What Is A Home Health Nurse?

Are you interested in a career where your compassion and expertise can truly change lives? As a home health nurse, you’ll have the chance to work one-on-one with patients in their own homes. This kind of setting allows for deeper connections and more personal experience than a hospital or medical office. Additionally, home health nurses often enjoy more independence, greater autonomy, and the flexibility to choose their own schedules. While many in-home nurses are registered nurses (RNs), licensed vocational nurses (LVNs), and nursing assistants can also work in patients’ homes. 

Keep reading to learn more about home health nurse jobs, including what the role involves, the education and credentials you’ll need, and what to expect in terms of salary and job outlook.

Registered nurses (RNs) working in home settings carry out a wide range of responsibilities that require medical expertise, sound clinical judgment, and a heart for helping others. Their duties extend beyond those of vocational nurses or nursing assistants, who typically focus on more routine, non-medical care. On an average day, an RN in a home setting might handle tasks such as: 

• Assessing each patient's needs and working closely with physicians to create a personalized care plan.

• Helping patients with daily activities like bathing, grooming, mobility, and eating.

• Monitoring patient symptoms and noting changes in the patient’s condition, including shifts in their appetite, mobility, mood, and cognitive function. 

• Administering medication and keeping detailed records about side effects and any changes in medication dosage or timing.

• Drawing blood for lab testing and collecting other specimens as ordered by the physician.

• Providing wound care, including cleaning, dressing, and monitoring wounds for signs of infection.

• Regularly communicating with other medical professionals to ensure everyone is on the same page regarding the patient’s care. 

• Performing physical assessments in the patient’s home to identify new or evolving medical conditions.

• Teaching patients and their caregivers how to manage medications, follow treatment plans, and handle symptoms.

• Making sure all care follows clinical standards and is documented clearly and correctly.

• Using electronic health records (EHR) systems or other software to record and assess clinical data. 

• Offering emotional support and guidance to patients and families during challenging times.

Also called licensed practical nurses, licensed vocational nurses (LVNs) work under the direction of a registered nurse or physician to provide hands-on assistance to patients. While RNs handle clinical decision-making and complex medical tasks, LPNs focus on providing practical, patient-centered care that supports healing and improves the patient’s quality of life. On a typical workday, an LVN may be responsible for the following tasks:

• Taking and recording vital signs, including blood pressure, temperature, and heart rate.

• Administering medications according to the care plan.

• Monitoring the patient’s status and reporting changes or concerns to the supervising RN. 

• Assisting with bathing, dressing, eating, and other activities of daily living (ADL).

• Helping patients with basic mobility exercises or physical therapy activities.

• Educating patients and caregivers about medication and basic care routines.

• Maintaining detailed, accurate records of patient conditions, symptoms, and recovery. 

• Working in partnership with RNs, nursing assistants, physicians, and specialists to ensure continuity of care.

• Providing emotional support and companionship to patients.

Nurse assistants are a crucial part of the care team, providing support that enhances the comfort, safety, and well-being of their patients. While the term "nurse assistant" is often used interchangeably with “CNA” or “personal health aide,” these roles differ in terms of educational requirements and job responsibilities. Certified nursing assistants complete state-approved training programs and pass a certification exam, which allows them to perform more advanced care services than noncertified assistants. Regardless of their title, nurse assistants play an essential role in maintaining patients’ well-being, independence, and dignity. Some typical responsibilities involved in a nurse assistant role include:

• Helping patients with eating, bathing, dressing, and toileting.

• Taking and recording patients’ vital signs.

• Changing bed linens and keeping the patient's home free of clutter. 

• Assisting with light house chores, such as cooking and cleaning up after meals.

• Running errands for patients, such as grocery shopping or picking up their medication from the pharmacy.

• Transporting patients to medical appointments.

• Monitoring patients for changes in physical or cognitive well-being. 

• Documenting patient activities, symptoms, medication adherence, and other important data.

If you’re interested in a home healthcare career, you have many different options to explore. Several different nursing positions offer the opportunity to work directly with patients in their homes, providing the care, companionship, and assistance they need to stay safe and comfortable. Many home health professionals start in entry-level roles, working as home health aides or nursing assistants, before advancing their education to become licensed vocational nurses or registered nurses. However, the path you take will depend on your career aspirations, skills, and personal circumstances. 

The first step toward a career in home-based nursing is meeting the appropriate educational requirements, which can vary depending on the state and the role you want to pursue. Most unlicensed nursing assistant positions only require a high school diploma and, depending on the employer, first aid and CPR training. For a certified nursing assistant role, you must complete a state-approved CNA training program and pass a competency exam. To become a licensed vocational nurse (LVN) or licensed practical nurse (LPN), you’ll need to complete a diploma or certificate program approved by your state’s nursing board. After completing your training, you must pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN) to gain licensure and begin practicing as an in-home LVN.

If you’re seeking a role with greater responsibility and higher pay, you may want to become a registered nurse (RN). Since this role comes with more authority and autonomy, it also has more rigorous educational requirements. To become an RN, you’ll need to finish a state-approved nursing program and pass the NCLEX-RN exam. Traditionally, a bachelor’s degree has not been required for an RN position. However, employers’ expectations are changing. The Bureau of Labor Statistics (BLS) reports that in 2024, 48% of registered nurses were required to have a bachelor’s degree. Earning a bachelor’s can unlock greater job opportunities, help you stand out from the competition, and prepare you for leadership roles with higher salaries. Many RNs enroll in RN-to-BSN programs to earn their bachelor’s degree. These programs are specifically designed to build upon existing nursing experience to enhance clinical decision-making, medical knowledge, and leadership skills. 

If you want to qualify for higher-level nursing roles, you can further your education by earning a Master of Science in Nursing (MSN). This advanced degree is often required to become a clinical nurse specialist or an advanced practice registered nurse (APRN). An MSN also opens doors to specialty areas such as mental health, public health, and acute care.

As a home nursing professional, you will provide tailored, one-on-one care services to patients with a variety of medical and personal needs. These individuals may be elderly, chronically or critically ill, living with a disability, or recovering from surgery or other medical procedures. Home-based nurses may also support expectant mothers and new parents by providing ongoing care, guidance, and education.

There are three primary levels of home nursing roles, each with different credentials and job expectations: registered nurses (RNs), licensed vocational nurses (LVNs), and nursing assistants. Professionals in these roles typically report to a coordinating facility at the start of their shift to receive their assignments, then travel to patients’ homes to provide care and support. However, in-home nurse job descriptions can vary dramatically based on the employer, the nurse’s credentials, the patient's needs, and the employer. Home nurses can work for a variety of organizations, including home health organizations, hospice facilities, hospitals, medical centers, nursing homes, and retirement communities.

Starting your career in healthcare often begins with entry-level roles like a nursing assistant, which typically require only a high school diploma and some on-the-job training. This provides a great opportunity to gain hands-on experience early in your career, either before or while you pursue a degree and licensure.

If you're aiming for more advanced positions, you'll need to meet specific educational requirements and acquire several years of practical experience. Real-world experience not only strengthens your résumé and opens doors to new opportunities but also boosts your confidence and expands your skill set. While classroom learning lays the foundation, true growth happens when you apply what you’ve learned to real-life situations.If you’re seeking a role with greater responsibility and higher pay, you may want to become a registered nurse (RN). Since this role comes with more authority and autonomy, it also has more rigorous educational requirements. To become an RN, you’ll need to finish a state-approved nursing program and pass the NCLEX-RN exam. Traditionally, a bachelor’s degree has not been required for an RN position. However, employers’ expectations are changing. The Bureau of Labor Statistics (BLS) reports that in 2024, 48% of registered nurses were required to have a bachelor’s degree. Earning a bachelor’s can unlock greater job opportunities, help you stand out from the competition, and prepare you for leadership roles with higher salaries. Many RNs enroll in RN-to-BSN programs to earn their bachelor’s degree. These programs are specifically designed to build upon existing nursing experience to enhance clinical decision-making, medical knowledge, and leadership skills. 

If you want to qualify for higher-level nursing roles, you can further your education by earning a Master of Science in Nursing (MSN). This advanced degree is often required to become a clinical nurse specialist or an advanced practice registered nurse (APRN). An MSN also opens doors to specialty areas such as mental health, public health, and acute care.

Caring for patients at home presents unique challenges compared to working in hospitals or other medical facilities. In clinical settings, nurses have immediate access to resources, equipment, peer support, and medical assistance. In home settings, nurses often operate independently. They must rely on their own clinical judgment to navigate complex or sensitive situations. To successfully care for patients in a home environment, home health professionals need a mix of medical expertise and soft skills, including: 

• Medical knowledge. While in-home nurses and CNAs aren’t expected to diagnose or treat medical conditions, they must have enough clinical and medical knowledge to carry out detailed treatment plans and respond appropriately to emergencies. They must be able to use equipment such as blood pressure monitors, feeding pumps, glucose monitors, and oxygen tanks.

• Regulatory knowledge and compliance. In-home nurses need a comprehensive understanding of laws, regulations, and ethical standards, such as HIPAA guidelines, State Nurse Practice Acts, OSHA regulations, and the ANA Code of Ethics. They must prioritize patient confidentiality and safety in every aspect of their job.

• Observational awareness. Home care nurses often interact with patients much more frequently than the patients’ doctors. This means that nurses must remain vigilant for subtle signs of new or worsening conditions. For example, a small patch of redness on a patient’s back might seem minor, but this could be a sign of a painful and potentially dangerous bed sore. If unnoticed, it could escalate quickly and become infected. 

• Integrity. Patients and their families place enormous trust in home-based care providers. These professionals frequently assist patients with deeply personal and potentially embarrassing tasks such as bathing and toileting. During sensitive moments like these, in-home professionals must consistently demonstrate respect, compassion, discretion, and professionalism. 

• Physical stamina. Caring for adults in their homes often involves physically demanding tasks, such as transferring patients from their beds to wheelchairs, moving equipment, or standing for extended periods. 

• Interpersonal skills. Patients often experience significant pain or emotional distress, so home care professionals must rely on genuine compassion and clear communication to understand their needs and provide assistance. An effective home health nurse builds strong relationships with patients and their families through exceptional interpersonal communication skills.

• Attention to detail. Precision and accuracy are essential for home care nurses. Something as simple as misunderstanding medication instructions could have disastrous consequences. For example, if a nurse accidentally gives a patient 10 mL of morphine instead of the prescribed dose of 1.0 mL of morphine, the mistake could be fatal.  

• Communication. In-home nurses must communicate clearly and effectively with supervisors, case managers, clinicians, patients, and families. This involves conveying crucial insights about a patient’s condition, explaining complex medical concepts, and sharing updates in a clear, comprehensible manner.

• Reporting and documentation. Home health nurses maintain detailed records of patient interactions, daily activities, medication administration, wound care, healing progress, and incidents such as falls or injuries. They need excellent organizational skills and written communication abilities to accurately record this information and share it with the appropriate individuals. 

• Empathy. Nurses and nurse assistants must be able to understand their patients’ fears, hopes, anxieties, and perspectives to provide compassionate care. Through active listening, patience, and authentic kindness, home care nurses help patients feel respected and heard.

Salaries for home health care workers vary widely depending on the specific role, employer, and other factors. According to the BLS, the median annual salary for nursing assistants is $39,430. Nursing assistants working in home healthcare settings earn a median annual salary of $36,910 as of May 2024. The median annual salary for licensed practical and vocational nurses is $62,340. LVNs and LPNs in home health care services earn a median salary of $61,300. The median annual salary for registered nurses is $93,600, with the highest 10% of earners making upwards of $135,000 a year. 

The job outlook for nurses and nursing assistants is favorable. According to the BLS, the employment of home health and personal care aides is projected to increase by 21% from 2023 to 2033. During the same period, the employment of registered nurses is projected to increase by 6%. The demand for in-home medical services is rapidly increasing due to several significant trends. Financial pressures prompt hospitals to discharge patients earlier, creating a greater need for follow-up care in residential settings. Additionally, many older adults prefer to remain in their own homes rather than move to assisted living communities, meaning they require care at home. Receiving medical support at home is often more affordable than institutional care options, making it an attractive alternative for  patients and families.

Whether you’re just starting a nursing career or you’ve already passed the NCLEX exam and become a registered nurse, WGU has nursing degree programs that can enhance your skills and expand your career opportunities. Our B.S. in Nursing (Prelicensure) program includes online coursework that you can complete on your schedule, as well as in-person clinical rotations and learning lab experiences that allow you to apply your skills to real-world scenarios. Our B.S. in Nursing (RN to BSN) program is designed for current RNs who want to earn their bachelor’s degree. This program builds on your existing nursing experience to help you develop skills in clinical leadership, care coordination, research, communication, and clinical reasoning. If you want to enhance your career prospects even further, we also offer several nursing master’s degrees. Take the next step toward a rewarding career by applying today!