Roxann Bradford said she has the best of both worlds as a pediatric home health nurse for Visiting Nurses of Georgia. She works every day with parents and children, plus she works flexible hours.

"It's the ideal job, because I have more time to work directly with the parents and the children," she said. "A big part of my job is education, and I have much more time to spend with the families in a home setting. Plus kids do much better at home."

Most home health nurses work for agencies, which often provide patient referrals, benefits and liability/ malpractice insurance coverage.

Aside from having hospital or clinical experience, many home health nurses go through an orientation with their agencies and they usually have a preceptor.

With health care providers and insurance companies trying to reduce hospital stays, the market for home health nurses is growing. The average salary for home health nurses is from the mid-$40,000s to the mid-$50,000s, depending on where the job is.

Becoming a pediatric home health nurse was a natural progression for Bradford, who has been a nurse since 1994. She began work at a children's hospital, gaining valuable experience that would lead her into the home health arena.

"It's essential for anyone in home health nursing to have worked in a hospital," Bradford said. "What we do at home is a continuation of what goes on in the hospital, working under the doctors' orders to help the patient. You must have that experience as a foundation."

Bradford said that being in home health gives her additional time to work with patients and their families.

"In the hospital it can be overwhelming for the family and it's hard to keep focused," she said. "When you're in their home, you have no distractions and can really focus on teaching them about the care of their child."

She frequently works with new mothers and fathers, completing follow-up visits once the family has left the hospital.

"Once the baby's here, there is a whole new realm of questions," she said. "As the parents learn more at home, we can involve the entire family - grandparents, other children - in a laid-back setting. At home everyone learns more."

Working in home health has other benefits.

"When we come into a home, we can see the whole picture of what's going on with the dynamics of the family," Bradford said. "We can help them beyond patient treatment to assist with opening the door for other resources they may need."

Bradford's job includes administering IVs, drawing blood, working with nutritional issues, feeding assessments and weight checks for preemies, plus providing various treatments, such as phototherapy for jaundiced babies.

"What we do makes it easier on the parents when we come to their homes," she said. "They don't have to take their children to the waiting room or doctor's office, possibly exposing an already-sick child to other illness. Everyone is more at ease."

Bradford has been a pediatric home health nurse since 1998, and while she loves her work, she said there are challenges.

"Home health is hands-on; it's more autonomous than working in a hospital and it makes you think, and you don't always have a backup or someone to call," she said. "In home health, I use my brain a lot more. It opens you up to what's going on in the real world."