Home health workers face an array of safety risks -- including overexertion, falls, car accidents and hostile pets -- that make their jobs more treacherous than those of their hospital counterparts. In fact, the injury rate in home care settings is about 50 percent higher than that in hospitals, the US Bureau of Labor Statistics reports.
Three home health veterans offer these tips for staying safe and injury-free when you're making house calls.
Keep Your Guard Up
Unlike the controlled environment of a hospital, working in patients' homes is unpredictable, so you must stay aware of your surroundings. "The risks [of providing home care] are the same reasons I love it," says Roger Herr, PT, MPA, a physical therapist for Swedish Home Care Services and president of the American Physical Therapy Association's Home Health Section. "It's a constant variable environment. You never know what you're going to see."
Don't Overexert Yourself
Back injuries from lifting or moving patients are one of the biggest risks to home health aides, nurses and other home health workers. To help prevent such injuries, some home health agencies use a buddy system that allows two workers to team up to provide care for heavy or hard-to-transfer patients.
If you're working alone, practice good body mechanics, says Mark Lueken, MSN, RN, clinical director of Verdugo Hills Hospital HomeCare. Take full advantage of transfer systems and other assistive devices, he says. Also, keep a reasonable pace and some flexibility in your daily schedule so you aren't tempted to take injury-inducing shortcuts.
Watch Your Step
Kathy Girling, MSW, director of social services for Girling Health Care, once had a porch collapse under her when visiting a client's home. While she wasn't injured, she has since become vigilant about watching where she steps.
Don't remove your shoes in a client's home, because you may slip, stub your toe or step on a nail, tack or piece of glass, Lueken says. To be culturally sensitive to clients who prefer their guests go shoeless, wear disposable surgical shoe covers, or leave a clean pair of shoes at the house to wear only there, Lueken suggests. Also be mindful of household hazards like slippery bathroom floors or open cupboards, which can also cause injury when you're engrossed in assisting patients, he says.
Follow basic personal-safety protocols, such as:
- Confirm with clients by phone before you visit.
- Make sure you have detailed directions to a new client's home.
- Keep your car in good working order and the gas tank full.
- Pull onto the shoulder or into a parking lot rather than trying to simultaneously drive, talk on the phone and read directions.
- Keep your car windows closed and your doors locked.
- Lock your bag in the trunk.
- Have an extra set of keys in case you lock yours in the car.
- Most importantly, make sure someone knows where you are at all times.
Trust Your Instincts
If you are driving into a high-crime area and see activity near a client's home that scares you, drive a few blocks away, and then call your client and/or supervisor to find out how to proceed. "Don't stop in front of the door," Herr says. "You look vulnerable."
Girling's advice: Go with your gut. "Most of the time it's not imperative that you make the visit at that moment. If you have a bad feeling about a situation, call your supervisor or the police. Never go into a situation where you feel you'll be unsafe." If you feel threatened in a home, leave immediately, Girling says.
Don't Touch the Animals
Even the friendliest pets can turn on you. The policy at Girling Health Care is to never touch an animal. Besides the potential threat, animals can distract you and interfere with your work.
When you call to confirm your appointment with a client, ask that animals be kept away during your visit. That's a request all caregivers should consistently make, says Herr. "You don't want a patient to say, ‘The nurse liked my dog. Why don't you?'"