What is a Home Health Nurse (HHN) in the USA?

By ShiftMed Team//Nursing Profession
Home health nurse talking to an older person

Not all nurses work in hospitals or medical practices. Some nurses travel to their patient's homes to deliver ongoing care and support as they recover from injuries and illnesses or manage life with chronic conditions.

Being a home health nurse (HHN) allows you to travel to different locations and serve various patients in their homes. You help them maintain a greater quality of life by providing dedicated care for their unique health needs. 

Some HHNs work exclusively with the elderly, while others specialize in rehabilitation and recovery. What matters most is that you are always available to provide comprehensive care that supports patients’ health and happiness.

What is the difference between a home health nurse (HHN) and a registered nurse (RN)?

As a home health nurse, you can help people of all ages live better. A home health nurse is a registered nurse or licensed practical nurse (LPN) with training in home healthcare. They provide ongoing patient care over several weeks, months, or even years. 

The home health nurse has greater responsibilities than an LPN if they are an RN. RN home health nurses can administer medications, maintain medical equipment, insert or adjust IV lines and catheters, and oversee patients’ entire care plans.

LPNs, on the other hand, work under the supervision of a registered nurse. They provide patients with mobility assistance, grooming, feeding, bathing, and basic wound care. They perform more supportive treatments than direct medical care. 

For the rest of this article, we will explore a career as a home health nurse with an RN license. These nurses are given the greatest level of responsibility in home healthcare.

What qualifications do home health nurses need?

To become a home health nurse, you must complete a nursing degree from an accredited school. You can earn an associate’s or bachelor’s degree in nursing, then take the NCLEX-RN exam. The NCLEX exam is the national certifying exam for all registered nurses in the United States.

After you have become a fully licensed RN, you can begin applying for jobs as a home health nurse through a home healthcare agency. Nurse staffing agencies like ShiftMed can also help you find home health nurse jobs near you.

If you do not have an RN, you can still look for home health nurse jobs as an LPN. To become an LPN, you must complete an LPN program in your state. These are typically offered through community colleges and vocational schools.

Note: LPNs are called LVNs (licensed vocational nurses) in California and Texas, but their jobs are the same.

What work does a home health nurse do day to day?

On a typical day, a home health nurse visits their patient(s) and performs routine medical responsibilities related to their care. This may include checking vitals, monitoring symptoms, administering medication and IVs, and dressing wounds. 

Some home health nurses work almost full-time with a single patient, while others tend to multiple throughout the week.

Many patients who require extensive home healthcare have chronic conditions or developmental disabilities. Their nurses comprehensively understand their patient's health and perform multidimensional care to ensure every facet of their health is cared for.

Home health nurses also update patient files and provide information to their physicians regarding their symptoms and conditions. 

Where do home health nurses work?

A home health nurse works for a staffing agency. They are assigned patients, then commute to their homes to provide care. Some home health nurses may work part-time in home healthcare and part-time in another medical setting. 

What is it like to be a home health nurse?

As a home health nurse, you benefit from developing long-term relationships with your patients. In some cases, you will see them every day as they recover. In others, you will work with them indefinitely to support their overall well-being as they live with chronic illnesses or disabilities. 

Home health nurses are often close to their patients and their families. They become a constant part of their lives, and their caregiving is invaluable to the people they treat.

If you work as a home health nurse, you will likely work shorter shifts than an RN in a hospital or medical practice. Rather than work 12-hour shifts several times a week, you may work shorter hours all week. Some home health nurses work nights or on weekends.

Being a home health nurse is a wonderful opportunity to improve people’s lives. You build deep bonds with your patients to support their recovery and long-term wellness.

How much do home health nurses make?

Home health nurses' salaries vary greatly depending on their education, credentials, and experience. For example, the average national salary of an LPN/LVN is $51,097.65, while an RN earns a median salary of $76,944.90.

Working overtime, nights, weekends, and holidays can also provide higher earnings for a home health nurse. Patients need them all year long, so it isn’t uncommon for them to work on days most people take off. 

Recommended Reading - How much do Home Health Nurses Make in The USA?

Are there different specialties of home health nurses?

There aren’t any dedicated specialties for home health nurses, but there are many types of certifications an RN can earn to bolster their resumes. By getting certified in different specializations, you can prepare yourself to work with a particular patient population.

Many home health nurses also take continuing education courses in specialty areas, such as asthma, chronic obstructive pulmonary disease, diabetes, and cardiac care. 

Advantages and disadvantages of a career as a home health nurse

If you’re interested in becoming a home health nurse or switching from hospital to home care, then these pros and cons can help you better understand what this job might look like.

Life as a home health nurse can be less stressful than hospital nursing, so many experienced nurses often see it as a good way to change their careers without leaving the field. You can also consider home health care if you are passionate about working with people recovering from injuries, living with chronic conditions, the elderly, or people with developmental disabilities.

Advantages of choosing a career as a home health nurse

1) Flexible work schedule

Home health nurses can work varying hours depending on their availability and patients. Some HHNs work a 9-to-5 schedule, and others choose different time frames, like nights, weekends, or only certain days per week.

For nurses balancing family life or other responsibilities, home health nursing can offer much-needed flexibility in their schedule.

2) Greater independence

Most HHNs treat patients alone, so they do not have to worry about workplace conflict or competitiveness. They must collaborate with their patients’ other caregivers, such as family members and physicians. But they can still enjoy greater freedom and responsibility as they decide how to treat and manage their patients’ conditions.

3) Special bonds with patients

In hospitals and other healthcare settings, there are always certain barriers that prevent nurses from getting to know their patients on a deep level. With in-home health care, these obstacles are absent. You tend to treat patients in their homes, and are often welcomed as a family member after a period of time.

You get to know your patients as people, understand their personalities, hear about their interests, and participate in their everyday lives.

Home health nurses also enjoy meeting friends and family members of their patients. The personal touch of home healthcare can make the work especially rewarding.

Disadvantages of choosing a career as a home health nurse

1) Less professional support

Working independently in a patient’s home means you don’t get the same camaraderie as nurses in medical facilities. One aspect of nursing that many RNs adore is getting to bond with their colleagues. For HHNs, this part of the job is largely absent, so they can miss out on getting to rely on their coworkers for support, especially during hard times.

2) Difficult patients

Not every patient is responsive to the nurse's efforts. Some outright refuse to participate in necessary treatments. There are also cases where family members feel they know best, so they will try to correct the nurse or tell them how to do their jobs. It can be a frustrating part of this work, and it’s an added challenge that stems from working in such an intimate setting. 

3) Lack of supplies and medical equipment

As a home health nurse, your resources travel with you. Whatever you have is what’s in your car. This can greatly limit your ability to aid a patient in certain scenarios. Being a home health nurse requires planning ahead, anticipating risks, and always keeping materials you might need on hand.

4) Safety and health risks

Hospitals and other medical facilities must follow protocol and maintain a sterile environment. In someone’s house, that isn’t the case. You can be exposed to bacteria, germs, and bodily fluids that may cause disease. You could also risk injury from other people in the home, animals, or problems with the house itself.

As an HHN, always be aware of your surroundings and protect yourself from danger.

How to become a home health nurse

Becoming a home health nurse starts by becoming an RN. After earning a nursing degree, you can take the NCLEX-RN exam and apply for nursing jobs. Most home health agencies do not hire new grads right away. Instead, you will need to work in a medical facility for a year or two to gain enough clinical experience.

Tending to patients on a med/surg floor in a hospital is a good way to build a resume and develop confidence as a new nurse.

Recommended Reading - How to become a Home Health Nurse (HHN) in The USA

Frequently asked questions about home health nurses

How long does it take to become a home health nurse?

On average, it takes 2 to 5 years to become a qualified Home Health Nurse. If you already have experience and an RN license, you may already be eligible to start working in home healthcare.

What skills does a home health nurse need?

Various skills are necessary to work confidently as a home health nurse. These include, but are not limited to:

  • Airway management

  • Tube feeding

  • Wound care

  • Catheter and IV insertion

  • Medication administration

  • Psychiatric care

  • Tracheostomy care

  • Rehabilitative care

  • Postoperative care 

What are the benefits of home nursing?

Home nursing can help patients recover comfortably in their own homes and maintain a better quality of life. As a nurse, working in home healthcare allows you to develop deeper bonds with your patients and work with greater independence.