Home care nurses play a crucial role in community healthcare. They make house calls, administer medication, offer emotional support, and adapt quickly to different environments — often under challenging conditions. This article gives a glimpse into a day in the life of one such nurse.
“I used to be a staff nurse at Bogoro (Providence) Hospital for 12 years,” she shares. “also worked on wards where patients needed medication at specific times and also assisted in theatre. I left after responding to an ad that read, ‘Whoever has speed and faith, this job is for you.’“
“Home care nursing is very difficult,” she admits. “You’re always on the road, often under the scorching sun. You leave one patient’s home only to return in an hour or two. These patients wake up early they want their food and medicine on time.”
On the Frontlines with Limited Support
At the hospital gate, she met Esther, another dedicated nurse. Esther guided her through a back path, past the cleaners’ toilet, into a white room lined with lockers. Near it, patients waited on wooden benches in a sage-green waiting room.
Esther and her team are responsible for the health of a community of about 150,000 people. “We’ve only been working together for three months,” Esther says. “We don’t have any resources. We open the gate of a home and just pray no one cuts our skin. Nurses deserve better support.”
Every day, home care nurses provide essential care that often goes unnoticed. They work with compassion, skill, and resilience. One patient said, “I’ve got someone who comes in once a week — she’s been with me for years. If she’s not here, it makes the day a lot harder.” Another woman shared, “Every day, home care nurses go about providing salubrious, our very lives, in so many ways.”
Morning Routine: Starting the Day with Purpose
For home care nurses, the day usually begins with a routine that sets the tone for the rest of their shift. For example, Sarah, a home care nurse with a decade of experience, starts her day at 7:00 a.m. She walks into her room and reviews her schedule one of six itineraries outlining visits to patients with a variety of needs, from wound care to chronic condition management.
Sarah’s first visit is to Mr. Thompson, now 88, who recently underwent hip surgery. She rings his bell right on time, and his wife greets her with heartfelt gratitude. Sarah carefully inspects his surgical wound, checks his vitals, administers pain medication, and offers reassuring words. This early morning visit not only addresses Mr. Thompson’s medical needs but also boosts his confidence in the recovery process, laying a strong foundation for his day.
Mid-Morning: Navigating Complex Care Needs
By mid-morning, her schedule slows down only slightly thanks to several required visits to patients who need more care. For example, is the story of Emily, one of Wagner’s home care nurses, who stops by Mrs Rodriguez’s home during her mid-morning. She administers medication, does range-of-motion exercises, and offers emotional support to Mrs Rodriguez, a woman living with advanced multiple sclerosis.
Emily has built a strong bond with Mrs Rodriguez, who enjoys her visits almost as much for company and intellectual stimulation as for her medical care. On this day, Emily sees that her patient is looking even more haggard than usual. She encourages her to vent about any new symptoms or worries. After a careful but empathetic ear, Mrs Rodriguez is glad that her new symptoms are being handled, and Emily has adjusted her care plan. This kind of detailed, personalized care, characteristic of home care nurses, helps to manage patient symptoms.
Lunch Break: Reflecting and Recharging
Lunchtime is one of the only breaks in the routine where they might compare notes with one another on how their morning visits went – adjust their hints for the afternoon – and just take a moment to digest. The break is for lunch but also for emotional replenishment, because home care nurses will experience profoundly intimate and sometimes distressing scenes.
For a home-care nurse providing palliative care, James, lunch can be a chance to process the morning visits with his team, ex Together they offer a closing and emotively, helping stead to do more. ‘The only place it doesn’t work at is picking up.’
Afternoon: Adapting to Changing Needs
Each day has its unique problems and opportunities, and the afternoon often presents particular challenges for nurses such as Rachel, who takes care of individuals with dementia and tries to keep their behavioral symptoms under control, as well as create some sense of normalcy. During her afternoon shift, Rachel checks in on Mr. Wilson, who has late-stage Alzheimer’s disease.
As she enters, she finds Mr. Wilson agitated and confused about his location—an issue that often arises in dementia care. Nevertheless, Rachel remains calm, using gentle language and intuitive redirection to guide him toward a favorite activity: putting together a puzzle. In this moment, we clearly see how patience and creativity serve as essential tools in effective dementia care.
Late Afternoon: Coordinating with Families and Healthcare Providers
And, in the later part of the day, their care for older adults also means coordinating between home-care nurses, families, and other frontline healthcare providers to ensure the best care possible. A lot of this work would involve deliberation, collaboration, and patient communication.
For example, Jessica, the home care nurse who is visiting a patient with diabetes to ensure that he’s keeping his blood sugar levels in the normal range, has spent her mid-afternoon talking with the patient’s family and his primary care physician to update them on recent changes in blood sugar and the latest adjustments in medications. She has also taken the time to educate the patient’s family members about caring for him between their visits and coordinated details of his current condition and issues with the nurse at his doctor’s office. Though the focus of this particular nurse is on delivering patient care, her role includes care coordination and patient education.
Evening: Providing Comfort and Companionship
Many, if not most evening visits are purely palliative, spent with patients opening up or being settled comfortably for the night. For the home care nurse David who visits patients with chronic heart failure, evening visits are key. ‘At night-time, you’ll pick up more symptoms when patients report that they’re wheezing, struggling to breathe, or having chest pain,’ he told me. ‘So I’ll focus on those symptoms and give patients a chance to vent their worries to me.
After making his nightly house call on Mrs Green, David checks for fluid retention and adjusts her medication as needed. He spends a moment or two chatting with her about how her day went, before gently guiding her door shut. Here is a doctor who understands that simply caring for his patients’ medical needs is insufficient – he must also alleviate his elderly patients’ anxiety, and offer them the support of companionship.
Night: Ensuring Safety and Continuity of Care
The end of a shift will involve wrapping up the paperwork and preparing for the next day. Nurses such as Laura who works in a hospice-type situation would commonly spend their evenings ensuring that patients are settled and that all their needs are met for the night.
Laura makes sure that every patient has their medications and is settled in a comfortable position, that care plans have been updated, and that she has communicated with on-call staff on what to expect overnight. In this way, the night shift staff continues the journey that the day shift has begun, guiding the patients through the night so that work, meals, and rest continue uninterrupted – for the patients as if there were no night shift at all.
Each day, they might weigh a man for a feeding-tube formula calculation, amuse a bored visitor, reminisce about shared geographical memories with a patient whose family ran a Florida waterpark, reposition a patient with an unorthodox gait, nurture her new puppy, or visit a man spending his final days alone.
