Home Health Nurses visit patients in their homes. There are many uncontrollable factors in a patient's home that can give rise to challenges home health nurses must overcome.

Physical Condition of the Home

A Home Health Nurse visits a patient in their home and has little control over the physical condition of a home. Home Health Nurses assist a variety of patients, including those who are struggling to care for themselves, lack a support system, or have no access to resources. Navigating an unkempt home isn't unusual for this type of nurse. Home Health Nurses must literally meet patients where they are at.

The layout or structure of the home can present challenges as well. Some patients with mobility issues may not have the appropriate safety equipment installed. For example, their bathroom may not be able to physically fit a wheelchair. This can be a safety risk, as improper transfer techniques may be used and result in injury to the staff and/or the patient. It is the responsibility of the Home Health Nurse to identify safety concerns and report to the appropriate agency as needed.

Sharps and Needle Stick Injury

Many patients require home injections or IV infusion. Depending on the home, some patients do not have access to a sharps container where needles can be easily and safely disposed of. To ensure a proper disposal, the nurse may have to administer a medication and then walk a distance to dispose of the needle in another room. He or she may not even have disposal access at all, causing them to recap the needle, which results in most needle stick injuries.


Confused or angry patients can become agitated with a stranger in their home and become physically violent. This is especially true for patients with dementia-related diseases such as Alzheimer's. The risk increases if the nurse must perform a procedure that will cause pain such as wound care, injections or lab draws. Unlike a hospital or healthcare setting, a Home Health Nurse does not have access to additional staff for assistance in case a patient confrontation escalates. Home Health Nurses must be diligent to check their safety and surroundings, remain calm, and report any suspicious activity or safety concerns when appropriate.

Amanda Bucceri Androus, RN, BSN
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