I often hear home care clinicians and managers say how difficult it is to recruit the right people to home care. However, how many of you as home care clinicians have mentored students? Does the leadership at your agency encourage and value students of all disciplines? If we don’t welcome students to home care, how will they know about this unique practice area and what it has to offer? I initially graduated from a hospital school of nursing. I didn’t receive training in community healthcare, so it wasn’t until I returned to school to obtain a bachelor of science in nursing that I was introduced to home care. That was a fortunate turn of events as it opened up a whole new world to me beyond the hospital setting (which is where I thought all healthcare took place).
Because of the difficulty obtaining clinical placement sites in home care, schools of nursing are increasingly turning to simulated home visits (Smith and Barry, 2013; Molloy et al., 2018). A room in the school is decorated with furnishings to resemble the home of an older adult or a post-partum woman and child. Typically, the room is set up in a way that encourages students to note issues with medication reconciliation, inadequate nutrition, tripping hazards and other safety problems. These experiences would be valuable in preparing students to make real home visits. Unfortunately, they are more often the only “home care” experience students will receive. I recognize there are formidable barriers – electronic medical records for one. While it is ideal for students to make independent visits, they can also learn a lot from shared visits. In that way, they won’t need training and access to the electronic medical record, and you can role model exceptional care. I urge each and every one of you to make the effort to welcome students to your home healthcare agency – share your knowledge, expertise and passion. The clinician you mentor might become your home care providers someday.
September is back to school month for young children as well, and a time to think about a rather unpleasant subject – that of head lice. The article by Webber and McConnell in this issue is an excellent guide for anyone in contact with children, as that is where the tiny terrorists tend to reside. While home healthcare clinicians would not be making a visit specifically for head lice, it is very possible that someone in the home other than the patient you are seeing will be infected. When one person in the home has head lice, the entire household and those who visit it are affected. This article dispels myths about head lice and brings you the latest evidence based actions to recommend.
Another very important topic this month – that of human trafficking. There has been a national effort to make healthcare providers aware of the scope of this heinous crime. It is known that almost 90% of the estimated 300,000 trafficked individuals come in contact with healthcare providers at some point during their time in captivity. The problem is, we don’t know how to recognize them as victims of human trafficking. Even the victims may not have an understanding of what happened to them and may not identify themselves as victims. Trafficked individuals often come from troubled backgrounds, have psychiatric or developmental issues and may feel they did something to deserve the treatment they are receiving. If they are undocumented immigrants, they may fear any contact with law enforcement. Home healthcare providers are well positioned to be the eyes and ears of the community. This article by Wyatt and Sinutko will increase your awareness of human trafficking, and help you recognize the subtle signs that suggest a person is being victimized. The authors provide actions to take while maintaining personal safety.
Finally, I draw your attention to an issue that needs to be addressed – that of hidden cameras in the home and implications for patients and home healthcare providers. Dr. Danielle Pierotti discusses this important topic in VNAA’s Voice. Have you personally encountered cameras in patients’ homes? Does your agency have a policy? Is this being discussed at your agency? Tell us your experiences with cameras in the home.
Molloy, M., Cary, M., Brennan-Cook, J., Cantey, D., Tocchi, C., Bailey, D., & Oermann, M. (2018 in press). Preparing Clinicians for Transitioning Patients across Care Settings and into the Home through Simulation. Home Healthcare Now, 36 (4).
Smith, S. & Barry, D. (2013). An innovative approach to preparing nursing students to care for the elderly in the home. Geriatric Nursing, 34, 30-34.