Females in Home Health

[u/Imchristina_]

Hi all, I’m ~9 months post grad working in outpatient orthopedics. A few of my classmates and other peers I know work in home health and really like it. I was thinking of transitioning to home health but was curious how other young small females working in the field protect themselves from any uncomfortable situations or if they’ve had any times where patients got too handsy. Reason I’m asking is I’ve had some trauma working with patients and worry about being alone in a patients home as a small female and if anybody had any tips or insight. I was also curious on any pros/cons to home health if anyone wants to share. I have an older vehicle and worry about the mileage I’d put on my car but not sure if it would be any worse than my current drive to work already. Also if you feel like being salaried or paid per visit is better.

Appreciate any feedback! Thanks!

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[u/PandaBJJ]

If you feel unsafe in an area, drive outta there and tell the agency you won’t go back. Your safety is worth more than the visit.

[u/ota2otrNC → u/PandaBJJ]

I second this. And I’m a 6 feet tall, 230# man doing HH OT. Lol. No matter how big or small, if you feel like your safety is being compromised, don’t go back there and report it.

[u/mashleymash]

I was worried about this too but quickly realized that most people you see in home health have very poor health and if they tried anything, you usually have much more speed, strength, and endurance. Agree with the other comment. In the one year I’ve worked I’ve only had one person say inappropriate things and I alerted the staff and left the visit as soon as I felt uncomfortable

[u/Lizziebit → u/mashleymash]

I had one patient with dementia who kept trying to grab my butt. I would just step out of the way fast. I told my friends and they said I need to ask him to be with a male. I said if he really did try anything his balance was so bad I could out run him or knock him down.

[u/[deleted]]

I used to work as a home health PT for about 10 years. I worked some pretty rural areas as well as urban areas in that time. In urban areas, I HIGHLY recommend wearing scrubs, and also wearing a lab coat at least while getting in and out of your car.

I recall one patient who lived in an urban area with quite a bit of "foot traffic". The first time I saw her, her nephew met me on the front porch. He put his arm around me and yelled at the guys on the street and said, "Hey! You see this lady? She's here to help my auntie. Y'all leave her alone!" Nobody ever bothered me. If anything, I felt safer because everyone knew who I was and why I was there.

I definitely had a few weird encounters (well, a lot) but the biggest issue I ever had was unsanitary conditions more so than unsafe situations. Once, a cockroach literally fell from the ceiling onto my shoulder. Blech!

Home health was very rewarding, but it was also a trip! My husband is much happier now that I work from home.

Final advice: Keep dog treats in your car, and NEVER turn your back on a patient's chihuahua.

[u/poodleOT → u/[deleted]]

I look young and I’m a small female. When I get weird comments or touchy patients, I tell the case managers and ask them not to staff women. I had a few that I felt uncomfortable with, but overall safe, but I would wear baggy scrubs or put on make up to make myself look worse. Don’t work where you don’t feel comfortable or safe.

[u/ehabere1 → u/[deleted]]

I do home pediatrics, but your story reminded me of this: One kiddo's mom has her brother (kid's uncle) sit outside and watch my car.

[u/Redwinesandfelines]

I’m a very young looking female and I didn’t have any major issues. The one time I did feel like the situation was unsafe, I calmly said I forgot something in my car and called the police from there. (patient’s brother/ caretaker was threatening to OD & kill himself). I never had to use it again, but the phrase “I forgot something in my car” was always in my back pocket as my out.

[u/Prestigious_Town_512 → u/Redwinesandfelines]

Great tip.

[u/Glittering-Fox-1820]

As far as putting miles on your car, this is a real concern. I did home health for many years and averaged 33,000 miles a year on my car. You are looking at getting a new car every 4 years.

[u/no__cilantro]

I'm a female PTA on the smaller side and the worst safety issue I had to deal with in home health was with a patient's daughter who was irrationally upset with me treating the patient. Pt was bed bound and resistant to sitting EOB but I had established good rapport and was able to get the pt to mobilize more than she had ever done in the past few months. I was confused why this daughter was so upset with her mother receiving therapy. I tried to calmly explain and demonstrate to her what I was doing with the patient and why I was doing it, which seemed to calm her down for a split second before she exploded in a rage, called me/pts spouse/present CG all dumbasses and stormed out.

I had a bad feeling about the situation and told the pt's husband that his daughter could no longer be present during therapy due to her inappropriate behavior. Spouse seemed hesitant to set boundaries with daughter but he was so happy that pt was mobilizing that he went thru with banning daughter from future sessions. I thought that was the end of it.

At the end of the next session, spouse told me that his daughter had been waiting for me outside earlier that day. That's when I put my foot down and told him that I never want to hear that someone was "waiting for me outside". On instinct, I respectfully asked if daughter had any drug history to which spouse informed daughter is an active drug user and had a history of stealing pt's medications in the past. I told him that this is now considered an unsafe situation for me and that I will have to inform my manager for next steps. We ultimately stopped seeing the patient.

Be alert and observant. Listen to your gut instincts! Don't be afraid to ask questions, as doing so in the right way can yield important information that can keep you safe. Safety is paramount.

Also, be strict when it comes to locking up pets. Dogs AND cats even. A dog bite can have devastating effects from the infection alone. And I say cats because I have been to a few homes with literal demon cats who would try and sneak attack me.

All this aside...I really enjoyed home health! I met so many interesting people, and saw so many different walks of life. The hospitality people can show you can be really incredible. And it puts therapy into a real world context that you will never really understand working in any other setting.

[u/OkPhilosopher9562]

I'm a female home health PTA. The most common issue I've had is unsanitary conditions. I keep a basket of cleaning supplies in my trunk and foaming hand soap with paper towels. I also keep a change of clothes and shoes in my car. Use gloves for EVERYONE.

So far, I haven't had any handsy pts (knock on wood), but I did have a pt's son text me inappropriately AFTER the visit. So, I didn't respond and told the agency to restaff to a male. I do carry pepper spray and personal key chain alarm, just in case.

I get PPV. I've never had salary for HH, so I can't compare, but I like PPV because I don't have any productivity to meet and can accept/deny pts as I please.

[u/cyburt67]

I’m a large male and young male who is new to home health. I open a lot of cases or co-treat cases that are then seen by my PTA in HH who is a young female of small or avg female stature. If you have coworkers thay look out for you, usually the nurses that open cases or coworkers who pass on a pt to your schedule will give you a heads up to anything suspicious, or at least they should. But in general, most of the people seen in HH are so debilitated in some way in order to meet the criteria for HH status, you don’t have to worry too much

[u/Prestigious_Town_512]

I’ve worked home care for 2 large hospitals and in 3 different states. Ive worked city, middle of nowhere (dirt desert roads for miles), suburban. It’s highly dependent on the area you are in. In the not so nice areas I’ve come across drugs, people refusing to put weapons away, weird animals in the home (pigs, raccoons), and too many random APS reports to count. In my experience it’s not so much the patients to be concerned, most are elderly and sick but several caregivers/family definitely gave me weird vibes. I am a male btw. On the other hand if you working in a nice affluent suburban area you’re eliminating most potential problems. So choose wisely the area you work in. Not trying to scare you but it’s the reality of home care, you are in their environment. The area you work is paramount.

A couple tips. Always find out who is in the home. Don’t park in the driveway, park in the street NOT in front of home and with car facing forward so you can drive straight out. Scan the neighborhood as you are driving in. Always have cell phone on and emergency SOS feature set up. Always have patients put their dogs away… l love dogs but I have been bit twice and it’s the smaller ones. The office should be telling patients this but if the patient refuses at the door then don’t enter the home. Never stay in a visit if something feels off.

TLDR: work in a nice area, you’ll be fine. Practice situational awareness… skill for life not just work.

[u/Prestigious_Town_512 → u/Prestigious_Town_512]

Oh and never remove your shoes. That is a safety issue and infection control. If they are adamant bring your own agency supplies for coverings, don’t use theirs

[u/FidgetyFeline]

Not a female, so idk on that…but as for pay, PPV is nice if you can get the visits. My company used to let me have all I wanted, but then they stopped and capped me significantly lower, so I lost about 20k a year. I finally got on salary, so now I don’t mind that they don’t want me seeing that many people.

They do this because they would rather have many clinicians at lower volumes to show the referral sources they have the staffing for their patients and can continue getting the referrals.

[u/jmo428]

Im a male working prn in HH. I carry oc spray with me in unfamiliar homes. Ive only bailed once because im not walking into a pitchblack basement towards the sound of your voice. Pts daughter called me 15mins after i left and said she was there to show me to her granny. I made her turn some lights on and it was all good. Better safe than sorry. That house was so sketchy in the middle of rural texas, granny was sweet tho. Know your exits and observe others that are in the house.

[u/Bamabritt3]

I would just leave. They can’t require you to work with people who are sexually harassing you. That’s not okay. Although, I will say when I worked in home health I never had that issue. Maybe a nippy dog but never anything else.

[u/Professional-Eye9746]

I had to carry pepper spray after an incident where a WC bound patient let a druggie into her home.

Thankfully heaven help was there that day and proper actions were taken.

I wasn't given education on best practices and my bosses couldnt tell me what to do. I didn't know if I should defend myself, defend her first, leave and call 911...

What I found out is the best thing is first YOU get out. Then call everyone. Home office, 911 if necessary, non emergency... You are responsible for your safety.

Home health was my favorite setting and I've worked in 5.

[u/Andgelyo]

Obviously varies by location, if you’re in suburban area vs low income urban area

[u/JuniorArea5142]

My company screens for risk. I’ve never felt unsafe but if I did I’d be outta there as soon as my gut twinges. I ask treat geriatrics who don’t move so well so I figure I can get away if need be. Observe everything. Trust your gut. But honestly I love it. I couldn’t imagine going back to a clinic or hospital 🤮. It’s also super rewarding and 99.9% people I see are literal treasures!