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Home Health: Addressing Health Care Issues from the Core

Published March 13, 2011 11:31 AM by Alexandra Cosan

On my first day of my home health rotation I shadowed a nurse on two of her visits. Any apprehension I had about home health care stemmed simply from the fact that I was not positive of what my role was as I entered the patient's homes--beyond the obvious assessment, vitals and any wound care that needed to be done. It did not take long for me to realize just how significant the role of the home health nurse can be...

Both of the patients we visited were diabetics. To say their individual diseases were uncontrolled is probably appropriate as both had blood glucose levels greater than 400. The nurse spent a significant amount of time teaching these patients ways to manage their diets and appropriate use of insulin. However, after the visits we discussed both cases and one of the patients she had been seeing for weeks now and was planning to discharge him. On this particular day due to his dangerously high blood glucose levels and other symptoms he was headed for the emergency room if nothing changed. The other patient was in the same situation, although a new patient and no symtoms associated with his high blood glucose levels, he too was a step away from an emergency room visit.

It was very eye opening for me to see how these two patients in particular could fall into this rapid cycle of emergency room visits, hospital admissions followed by referrals to home health. Because of this, I was able to recognize how important it is to really try to get through to these patients with teaching and follow up so as to avoid this cycle which not only hurts them but ultimately hurts the health care system. After one day it would seem as though helping patients to be compliant is one of the most important aspects of home health care and could have a significant positive impact on the health care system if successful. 


I am a HH nurse and unfortunately see this a lot.  You can teach but if the patient is not willing to make the changes you are teaching you are waisting your time, their time and medicare dollars.  It is very frustrating to know you can help a patient but they do not want the help.

Patricia Bolin March 27, 2011 11:03 PM

I am not sure why the nurse would be planning to discharge a patient that was on the verge of an ER trip. Did the nurse explain why the patient would be discharged from home health if the diabetes was still out of control?

Katherine Burke March 26, 2011 6:52 PM

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