Latest / Home Health Revealed (+Palliative and Hospice) / Heart on the Doorstep: How an Ohio Community College, Local Home Health Agency, and Ride-Alongs Are Growing the Home Health Workforce

Transcript

Heart on the Doorstep: How an Ohio Community College, Local Home Health Agency, and Ride-Alongs Are Growing the Home Health Workforce · Home Health Revealed (+Palliative and Hospice)

• 0:02
  Speaker A: Welcome to Home Health Revealed, where we share real stories from industry leaders about home health, palliative and hospice care brought to you by Velocity. Velocity's easy to read coding and revenue cycle dashboards let you grab your cup of coffee and quickly see the health of your organization. Welcome back to Home Health Reveal, the podcast that brings you the real world of home health and hospice care. And I am your host, Hannah Vail. Today's episode is a little bit different and a little more personal. Recently I had the opportunity to head into the field alongside home health nurses here in Northeast Ohio. And it's one thing to talk about what happens in the home, but it's something else entirely to see it. To sit in that patient's living room, to watch the care unfold and to really feel the connection that happens there. And I wasn't the only one who got to go. Joining me today are incredible representatives from Lorine County Community College College who also participated in these ride alongs. Plus we are joined by Chris Hirschler, Dean of the Health and Wellness Science Division at Lorian County Community College, and Lisa Von Lemden from the Ohio Council for Home Care. So they are going to talk with us about why being in the home matters so much, both for patients and for clinicians. So thank you all for being here. It is going to be a great conversation. So let's start at the beginning. So before you ever stepped foot into a patient's home, and I'm just going to add to give some context, it was snowy that day. People's doors were shut, it snowed in and so we got out there early in the morning and it was quite the day. But what were your expectations? What did you imagine home health looked like before you got out in the field? Hannah, let's start with you.
• 1:57
  Speaker B: So my name is Hannah DiVincenzo and I'm a program developer at Lorain County Community College. And I was very, very excited to be able to participate in ride alongs with Nurse Mary. My expectations. I feel very fortunate. I had a little more experience in this world just because I have been an EMT basic and no longer am doing that, but I had a better understanding of what it's like to provide care in people's homes. So one of the things that I thought through before going into this environment and learning from Nurse Mary is kind of what it would be like to be a home care nurse. So some of the things that I learned about at the very beginning in setting expectations, especially things that I didn't know were along the lines of scheduling, providing care, basically having to have tools, you know, in their car. So my expectations were around what it would be like for being in people's homes. Those that turned out to be what I thought it would be. But also my expectations were definitely exceeded by the level of care that Nurse Mary was able to offer and really what that one on one relationship was when providing care in the home.
• 3:18
  Speaker C: So my name is Abby Farvaugh. I am a career and academic advisement professional at Lorant County Community College. And my expectations. Before stepping into a patient's home, I was briefed in advance of some general head things to dress more casually, that the patients would have caregivers probably with them in the home. And so I was under the impression that it would be pretty casual and maybe even a little relaxed because they're in their own home environment. So, so the patients are more comfortable. And I imagined home health to look comparable to nursing home as that's my only other kind of health care for patients outside of a hospital setting that I'm familiar with. So I thought it would be a little bit more interpersonal again because it would be in the patient's home, but was not in any way prepared good and bad for the experiences that I did have stepping into the patient's actual home, so. Or actual homes. So that was really eye opening to have that idea and then see what the reality was.
• 4:30
  Speaker D: I'm Cindy Kushner. I serve as the director of school workforce and community partnerships here at the college. And my perspective was maybe a little different because I have been an in home patient before and I have had healthcare provided to me in home over some medical surgeries, things like that. So I knew what to. I thought I knew what to expect because of that, but it was really different coming at it from the perspective of coming in with. I had Nurse Octavia. She was amazing. She is amazing. And coming in from her perspective and seeing the tools and support she has from the organization that she works with and how she really was welcomed in as, as part of the family when we would go into the different homes that we went into. Yet the way she fluidly moved between different roles like, all right, I'm family member now. I'm glad to see you, haven't seen you since last week. To becoming that educator and then flowing right into giving the care and such, it was just truly amazing and so grateful to have been able to be a part of the experience.
• 5:51
  Speaker E: Chris Hirschler, Dean of Health and Wellness Sciences I did not do a ride along, but I did speak with Nurse Laurie and learned about the logistics and the motivations. She's really interested in giving back to the profession and making sure that people are sort of welcomed into this line of the profession. I also have experience. My grandmother was an LPN who did home care for decades. And recently, several months ago, I visited my aunt in Virginia and she was cared for by her daughters who had, you know, sort of suspended their lives, their personal lives to care for her. But also they had a home health care nurse come and we, you know, to Cindy's point about the family, we, you know, she did feel like part of the family and we took her out to dinner. When I was there, my aunt had not been out in months, but she was motivated to go out to dinner with us. So it's a very different feeling. I think, when you're a home health nurse.
• 6:48
  Speaker A: These are such great perspectives. I remember thinking the same thing, how different it might be from what we imagine nursing especially to look like in a hospital or a doctor's office. From my perspective, I usually see what we at Health Rev affectionately call a paper patient, where we review the documentation, we bill the claims, so we see what is built on the back end side of the office, but definitely not the same as experiencing the in home visit. Getting to be there. It just really brings a reality to it. But now that you've done it, how did the experience match or maybe challenge, I want to use the word challenge, your expectations of what home health nursing is.
• 7:35
  Speaker E: So Nurse Laurie spoke a bit about sort of the flexibility that's involved and also the experience and how she's able to sort of create a schedule and also geographically how to design her visits. And just I think the flexibility that came with this particular role I thought was interesting. And then again, just the connection she talked about the connection with patients, but also mentoring students. So I was very, very interested in the logistics of, you know, how many patients, how much time, how much charting. And that was. That was pretty interesting. And knowing that you could see, let's say six, you know, four to six patients and then later chart. And so that provided some flexibility within the nurses day.
• 8:24
  Speaker B: I'll echo what Chris said from an expectations perspective. It really was nice to see. And what exceeded my expectations the most was around the flexibility, but also just the amount of knowledge that Nurse Mary had in order to act as not only caregiver, like you said, family member, but also then even down to having to find a family member in her cell phone, you know, so that she could update a family member who wasn't there. And to me, that exceeded my expectations of just the knowledge that home health care nurses have as a whole entire system of family member and then the actual care. So by shadowing, she was also walking through with me while giving care, some of the things that she was doing. So I thought that that was really. That was definitely something that exceeded my.
• 9:18
  Speaker A: I would agree, It's. They have to be so many things from wound care. And we had nine visits in my day, which she did say she has the flexibility, but kind of things fell. And so she was able to meet the needs of her patients. And she did that. And so kudos to her. Right? Because it would have been easy to say, you know what, That's a full day for me. But she did, and she managed it really well from wound care to. And having to be an expert in that. Right. Medication management. Then we went down to. And okay, are you taking those vitamins? Can you get those ordered from the grocery store? Right? You become like, almost. Almost that mom hat in some ways for, let me help you get these things taken care of so that I can take care of you the best way. And then therapist somebody wanted to talk about something that wasn't necessarily going in any documentation anywhere, but they really needed to get something off their chest. And she was so kind and listened and a listening ear, really essentially. But I was like, man, you have to be so many things. And then we did a blood draw, so I was like, well, and then we got phlebotomist here. So she had to do so many things within her day. And I think that really challenged my thinking of what a home health nurse is and the way they have to skip from thing to thing and do it well and talk the whole time. Like you said, Hannah, she was just, you know, kind of jovial. It was joking. It was, I'm here. I knew that about you.
• 10:42
  Speaker B: Ha ha.
• 10:42
  Speaker A: That happened last week. And the whole time it was like watching a Broadway show.
• 10:49
  Speaker F: And it's interesting, Hannah, because I heard a little bit about your day and I thought it was kind of cool that you also had the opportunity to see those oh, crap moments, right, where we didn't have the right color tube. So all of a sudden, it's teamwork. I mean, you would think home care, you're on an island by yourself. But she's calling her nurse colleagues, they're figuring out where they're going to meet in between patients so that she can go ahead and get equipment, whatnot. And, you know, although Amy was like, you know, Hannah saw One heck of a day. I said, that's good, because we want you guys to see the good, the bad, and maybe some of the challenging.
• 11:30
  Speaker C: Yeah.
• 11:30
  Speaker A: So what Lisa is talking about is her tube for her blood draw was expired, and she was like, oh, no, I can't use this. She didn't realize. She's like, I should have checked this the day before. I didn't look at the expiration date, but I can't use this. We met another nurse. She put out a little chat and said, hey, and her team showed up. I will say that. Hey, I have some in the back of my trunk. Well, her nurse showed up, and we realized hers were also expired. So we're standing out there with our little trunks open, and we're like, oh, no. So we had to have another rescue team come in, and we got it done. She was determined to get it done.
• 12:04
  Speaker D: I just wanted to add, that was one of the. Something that really stood out to me was the support the nurse has. So. So while you. You're. You're everything. Like you mentioned, you need to be able to do, like, 150 different jobs, but at the same time, if you get, like, a little stumped or if something's getting beyond your sort of expertise, you just pick up the phone, and you have a variety of resources at your fingertips, and. And you can get that. That backup immediately. So. And then Octavia was able to. To move forward with the, you know, the next proper bit of care, even though she was a little unsure about, you know, whatever it was. Now I can't even remember. She.
• 12:52
  Speaker C: She.
• 12:52
  Speaker D: She called right away, got the answer she needed, and boom, she. She kept things moving. So that was impressive. That whole network of care behind that one person who. Who knows a ton, but, you know, we all have, you know, at some point. But then that back. That support in the background that you get.
• 13:13
  Speaker A: Just in a minute, let's talk about the moments that stuck with you. So I want to zoom in on a particular moment or conversation, a patient interaction or something small that you noticed. Maybe that really captured what home health is all about for you. One.
• 13:30
  Speaker B: One moment that I captured that really rounded out my day of learning about home health care. Seeing it in a different way than I thought it would be was my first visit. The first patient had an entire basket full of medications, and one of the things that Nurse Mary did was by the end of the visit, she had all of them organized in a way to kind of help the patient have a better understanding of why they're taking a certain medication and what it's for, and perhaps also the education piece that goes along with, well, this may be forever, this might not be forever. And that education to the patient was wonderful to see in person. She even went above and beyond because she wrote down a list of questions that she wanted the patient to take to the doctor because the doctor or she was going to the doctor in a couple days after the visit. And so it was really wonderful to see how important and how much how they're such a vital care, a piece of a patient's care, because they're able to look at everything collectively across all the doctors somebody might be seeing and make sure that their meds are reconciled correctly.
• 14:41
  Speaker C: I'd say for me, something that stuck out a lot was I saw three patients. I had Nurse Kim, who was really kind and very helpful, informative and knowledgeable in her field. And of the three patients we saw, the second individual or patient had a very bright home, very clean home. And we had spoken about how the state of the homes sometimes reflected or were a result of the patient's well being. And that was just really eye opening to think about those who had more light in the home or more access to windows and bright walls and just general clean spaces, did not have the same severity of needs that other patients we visited had, who maybe had more darker rooms that the windows were all curtained or blackout curtains, so to speak, and, or dark walls and things like that. And it really opened up a conversation for me and Nurse Kim about mental health in addition to how it relates to the physical health and well being of patients. And I was really happy to have that conversation and just learn more about how that could be something that we all do in practice in our own lives to make sure we're continuing to get enough natural light and stay in bright spaces and things like that for our own well being.
• 16:02
  Speaker A: Definitely in Northeast Ohio, I feel like we need our doses of vitamin D and some sunlight if we can get it. It's so true, Abby. It's amazing, right, that home health nurses don't just treat the medical condition. They see everything that affects a person's health from how they move through their home to what support systems they have in place or don't have in place, down to lighting in their home and lighter, dark spaces.
• 16:30
  Speaker D: I think, I think that's something that really stuck out to me too, was how, how different each situation was and each, each of each of the homes as well. And just the incredible resilience that the, you know, the individuals we served that day had as well as their caregivers. Because some of the situations that I observed were, you know, really just heartbreaking. You know, we visited, cared for a young woman who was bedridden and just, you know, just such a sad, sad situation. And the home was small. It was a couple stories that family took their living room and, and that's, that's her living space, every little inch of it, you know, because she was in one of those hospital beds with, you know, everything that goes with that and all her supplies. And then their, their first floor, which wasn't a huge first, wasn't big, was, was her bedroom and her, her care area. And they just, they just worked around it and they were just, they were as upbeat as they could be. And just the resilience that I, that I saw was absolutely incredible. And how they, the family came together to, to give her the best, best life they can.
• 17:56
  Speaker E: I think the, the situations that were described just now really get to the social determinants of health and how, you know, people's, you know, sometimes the living space. You talked about mental health related to living space. I'm currently teaching a public health course and we just talk about like the housing stock. So even older housing stock can have more lead based paint because of the windows being opened in this old paint. And so, you know, what you're describing is, I think from a nurse's perspective, you would go in and you would begin to quickly analyze the situation, like what are the issues that are going on in the house? So it might be, and even education levels, et cetera. I mean, like really taking that all in because I think you have to sort of think through the patient's perspective and it might be there's a lot of tripping hazards here. And you know, they may not have a lot of social support. Maybe they're living alone, let's say, or mostly alone, and some of the things aren't being picked up. And so I think a nurse has to take all of that in and make decisions that help the patient. And it could also be a patient might not be as willing to utilize traditional healthcare services. They might have a, you know, based on experience and history, previous discrimination, they may be reluctant to utilize traditional healthcare services and they may feel much more comfortable in the home. Right. And so there's just all of these factors that I think a nurse would be doing really almost unconsciously, I think, to some degree. But then also just, you know, to the point of, as Hannah pointed out, that the medications and thinking through how a person will do that and Then also again thinking about education levels possibly and maybe reluctance to engage in doctors. So here are some questions. Right. So I think it's, that's where I think the nurse can spend the time that's needed to really help them be as successful, whatever their situation is.
• 20:04
  Speaker A: Yeah, and that leads perfectly into my next question. Chris, you've always said that there's something sacred about being invited into someone's home. So can you expand on what that means for you and why you feel like home health is so special?
• 20:17
  Speaker E: Yeah, I think it begins, you know, the first thought I think of is my grandma Herschler, who lived to 104 again LPN for decades, who did home health care. And it was so important for her to stay in her home. And she was 99 and had a procedure. My dad called me, it was invasive procedure and I said, do not do that. There's no reason to do that. She's 99, of course they'll find something. And she actually went into cardiac arrest during that procedure. As a result, she wound up going to nursing home care. But she was very upset having to leave her home. And so not only are you now dealing with the physical aspect of whatever the situation is for someone, but you're also having to really grieve the loss of your home, your sacred space, the space that contains all these memories. It's the space that you can invite people in. I think think it's not always possible, but it's possible more often than I think many people are aware of. There are also cultural differences and sort of the, you know, stay at home versus go into a nursing home. But yeah, I just, you know, I think for myself sort of in some ways selfishly that the couch that my grandmother had, it's like I would sleep like a baby on that couch as a 50 something year old, you know, and so it has all those memories. It has the smells of my grandmother's home cooked food and all of those things. And so. And I also want to say nursing homes do serve an important role. So it's not just, you know, downing nursing homes, but it's like when possible and if a person wants it, some people may want to go into a nursing home, but if a person has a strong preference for staying at home, like this is where those services are essential.
• 22:06
  Speaker A: Yes, absolutely. I think we can tip our hats to the nursing home structure and the purpose that it serves and also identify that more people are choosing to age in place and utilize home health. And so what we have to offer, I think we Want to bring light to the fascinating ground that these nurses cover. Right. That we've all talked about. So literally and figuratively, they're covering ground from driving from home to home, managing documentation, assessing these patients, communicating with doctors. They're really juggling a lot, even the weather. I know I had to laugh because one of the first homes we went to, I got to the door and it was stuck from the ice. So the gentleman on the other side, he's yelling, put your backside into it. And nurse Erica's just heave hoeing at the door. And we got it open and we laughed about it once we got inside because his wife was like, I told him to work on that door before you got here. But they're literally juggling everything and getting to their patients. But they really balance it all. They, they handle it really well. They have this rhythm down. It's organized, but it's also flexible. I'm sure that no two days and no two patients have ever really been the same. But, Chris, with what you've seen professionally and then in working with Lisa and the och, how can agencies support the nurse autonomy? And, and how can technology play a role in what's going on in the field today?
• 23:35
  Speaker E: I'll start with technology. So we have a. A faculty fellow here who has talked about his experience with AI and he got some results, and he's. And he speaks quite freely about this. And so he actually used AI to prepare for his doctor's visit. And I think there's an opportunity similar to the nurse who helped write down questions. I think there's a role for nurses, for educators, to help people understand AI, to help them prep, to help them walk into an appointment. So I think there's an educational component to AI, and I will say, as a dean, I've talked to our program directors and faculty and have said no one should graduate without having been exposed to AI in the classroom to know lots of different apps and how to use them. I don't want someone going into their first job and having an employer say, so what did you learn about AI in your degree? Oh, we didn't cover that. So, no, that can't happen. I think AI has an important role. It'll be an increasingly important role. A quick story. A good friend of mine from high school is a gastroenterologist, and two years ago we were talking about AI and he said, in the near future it will be malpractice to not use AI because it's so beneficial in detecting things that doctors might miss, for example, and so, yes, there's absolutely a role for AI, and I think agencies helping, I would say, especially probably newer nurses, for example, know all of their options. I think that's incredibly important. And probably even providing somewhat of a mentorship role, guidance in terms of their onboarding. At the college, we use handshake for employers. And I talked to a handshake representative, and I said, why handshake and not LinkedIn, for example, what's your pitch? And she said, it's early talent. That's where we specialize, and it's helping that person who's new to the field. And I think that's also where agencies can be especially helpful, especially if someone's sort of transitioning and is now interested in hospice or home health care.
• 25:59
  Speaker A: Flexibility always comes up first, I think when we talk about home health and what makes it such an attractive career option, the ability to create your own schedule, have more control over your day from those of us who went out in the field, from what you observed, how did that flexibility show up for your nurses in the field?
• 26:20
  Speaker B: One thing that I observed in the field with Nurse Mary is we were texting before we even arrived at the first patient's house, and she was communicating already with me and the patient, hey, I'll be there in 15 minutes. And so then that way, the patient, which this specific patient really appreciated, they wanted to know within that time window exactly what, when Mary was going to be there. And so the flexibility showed up in just the day. So I asked Nurse Mary about, well, how do you schedule your day, and what does that look like? And she gives patients windows. So then that way, in case if she spends a little bit longer time with one patient and then has to document later, she at least then covered everything she needed to during that visit, but it doesn't make her late to the next one. So by giving that window, it allowed for the flexibility within her day. And then she started a little bit later than she wanted to that day, just because some things happened at home and she wanted to get on the road but needed to give herself a teeny bit of extra time. And she just knew that by the end of the day, she'd still have all of her work completed. It just would depend on kind of how everything went with each patient. So that can be beneficial. And for some, what's nice about that is if I know for others who observed, they were able to see more patients. So depending on the structure by which they are compensated, that could be an extreme benefit.
• 27:47
  Speaker C: And when I was observing Nurse Kim, she Had as the third patient had to do a blood draw. And so right after our visit with that patient, she was able to swing by the hospital to just immediately drop off those blood samples before she was going to go on to her next two or three patients for the day. And so that flexibility of being able to do what was required within that appointment or meeting with the patient and be able to then also drop off those work related, not paper, so to speak, but in this case, blood samples and get that all done before she could go on to our next patient. I thought was very well organized in terms of making sure everything was done in a specific order and then she didn't have to worry about misplacing anything, but also that it could be done and squared away, so to speak, before she had to go do some other blood samples later on with other patients.
• 28:43
  Speaker D: I think we covered that pretty well. But they are the master of their time and how they schedule or let's say they don't do a good job one day. I think they learn for the future because they did have it down to science. I know Octavia, Octavia had only been a nurse for, for a year, and I would have never guessed, I would have thought she had 10 years under her belt. Even though she was quite young, she just had that, that presence and, and she, she knew what, you know, she was, I think, motivated to, to learn how to be really efficient with her time. And she had it down. We got. We did five visits and it was, I think about three and a half hours. And we had a coffee break in there, but we were in, you know, more urban areas, so the houses were closer together. We could get back and forth pretty quick. And we had a plan and she executed was great.
• 29:42
  Speaker A: Yeah, same with Erica. And Erica actually shared with me that she had experienced being an ICU nurse. So she had come from a very rigorous type of background. So she was very open and thankful for the way she has flexibility. And even though she did have nine patients in her day, she had a break between the first and second. We definitely stopped for coffee, which you just can't do in every, in every line of work. You don't have time for a Starbucks stop. But we used that few minutes to kind of talk about her emr and she shared with me some of her background and how she was organizing her day and whatever. So we utilized it just to kind of talk through some things. But she definitely loved that as well as her ability to get additional points. So they have a minimum point requirement that's paid out at a certain rate and then anything above that she is able to get at a slightly higher rate. But it gives her the ability. She said, hey, Christmas is coming. I wanted some extra time in, some extra visits. And so she loved having that flexibility as well. Not just to manage her schedule, but also to somewhat manage her paycheck and her ability to make more more when she needs it. And I'm sure Christmas aside, right, you don't know when a tire is going to blow. You're going to need a new roof, whatever stuff comes up. So being able to get paid a very decent wage as well as have some wiggle room to kind of incentivize yourself to do those extra visits. And then she said, you know, if I don't get my documentation done during the day, I can sit at home with my dogs in the evening and get it done then. She definitely loved the flexibility and what this job has offered her.
• 31:16
  Speaker C: So.
• 31:17
  Speaker A: And you could just see how much ownership they all. I think everybody on this call, we were able to see the ownership they took in their work, follow up tasks, leaders in every home they entered, they really had to lead the conversation, lead the task list. And that kind of autonomy is very empowering. It's also very motivating. Lisa, I would love for you to talk a little bit about the nurses confidence, their clinical judgment, and really those personal connections that you get to see within your agency.
• 31:49
  Speaker F: Thank you. You know, I've been in this industry for just over 20 years and it's really the only portion of health care that I've ever really been this involved in. And you're going to have to pardon my voice. I have one of these lovely seasonal colds right now. But, you know, I think people have an idea of what home care is and then they get into it and they have a completely different view. The industry, I think, is in prime position really, because we're coming into a world that really is on demand. We want things in our home, we want things delivered to our home. And that's not just our groceries, that's also our care and our worker. Our workforce really wants work, life balance and they want flexibility and they want autonomy. And we're starting to see a whole different wave of today's work, you know, worker or colleague, if you will. And home care lends to all of that. What I love seeing about the nurses as they come in, if they're coming in from, let's say, a hospital or a facility, you know, we often talk about the ratios, right? They were one nurse and they were managing several patients. From a case management standpoint, they will manage several patients. But when they're in that home, that time, that's one on one. You know, it is a completely intimate time to be able to provide care in the safety of their own home. Right. They are working with the family members and the physicians and other healthcare, you know, team members. But it really is empowering to the nurses. And we say all the time, even if you don't have a ton of experience, we're going to mentor you, we're going to take you under our wing, and we're going to make sure that you understand the job before we kind of kick you out into your own. Because you do have to have good clinical decision making skills. You know, I used to challenge the idea of bringing on a fresh graduate because we would say, now they got to stop the floors in the hospital for a couple of years, learn how to make clinical decisions. We're not there anymore, really. I mean, I think we're at a point where if an agency can afford to take the time to mentor a new nurse coming in, we can really empower that nurse to understand his and hers roles in the. In the home. But also with technology, to Chris's point, we have the ability to on demand, speak with another nurse as though they're right down the hall from us. So it's a changing and evolving environment, but it's an environment where I think a lot of people want to be, and it makes a ton of sense. The center for Community Based care just received $2 million from the department of Higher Ed. So that's partially why we're partnering with Lorain county as well another college and university down in Southeast Ohio. Because the Ohio Council for Home Care and Hospice and the center for Community Based Care want to invest in the workforce, Right? We want to invest in the clinicians that are becoming nurses. We want to give them sites to land with mentorship programs that are truly going to wrap our arms around these nurses and help them see this type of environment. I say all the time, I think when you ask a nursing student what kind of nurse you want to be, you're going to hear, I want to be in the icu. I want to be in labor and delivery. Like, those are really sexy occupations. But you're punching a time clock, you're working 3:12, right? You can go into home care and hospice, and potentially somebody like Erica, who's doing nine points a day, is going to make a lot of money because she's paid per point and Somebody like Mary, who's got a little one at home, she does her six points a day, but she. She drops her baby off in the morning, and she picks her up in the afternoon, and she spends all of that time with her working for the same agency. They're making different money because they're at different times in their lives, but they're both taking care of patients, and they have each other on speed dials. So I think it's a really cool industry to be in.
• 35:39
  Speaker A: It's a smart career move right now. Nurses can make great money while doing incredibly meaningful work. And, you know, if you're working for money, that's nice. Money's nice, but it's not what makes life rich. This is a job where you truly can have the best of both worlds. You can make the good money. You can have that fulfilling job that you go home at night feeling like you've done something well, you've connected with your patient. Lisa, I want you to touch a little bit on that balance, because I know you're passionate about this as well. You just alluded to it between purpose.
• 36:19
  Speaker F: And earning potential, the beauty of home care. First of all, there's many different ways in which a nurse in home care can get paid. Some of them are salaried, some are paid by the hour, and some are paid by the visit. Right? But there is that autonomy, I think, with most agencies. You know, you. You start your day in the morning, you end your day in the afternoon, but really, for the most part, you aren't punching a time clock. I think that is a really attractive aspect of home care. But then you get into the home, then you meet Ted, and Ted's this grumpy old guy, and he's mad at the world. He's got a diagnosis of hf. He knows everything. He knows all about his medications. He doesn't need you. And then you kind of break through. The next thing you know, Ted's starting to talk about some of the other things that are going on, Right? And then all of a sudden, you find out that Ted's having a really difficult time getting his meds. Ted also has a tough time because his son is not coming around nearly as often as he claims he's coming. And Ted's actually not doing well. You know, Ted's a little mentally exhausted, and he's got a lot of things going on. And because of that closeness, because of the intimacy, because we're on his turf right now, we're starting to talk to him a little differently. I say compliance goes out the window in home health, it opens up a level of intimacy. I mean, we've had patients where our whole goal was to get them to take their morning meds before they had their first beer. We didn't try and prevent them from drinking. They're in their 70s and 80s, you know, I mean, like, that's not our job. Our job is to help them manage their situation to the best of their ability in their home. And I think that that's when the flip switches, you know, that that's, that's when the switch flips. Excuse me. And that's when you really start to see a totally different side of nursing. And it's, it's a type of nursing where you are going to go home. And I don't care if you made over a hundred thousand dollars seeing 10 patients a day or you made 75,000 seeing six patients a day or your salary to 83 when you get home and you had that breakthrough moment with Ted. That's when this whole thing starts to make sense. And I just think it's a really compelling career choice. And I really wish more people knew about it because I think people often don't think about home care until they've done their time in other environments. And they're like, I think I might want to slow down. It ain't slowing down, folks. This is, I say it's cowboy nursing. We are following orders, but we are going into our trunk stock and pulling out everything we can to be able to take care of that wound or that set of circumstances. It's not for the weak of heart, but it is for the passionate person.
• 39:07
  Speaker A: Such an important message, especially for anyone thinking about their next step in their healthcare journey. Let's talk about Lorian County Community College definitely has a special place in my heart. I am an alumni, graduated from there. My grandfather was a teacher on the campus and so I grew up going to some of his classes in the evenings and then, you know, doing my own PSEO project. So definitely, definitely a place that has meant a lot to me personally. Also a place I believe in because the education there is top notch and there are a lot of partnerships and opportunities. So for anyone listening who might be curious, how can someone get started? What programs or partnerships are helping people explore home health as a career path?
• 39:56
  Speaker B: Lorain County Community College is really excited to partner with Ohio for home care and Hospice because we are able to take workforce programming and give students a deep dive into, well, what does this experience look like before they ever have to make a decision about if that's the career that they're going to go into. Lisa mentioned earlier that we're partnering on an initiative in order to expose students who've never been exposed to home care before. So they have an idea of what to expect. And we're going to find the ones that are passionate. We're going to find those nurses who they maybe have never had the chance to be a part of this before, but because they've had that experience, they know that this is for them. And in my shadowing experience, that's exactly what I learned. Nurse Mary is an LCCC graduate and what was exciting about that is to hear about the experience that she had here at Lorain County Community College and how that really did shape her experience as a nurse. The things that she learned in her courses were able to prepare her not only for when she first left and was in the hospital, but also when she is now in her current role and able to be more autonomous. And she felt that her education was the thing that really excelled her to take this step.
• 41:10
  Speaker E: So some months ago, as part of achieving the dream unlocking opportunities, we created a health and wellness pathways page which is on canvas, which is our college's learning management system. And so it's a course for students who are health and wellness intent. Many of those students know that they're interested in, let's say nursing or surg tech or sonography, et cetera. But it shows all of the different career options. And so I think what I envision would be a link to this video saying home healthcare and hospice. And so by watching this they'll be exposed to, you know, this is a career choice and learn more about the flexibility, about the connections with patients and you know, cowboy nursing and all of these things. So I think that's, you know, so I'm very glad that we're doing this. And then we also have a nurse recruiter who I will share this with her, Ann Horning. She's fantastic. And so a lot of it is, is helping students become aware of the options. And I think we're doing a good job with that.
• 42:14
  Speaker A: Yeah, the collaboration between the education and the real world experience is so important. And it's not just about learning the skills, it's about seeing how they really translate into life changing care and an opportunity for a career path that's fulfilling and meaningful. Before we wrap up though, I would love to hear one final thought from each of you. What's the biggest takeaway from your ride along experience?
• 42:40
  Speaker D: I'll start. I think one of My biggest takeo takeaways was truly the, the love that Octavia, the nurse I was shadowing, the love she has for her job, the love she has for her patients, and the intense loyalty she has towards her organization. They, they invested in her from a lower level position into becoming an LPN and to open the door to this career that she just absolutely loves. And it just all fits for her and she's walking with great confidence, doing something she's incredibly gratified to do and being well compensated for it. So I think it's been incredible for her and I love seeing, seeing her win.
• 43:34
  Speaker B: One takeaway that I had is we hear from employers a lot in our line of work that I can't find the workforce. I can't find the workforce. And so then you hear what the experience is like from a patient's perspective. And we talked a little bit about it earlier where, you know, perhaps in a hospital or a different setting, a nurse might have more patients than they would if they were in this side of the industry. And so my biggest takeaway was that depending on someone's personality, there's a job out there for them. And one of the things I found interesting was Nurse Mary commented about if somebody perhaps doesn't want to be in a setting where you've got a lot of chaos, there's family members walking down the hall, there's machines beeping, there's all the things happening, this could be for them, this could definitely be an option for them. And so my biggest takeaway is that there are options in nursing and this is one for individuals that truly want that one on one connection and can really shine through their, through their skills as well as their compassion.
• 44:38
  Speaker C: And a reflection I had was, or I keep coming back to, I should say is how much Nurse Kim and all of the nurses that we were so fortunate to shadow earlier this week, how much they embody the phrase meeting someone where they are in terms of how providing that home health care and service to their patients and the caregivers in addition to the patients was just so impressive. And seeing just how prepared and multifaceted they were in their experience and knowledge and the different communication styles they took on in one appointment or meeting with a patient to make sure their questions were answered, everything was taken care of in terms of their own health, and then making sure everyone was on the same page for next steps or after care for maybe the blood drawn or some other procedures I saw earlier this week and making sure the patient was informed of what those next steps looked like. And when they would be able to see their nurse again. It was just so refreshing to see in the healthcare field how nurses, or these nurses in particular, were making sure that those patients needs were being met and exemplifying that customer service aspect in the healthcare industry.
• 45:58
  Speaker E: I did not do a ride along, but I will talk about my grandmother, Rita Herschler again. She was an LPN and she talked, I interviewed her when she was in her late 90s and she, she's talked a lot about caring for people, especially basically sitting vigil as they're, you know, transitioning and about the family members that she cared for. And at one point she broke down crying and she said, I hope there's someone there for me. And I said, there will be, grandmother. And in that moment I committed to being with her. She was in the nursing home at 104 years old and was not able to have visitors because of COVID At a certain point she just said, enough, no mas, you know, and she just said no more medication, food, liquids, I'm done. Because it was about a year of isolation. And once she went to hospice, she was able to get visitors. So I immediately left New Jersey, drove to Rochester, New York and I spent the last 10 days with her. And as soon as I got there, I played Frank Sinatra a song and she whispered thank you. Just grateful that I was there. But that also shows again, nursing homes serve a super important purpose. But had she been in a home, she wouldn't have had that social isolation the way she did. So you lose some autonomy. But I think, you know, with home health care again, sometimes that is going to involve someone transitioning to hospice care and it just that that care continues. So anyway, it's just, it's, it can be so helpful for someone to be in their home. And I'm fortunate for both my grandmother and my dad. I was able to be by their side, in my grandmother's case, 10 straight days, my dad, 13 straight days during hospice. And the, you know, the nurses were a really big part of that. And so anyway, that's, that's my experience. And I did write an article in American Nurse. Search Rita Herschler, American Nurse. You'll, you'll see her story.
• 48:03
  Speaker A: It's, it's really clear, Chris, that this is something near and dear to your heart based on personal experience. And the work you're doing with Lorian County Community College is really going to further that mission. And so thank you. I think for me the biggest takeaway is just how deeply personal this work is when you're walking into someone's space, their story, their level of trust and compassion. It really can't be replicated in any other setting and I admire it. If you know a home health nurse, you should buy them a coffee today because they're probably running from place to place. So reach out to them and tell them, good job. Keep up the good work. This has been such a meaningful conversation. I'm so thankful. Thank you, Lisa. Thank you to Chris, Cynthia, Hannah, Abby for being a part of this conversation, for sharing all of your insights and really just your heartfelt thoughts. If you're listening and you're thinking, hmm, maybe this is the kind of work I would love to do.
• 49:07
  Speaker F: If you go to www.ochch.org, do an inquiry or a contact us and we will get back in touch with you. That would probably be the easiest way. If you're not in Northeast Ohio, but you're anywhere in Ohio and you want to hear more about the opportunities within the center for Community based Care and tuition reimbursement or grant opportunities, go to www.och.org and we will be happy to talk you through it. And on behalf of the Ohio Council, lccc, thank you so much. You guys have been amazing to work with thus far. We're looking forward to a long and prosperous relationship and a happy holidays to all.