A Day in the Life: Home Health Care Nurse

Home is where her heart is

By Stephanie Abbajay

The nursing profession has many different specialties. There are pediatric nurses, cardiac nurses, emergency room nurses, nurses in hospitals, doctor’s offices, schools and health departments. One niche, home health care, is where registered nurse Rhonda Dougherty of Jerseyville found her calling.

“I love to spend time with patients,” she said. “That is why I am a home health care nurse. This is my niche.”

Dougherty, 44, has been an RN since 1991. She received a nurse’s degree from Lewis & Clark School of Nursing, and then went to McKendree College for a bachelor’s degree in nursing. While at McKendree she began working in home health care at the Jersey County Health Department in 1994. She’s been there ever since.

Dougherty explained the difference between a hospital nurse and a home health care nurse.

“In home health care, you spend more time with your patients,” she said. “When you are a nurse in a hospital you are trying to get them well enough to send home. When you are a home health care nurse you do a lot of teaching, because the goal is to make the patient and or the family more independent. We want to see them graduate to being able to care of themselves.”

In order to avail oneself of home health care, a patient must be referred by a doctor or a hospital and must be homebound.

“That means you can go to a doctor but otherwise you are unable to leave your home without a ‘considerable and taxing effort,’ according to Medicare rules,” Dougherty explained.

Dougherty is one of four full time home health care nurses at JCHD. The mornings are spent visiting patients and the afternoons are spent scheduling the next day’s visits, writing reports, conversing with doctors and doing paperwork. Dougherty’s patients run the gamut.

“We do rehab after a patient has had a fracture or joint replacement. We do dressing changes after wounds or surgeries or accidents. We do diabetic care, stroke care, etc. We see everything,” she said.

The biggest part of the job is training and education.

“Our service is basically follow-up,” she said. “They’ll come home from the hospital but still need a little more time and a little more help. It can be very overwhelming for them, so we help them adjust to their home. We train them and their family on proper care and, when they are ready, we release them.”

Dougherty makes five patient visits a day. Each visit begins with a complete head-to-toe nursing assessment.

“A normal visit takes 30 to 45 minutes,” she said. “But I may have to start or change an IV, draw blood for lab work, change dressings, measure swelling, whatever that patient needs. It’s always different.”

There are challenges, too. Unlike in an office or a hospital, a home health care nurse is on the patient’s home turf.

“You can’t just run in and tell them you have to change all these things. You have to show them how it will make their life better, you have to teach them,” she said. “You must be patient and flexible. That’s part of the challenge, to educate them and see the changes happen.”

And that is what Dougherty loves so much about her profession.

“I love all my patients and it is very rewarding to see them progress,” she said. “You get to help them reach their goal of getting better.”

Dougherty said she is always pleased to see her once homebound patients out and about.

“When we are getting ready to discharge them I tell them they are graduating,” she said. “If I run into them at the grocery store that makes me very happy. I think, ‘I helped care for them.’ That makes me feel good.”

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For Telegraph photographer: Rhonda may be reached at 498-9565