Date of Conferral

2020

Degree

Ph.D.

School

Nursing

Advisor

Eileen R. Fowles

Abstract

The demand for competent nurses working in a home care setting continues to grow because of decreased length of stay in hospitals and population needs for chronic care management when homebound. Nursing educational programs introduce students to community health and home care nursing, which could influence a student nurse's choice of home health care as an initial practice setting. This qualitative study examined the perceptions of newly licensed registered nurses (NLRNs) about home care as an initial practice area. Ten NLRNs not working in home health care areas responded to 16 open-ended interview questions that were based on the career awareness model constructs of institutional influences, career awareness itself, self-assessment, and decision-making skills, and factors influencing the actual decision. Narrative analysis of the transcripts was conducted. Responses to self-assessment questions revealed that NLRNs' valued interdisciplinary collaboration and having confidence in performing the basic skills of a nurse. Institutional influences were family and friends, financial support from a hospital, encouragement from faculty, and exposure to different practice settings. NLRNs cited fear of being on one's own, lacking skills to treat homebound patients, having a different career path, and lack of available positions as factors in not choosing home health care as an initial practice area. The results of this study have the potential for positive social change. The health outcomes of homebound patients could be improved if the need for collaboration between educational institutions and home care agencies are emphasized in order to enhance home health care skill development and to encourage NLRNs to choose home health care as an initial practice setting.

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