Forming the largest proportion of healthcare workers, nurses are much like the cogs that help our healthcare system run smoothly. While much has changed since the time of Florence Nightingale, who is often regarded as the pioneer of modern nursing, the core duty of nurses has remained the same – patient-centric care.
Today, the term “nursing” encompasses a vast spectrum of career specialities, spread across a wide range of institutions. Despite the diversity, one element remains constant: the passion to care. No matter where you are in your nursing career – fresh out of school, considering moving into home care, or even contemplating a mid-career switch into nursing – you can be sure that it will be a meaningful and fulfilling one.
To briefly unpack the complex career options available for nurses, we will focus on three different environments you might want to explore in your nursing career: Hospitals, Nursing Homes, and Home Care. How will your experiences differ across these three settings?
Unsurprisingly, one of the key differences between working in the hospital, a patient’s residence, or in a nursing home is the working environment.
Pace: Hospitals are generally described as fast-paced, and nurses have to assist with attending to emergency care situations like administering CPR. This fast-paced environment is expected due to the high inflow of patients daily, each with different needs. The wide variance in patient needs in hospitals allow the nurses here to become familiar with a greater range of cases.
People you work with: Hospital-based nurses will naturally curate a network that includes doctors, other nurses, occupational therapists, and medical students. In fact, if you have chosen to specialise in one of the many fields of study in a hospital, you will also work closely with specialists and other staff in this specialisation.
Pace: Nursing homes are slower-paced, and nurses here tend to be able to give each resident more focused and holistic attention, especially since the patients tend to stay in a nursing home for a longer period of time, as compared to hospitals.
People you work with: Nursing homes are more community-based, allowing the nurses here to work with social workers and activity coordinators in addition to healthcare professionals. Not only does this expand your network outside of healthcare, but it also gives you a better understanding of a patient’s needs beyond medical aid.
Pace: Home care nurses’ schedules are pegged to their patients, which means the pace would vary depending on the assignment you take up. Assignments are also segmented into long-hour (up to 12 hours) or short-hour (from 1 hour onwards) cases. For short-hour visits, you can expect to have a relatively faster pace of work as you will be shuttling from one residence to another within a day. Long-hour visits tend to be for overnight care duties, where you can expect a slower pace of work as your patients would be asleep for a large part of it.
⏰ Flexible work schedules, better work-life balance
People you work with: Similar to nursing homes, home care nurses can also expect to work with social workers and other healthcare professionals. However, you can also expect to work independently, which may be a perk as you do not have to manage any workplace politics and can focus on providing the best care to your patients. On top of working with your patients, it is also important to build good relationships with the family or primary caregiver or the patients you care for, such that they can trust to leave their family member under your care.
In general, nurses in all hospitals, nursing homes, and home care have similar roles. They all assist in clinical care, including the monitoring of vital signs, helping patients with activities of daily living, and work tightly with other care staff like doctors and fellow nurses to ensure the well-being of their patients.
That said, there are several differences in job scope due to the nature of the working environment.
Hospital nurses will be trained to perform emergency interventions, like administering CPR. They will also be tasked to prepare trolleys and equipment for ward-based procedures, bedside care, and perform front-counter and administrative duties.
Nursing home nurses are expected to ensure that their patients receive all the support needed throughout the day. In general, your role would expand into the sphere of social work, which includes conducting financial counselling for existing and potential clients, and ensuring the holistic care of your patients. Administrative tasks in these settings include putting together reports for audits and following residential guidelines to ensure patients’ safety.
As a home care nurse, you can expect to conduct many common home nursing procedures such as NGT feeding, stoma bag drainage/change, injections, wound care, administering IV drips, and more.
Similar to a nursing home nurse, a home care nurse has a more holistic scope than a hospital nurse’s; your role can intersect that of a social worker as you work with your patient’s community to ensure the best care plan. You will travel to your patients’ homes and help administer their medication, monitor their vitals, and understand the concerns of their family members. You may also be expected to compile patient reports for the patient’s physician or primary caregiver. The job scope for home care nurses will vary depending on the needs of each patient, but that will give you exposure to a variety of various work, as well as interpersonal skills that are very valuable in any job.
Types of patients
What kind of patients will you be working with?
If you are someone who enjoys great variety on a daily basis, the hospital can be a great option, solely based on the sheer number of individuals who come in each day, all with different conditions and of diverse demographics. That said, hospital nurses spend the least amount of time on each patient, compared to nursing home and home care nurses. Patients admitted to a hospital would tend to have high care needs and require 24-hour surveillance and monitoring.
In contrast, nursing home residents are typically seniors. These seniors may also have higher care needs as compared to patients in home care. Many of these individuals only have a small support group of family and friends – so your relationships with them can make a huge difference in their quality of life. Similar to bedside and ward care in a hospital, you may be expected to care for a few patients at one go, but your relationships with your patients should be less transient as compared to working in a hospital as nursing home patients tend to stay there for a longer period of time.
One of the many benefits of being a home care nurse is that patients are typically more comfortable at home and can be more receptive to you. Home care nurses also tend to be assigned to look after a particular patient on a regular basis. This way, you will be able to develop tighter bonds with your patients as you are able to provide more personalised, one-on-one care at your patients’ residence. Patients in home care can also be very varied, such as those with disabilities and need support with activities of daily living, but a large majority of home care patients would be the elderly.
Additionally, more often than not, apart from the required nursing procedures, home care patients also need companionship, as they are often at home alone without much interaction with others. Spending time and chatting with them is something that home care patients value immensely.
Both nursing home and home care nurses will likely develop more holistic and in-depth competencies for specific cases or conditions as well. Such skill sets can only be developed through long-term exposure to a handful of patients.
Unsure of which care setting is best for you as a nurse?
With so many factors to consider – which care setting will be best for you as a nurse? That really depends on your preferences. While many often think that working in a hospital comes with its own prestige, the pandemic has laid bare how stretched hospital nurses are, especially in times of crisis. The fast life is not for everyone, but thankfully, there are always alternatives.
If you are unsure of which care setting is best for you, being a Homage Nurse will give you exposure to caregiving across a variety of settings including private homes, day care centres, nursing homes and hospitals. What’s more, stand to work flexible hours and earn rewarding hourly rates as well.
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