have palliative patients, heart failure patients, wound care, diabetes education—all kinds of cases.”
Thanks to advances in medicine, patients are coming home from the hospital sooner and with greater health needs. As a result, home care nursing is more challenging and exciting than ever.
“I learn something new every week,” Rosa says. “You also need to have very sharp assessment skills.”
Sometimes all patients need is someone to listen.
From professional challenges to therapeutic listening
Rosa chose to practice in home care soon after nursing school. “I fell in love with it because it’s challenging and I have time to spend with my patients.”
Because home care nurses may see a single patient dozens of times, they really get to know them and can build trust.
That trust is essential when helping someone face the new reality of a serious diagnosis. Many patients have a long road to get back on their feet, often with major lifestyle changes.
Home care nurses offer a path forward, offering medical care, education and therapeutic listening. “You sit there and listen,” Rosa says. “If you have advice, you can give it. But sometimes all they need is someone to listen.”
They also have the time to explain the rationale of treatment. For example, Rosa might talk about the science behind low-salt diets or medications that build up in the body over time. Many patients are more likely to follow guidance if they know why it’s important.
Rosa also bonds with people who speak her native Spanish. Language barriers can be intimidating for patients. They may not answer questions candidly or ask follow-up questions, which can impact their health.
“When they see that I speak the language, they just open up and tell me everything that’s going on, especially after I’ve seen them a few times,” Rosa says.
I love the fact that the patient gets so many eyes on them.
Technology in home care
Technology is a tool of the trade for today’s home care nurses.
Patients can come home with a variety of equipment, like PICC lines (peripherally inserted central catheter), gastronomy tubes, and wound VACs (vacuum-assisted closures).
HopeHealth uses telehealth for Hearts at Home, a new pilot program for people recovering from heart failure.
Heart failure is a chronic condition in which the heart muscle weakens and can’t pump enough blood through the body. Many patients end up in and out of the hospital.
Rosa is part of the Hearts at Home team of nurses, therapists, social workers and aides. They work together to monitor and educate patients and empower them to take an active role in managing it.
Patients use a kit of computerized devices to report their health status every day. The kit includes a digital scale—rapid weight gains are a red flag for heart patients—as well as devices to measure vital signs like blood pressure, pulse and blood oxygen saturation.
They also receive a computer tablet with pre-loaded yes-or-no questions for patients to answer about their symptoms.
“It’s easy to use, even if they aren’t good with technology,” Rosa says. “I love the fact that the patient gets so many eyes on them. If they know people are checking up on them, they’re more likely to do what they need to do to manage their health.”
Early results from the program have been positive, with fewer people requiring rehospitalization.
I wouldn’t work anywhere else.
Even though she works with relative independence, Rosa still feels support and care from her colleagues. She also appreciates the little things, like thank-you notes and Nurses Week celebrations.
“This is the only organization that I would refer my mom or any family members to with my eyes closed,” Rosa says. “HopeHealth cares about the patient, and that’s really important for me. I’m a nurse, this is what I do—I care for people.”
“I wouldn’t work anywhere else,” she adds.