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With a background in labor and delivery nursing, Gerber says she didn’t find it difficult to move into geriatric care. Her work has given her a new understanding of the elderly and the low-income communities where many of them live.

“When I first started, I felt like Alice in Wonderland,” Gerber says. “You drive through these neighborhoods and you see these houses, and you never know what’s going on inside them. You open the door and worlds and worlds open to you.”

For Kathy Daniels, RN, MSN, BSN, a former cardiac intensive care nurse, one of the biggest attractions to home health is the opportunity to do patient education. She enjoys teaching patients and family members how to live with their illnesses and care for themselves or their loved one. The assessment skills she honed as a critical care nurse have helped her in home health.

“We’re the eyes and ears of the doctors,” she says, because it’s often the nurse making a house call who sees a patient’s deteriorating condition or need for different treatments.

Home health also has given her a way to stay active in the nursing profession. “I’m 60 years old, and at some point critical care would become too exhausting,” Daniels says. “I love teaching, and I love working with seniors.”

Unknown territory

Of course, there are downsides. Many times nurses don’t know exactly what they’ll encounter going into unfamiliar neighborhoods or a stranger’s home. If a frail elder lives alone without family or social support, sometimes the home can be dirty, and sometimes the neighborhood can be intimidating.

Travis remembers getting caught in the crossfire of a drive-by shooting on one of her first home health visits to an elderly man in South Central Los Angeles.

“I got my supplies and was walking into the house when I heard this rat-a-tat-tat,” Travis says. “I didn’t know it was gunfire because I had never heard gunfire. When I turned around, I saw a car speeding by with a person with a gun and a black hood.”

After she got inside, she and the patient’s family sprawled on the floor until the shooting stopped, and no one was hurt.

However, those kinds of experiences can happen to anyone anywhere, says Mary Gumbrecht, RN, BSN, PHN, a field supervisor for UCLA Home Health. Violence, or the threat of it, can happen in a hospital just as easily as someone’s home. Home health nurses do receive annual safety training, she says, and they’re cautioned not to put themselves in dangerous situations.

“We’re not expected to risk our lives to be supernurses,” she says.

If nurses are considering going into home health, they do need to be able to hit the ground running every morning and feel confident with their assessment skills, Gumbrecht says.

“A lot of focus is on teaching, which is what I felt was lacking in the hospital,” she says. “In the hospital, we just pieced them back together and sent them out the door.”

Gumbrecht, who says she didn’t enjoy the “go-go” pace of hospital work, initially tried home health when she started having back problems and needed a job with less lifting. She found the home health work suited her and she finds a lot of room for personal growth and developing specialties.

“I think home health nurses are awesome,” she says. “I know that sounds simplistic, but we have to be so well-rounded. In home health, we have to change gears from visit to visit. You really use what you learned in nursing school.”

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