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Top challenges in home health nursing

Home health care comes in all shapes and sizes, from a quick doctor visit to long-term care by a registered nurse. But this valuable field isn’t without its challenges.

To continue meeting patient outcomes in an increasingly complex health system, health care experts — especially nurses — need to be equipped for just about anything.

But what are the biggest challenges in home health care nursing — and what are the solutions, tactics or best practices that can overcome them? Let’s take a closer look at how quality care comes to life for today’s patients.

The ongoing value of home health care

In 2020 alone, 3 million people received and ended home care services.1 While the pandemic certainly didn’t invent this field, it brought attention to the value, reach and scale of health at home. Unfortunately, it also introduced new concerns and intensified existing ones.2

It’s no surprise that post-pandemic home care is more complicated than ever — but it’s also increasingly critical.

For example, home health patients may be older, sicker and more economically vulnerable than other populations — and they’re more likely to have a higher number of chronic conditions, too.3 Worse yet, with national healthcare spending reaching $4.5 trillion in 2022, patients are increasingly driven to delay or skip treatment.4,5 This can potentially lead to more serious ailments down the road.

Fortunately, home care is often equipped to address these unique market pressures. Home health care frequently has positive impacts on medication adherence, quality of life and patient satisfaction.6 There are also substantial cost savings — a key benefit in this economic landscape.

But it’s not just patients who see the value. With employment in the sector growing steadily and opportunities opening much faster than average, it seems providers have also recognized the mounting importance of this field.7,8

Types of home health care

Home-based care is often divided into two categories: skilled and personal.9 This is a reflection of the medical complexity of the job — not the objective “skill” of the providers.

  • Skilled care includes wound care, injections, monitoring, caregiver education and more.
  • Personal care covers assistance with daily tasks such as bathing, dressing, walking, shopping and housekeeping.

Roles in home health care

All kinds of professionals may be involved in a home care plan. These can include:

  • Primary physicians, who make recommendations and help set expectations.
  • Therapists, including speech and occupational therapists, who help patients regain everyday functionality.
  • Medical social workers, who help coordinate home care services.
  • Home health aides, who focus on supporting basic personal needs.

However, most home health care is generally provided by nurses — including registered nurses, licensed vocational nurses, nurse assistants and more.

3 challenges in home health care

In one survey,10 different providers agreed that quality home health care requires four things:

  • Competent teams.
  • Communication, information flow and collaboration.
  • Care continuity and organization.
  • Resources.

Naturally, shortcomings in these areas can have serious consequences for care delivery and quality. But what do these challenges look like from a nurse’s perspective? Let’s take a look:

#1 Nurse shortages

When asked why they joined the profession, nurses overwhelmingly responded that their top motivation was helping others. Although 60% still love the job, 62% are concerned about the future of their field.11 On top of that, 91% believe the nursing shortage is getting worse, likely due to burnout, poor working conditions and inadequate pay.

Unfortunately, research supports these concerns.12 Nursing school enrollment isn’t growing fast enough to meet a fast-growing demand, and the schools themselves have limited resources and capacity. That’s on top of a host of concerns in the existing workforce, including:

  • Increased stress levels related to insufficient staffing.
  • Significant portions of the nursing workforce reaching retirement age.
  • Lingering pandemic-related frustrations and issues.

#2 Job dissatisfaction

Although long work hours, highly stressful environments and emotionally difficult situations have always been a concern in nursing, these issues are only getting worse. That’s because new problems have risen to complicate matters.

For example, with nursing schools already struggling to meet increased demands, there’s limited opportunity to advance in this field. That means a nurse may feel “trapped” in one type or level of medical care — and this can lead to worries about compensation and future career prospects.

There are also ongoing concerns about internal teams. Staff shortages leave nurses feeling overworked and undersupported — and that’s a significant source of stress in any industry, let alone one where patient care and public health can suffer directly. Plus, a lack of skilled nursing mentors can make new health care providers feel uncertain, particularly in more complicated or isolated environment like home care.

On top of all that, the factors influencing job dissatisfaction differ across populations,13 with minorities intending to leave the profession more frequently. That means there’s no single nursing experience that can act as a model for improvements or solutions.

#3 Patient preferences, expectations and concerns

From vaccine hesitancy to growing health care debts, patients have more concerns than ever — which means nurses have more concerns than ever.14,15 This can lead to a variety of challenges in home health care, including:

  • Health inequities.
  • Communication challenges.
  • Resource allocation.
  • Legal and ethical concerns.

These problems can point to underlying weaknesses in the health system, including a lack of public education and trust. The issue is that nurses aren’t equipped to face these large-scale issues and can only deal with their consequences.

FAQs about home health care challenges

A home care nurse may face all of these challenges in a single workday. So, what’s the outlook for home care nursing and how can the future be improved? Here are a few FAQs that help address these topics:


Are there other challenges?

We’ve focused on broad industry challenges so far, but there’s no way to cover every single home health care challenge. Other common issues include:

  • Funding shortages.
  • Technology integration.
  • Regulatory compliance.
  • Safety and security.

That’s on top of unique challenges that arise for each individual patient, environment and scenario.


Do all providers face these challenges?

Although we explore the above issues from a home care perspective, it’s safe to say that these stories are familiar to nearly everyone who works with patients — from a family nurse practitioner to a brain surgeon. While each expert may have a unique experience and perspective, the reality is that health care is inherently complicated, particularly in the wake of a global pandemic. Fortunately, this also means that providers from different fields can work together to overcome challenges and communicate more clearly with patients.


Are there any simple solutions?

For example, nurses interested in ongoing education could try online learning until there’s more capacity at nursing schools. This can help build vital skills for a complicated work environment and even support career advancement.

Similarly, there are plenty of equipment solutions that help improve access, availability and organization. That doesn’t just support resource allocation; it also eliminates stressors like uncertainty and wasted time, which can be exacerbated by staff shortages.


How can nurses prepare for the future of home health care?

Challenges like these will continue to evolve, but nursing care can do the same. Here are a few ways to prepare for the future:

  • Prioritize self-care: Nurses and other health care workers should focus on physical, mental and emotional well-being both personally and professionally.
  • Learn about patients: It’s important to be aware of cultural backgrounds to provide sensitive, effective care.
  • Identify problem areas: Whether independently or with a team or mentor, nurses can identify areas for improvement, including adaptability, communication, collaboration and more.
  • Research trends: Health care trends help experts know what to think about and prepare for.

Better home health care with a click

Home health care nursing is an increasingly important part of our world, but it’s not without its challenges. From staff shortages to tricky patient preferences, there’s always something new to consider.

Fortunately, nurses don’t have to tackle these issues alone. McKesson solutions address nursing needs and the underlying problems — for example, SupplyManager, which supports everything from online supply ordering to customized reporting.

Make home health care easier with just a few clicks. Log into SupplyManager or learn about setting up a new account today.