Home care nursing practice: the new frontier

Home care is an integral part of the health care delivery system. Although home care has been discussed as a less costly alternative to hospital care, it is quite reasonable to consider the home the primary site for the delivery of health care, with the institution the alternative site. Thus, home care nursing, as the new frontier of health care, does and will continue to involve an array of nursing responsibilities from high-technology skills to case management of the chronically ill patient's multiple needs. There are specific areas that need to be addressed in home care, three of which were included in this discussion. These include the changing practice of the home care nurse, the lack of preventive and supportive services, and home care financing. Home care nursing has changed since the first sick poor people were visited in their homes by nurses in 1877. It would behoove nurses to try creative ways to reconstruct Wald's model of home care in today's home care system. Nurses in home care must be actively involved in practice (including care of the sick, chronically ill, and those at risk for potential health problems), continuing education, research, and political action. Home care nursing is more than caring for an individual or family at home; it is being aware of and involved in changing the home care climate for a holistic nursing practice.