Becoming an Expert Home Health Nurse

Abstract

The purpose of this article is to discuss the five levels of skill acquisition (novice, advanced beginner, competent, proficient, and expert) developed by Patricia Benner and colleagues, within the unique context of home health nursing. Descriptions of practice at each level are provided and can help nurses have reasonable expectations of performance. Recommendations are made for competence-based clinical support programs such as orientation, mentoring, and clinical ladders that identify, measure, and reward clinical knowledge and skill.

2022 IHCNO Research Award

“…Findings of the study will provide valuable information to support home health nurses toward achieving confidence and autonomy in their practice. The findings can support the development of clinical education for prelicensure students as well as education of licensed nurses to increase their skills and knowledge in home care residency programs (Linscheid & Bell, 2021), the transition of practice to the home care setting, and the clinical learning of experi-enced nurses on their journey toward expertise (Hinck, 2021). The purpose of the pilot study titled Bringing Nursing Home: Examining the Effectiveness of Home Care Simulation Among Practicing Home Care Nurses is to examine the effectiveness of home care simulation toward achieving autonomy and confidence among practicing home care nurses.…”

“…Findings of the study will provide valuable information to support home health nurses toward achieving confidence and autonomy in their practice. The findings can support the development of clinical education for prelicensure students as well as education of licensed nurses to increase their skills and knowledge in home care residency programs (Linscheid & Bell, 2021), the transition of practice to the home care setting, and the clinical learning of experienced nurses on their journey toward expertise (Hinck, 2021).…”

A Theoretical Framework of Home-Based Professional Nursing Practice

“…Remaining in their own homes is important, especially to older adults, because it offers familiarity and connection to a meaningful past that forms the persons they are. The context of the home and the physical environment shape both opportunities and limitations of the patient's behaviors and self-care activities (Hinck, 2004).…”

“…Home-based nursing provides individualized direct care to patients of any age and families at home and is different than nursing practice in institutions such as hospitals or population-level community healthcare (Hinck, 2021). Home-based nursing practice is more than nursing care provided in a particular location or setting.…”

Management of the decompensating patient receiving home health

“…In addition to adjusting methods of care provided in this setting, there's been a growing trend of novice nurses entering the home health subspecialty. This is due to various factors, including the increasing demand for home health services and staffing shortages in the healthcare industry 4. It's essential that the home health nurse can identify when a patient's condition worsens and takes appropriate action to ensure their safety and well-being.…”