I recently received my copy of the 6th edition of the Handbook of Home Health Care Administration, edited by Marilyn D. Harris, an editorial board member and long-time friend of Home Healthcare Now. What a treasure this handbook is! I wish it had been available to me as a new home care nurse many years ago. Given the title, you may assume it is only for administrators, but that is not the case. Written by content experts, this book contains wisdom and guidance, for experienced as well as new home healthcare administrators and clinicians. An example of this can be found in the information in Chapters 15, 37 and 38. The titles are: "Implementing a Competency System in Home Care", "Transitioning Nurses to Home Care", and "Staff Development". They contain excellent information for those who are helping new clinicians transition into home care, and a great overview of home care practice for home care clinicians entering this important specialty area. This universal appeal can be found in all chapters. The handbook can be purchased online at www.jblearning.com. Search for the book by title or author's name.
Now that I've told you about the handbook, I'd like you to know more about the editor, Marilyn Harris, MSN, RN, NEA-BC, FAAN. Marilyn began her career in home care in 1960. She has remained committed to promoting professional, high quality, compassionate home healthcare well beyond her retirement from Abington Memorial Hospital Home Care in Willow Grove, Pennsylvania where she served as Executive Director. I emailed Marilyn to ask her more about her long career in home care.
Question: How did you find your way to home care in 1960?
Reply: I originally worked in the emergency room, but one of my friend's who worked for the Visiting Nurse Association suggested I apply for her position because she was moving to California. The opportunity to provide nursing care in the patient's home rather than in the hospital sounded challenging and interesting. I applied and got the position. I worked 12 years as a staff nurse. Working in the same area for a length of time allowed the community to know you as their nurse. Keep in mind that in the 1960s visiting nurses provided care in the home, made antepartum and postpartum visits and also staffed well-baby clinics in the area, and participated in community events where they had the opportunity to interact with all residents, not just patients.
Question: What was it that made you stay in home care all these years?
Reply: I received my diploma from Abington Memorial Hospital School of Nursing in 1957 and enrolled at the University of Pennsylvania School of Nursing (UPSN) in Philadelphia, PA in 1960 on a part-time basis. It took me 12 years to earn my bachelor's degree, taking evening courses while working full-time. I determined nursing was my profession and home care would be my career. I needed to earn my bachelor's degree if I wanted to move to a supervisory or higher position in the future. After I completed my degree I was promoted to supervisor and then made the decision to enroll in the master's in nursing administration program at UPSN on a part-time basis and completed that degree in 1976. In 1976, the VNA's executive director announced her retirement. I applied for the position and was selected as the director and assumed the role in 1977. In 1988 the VNA affiliated with Abington Memorial Hospital and I was selected to continue as the executive director of Abington Hospital Home Care. I had the privilege of serving as director for a total of 22 years until I retired in 1999.
Each of my positions at the VNA, as staff nurse, supervisor, and executive director, were rewarding and challenging experiences. My decision to earn my BSN and MSN and the timing were important since I had the required experience and met the selection criteria when the director position became available. I continued my professional career in home care as it offered the opportunity to work with staff to plan and provide high quality care for patients, to interact with colleagues and elected officials at the local, state, national and international levels and to effect change to improve health care for patients and families.
Question: What would you say to a clinician contemplating a transition to home care?
Reply: The transition from any other area of nursing to home care presents challenges but also many rewards. Home health nursing is a specialized area of practice. The 2014 American Nurses Association's Scope and Standards of Practice: Home Health Nursing – 2nd Edition references several challenges including: working independently, caring for patients of all ages in private homes and facilities, travel in all types of weather, adjusting to new technologies used in the home, responsibility for documentation to meet professional standards, patient outcomes, and reimbursement, all while using point-of-care computer technology. A home care nurse experiences professional and personal benefits that far exceed the challenges. My advice to a nurse who is open to challenges, and new and rewarding experiences is to apply for a home health position where your general, specialized, or advanced practice nursing skills provide the opportunity for you to make a difference for patients and their families.