Nurse practitioner and nurse visits for medical care
The visits described here are nurse practitioner and nurse visits for medical care. Gateway is not a home health agency. If you are looking for an agency to send a nurse or therapist under a home health plan of care, see our page on home health in St. Louis. Gateway arranges visits by partner clinicians, and the treating clinician makes the clinical decisions.
That difference matters because the words “nursing at home” are used loosely. Here they mean a licensed clinician visiting to examine, assess and follow a medical problem, not a standing arrangement of daily help.
What a nurse practitioner can do at a home visit
A nurse practitioner (NP, and in some cases a DNP, which is a doctoral degree in nursing practice) is an advanced practice nurse. What an NP does depends on the training, the practice and Missouri or Illinois rules, so the treating practice is the best source for specifics. At a home visit, an NP may:
- Talk through how the patient has been feeling and what has changed
- Examine the patient and review current health problems
- Look at a wound, measure it and discuss the plan for its care
- Go over the medication list so questions reach the right clinician
- Coordinate with the patient’s physician, specialists and pharmacy
The visit is a real clinical appointment held in a living room instead of an office. An overview of primary care at home shows how this fits with ongoing care.
When a nurse visits
A nurse may join the care team for a specific task, such as a wound check, a follow-up on a dressing plan or help collecting information for the treating clinician. Which nurse tasks are appropriate depends on the clinician’s orders and the setting.
Nurse visits are not a daily caregiver. A visit is a scheduled medical contact with a defined purpose. If a patient needs someone present for hours each day, that is a different kind of help, covered in the next section.
How this differs from home health and private duty nursing
Three kinds of help are often mixed up:
- Home health. An agency that takes part in Medicare, or one paid another way, sends nurses or therapists under a plan of care that a physician or other authorized clinician orders. It is usually time-limited.
- Private duty nursing. A nurse is hired for longer shifts at home, often for people with ongoing, complex needs. Families usually arrange and pay for it directly or through a plan that allows it.
- Nurse practitioner and nurse visits arranged by Gateway. Medical visits to assess, follow and plan care, with orders from the treating clinician.
For a fuller comparison, read our guide to in-home nursing and house calls. It walks through who orders each service, who provides it and what to ask.
Working with your home health agency
If a home health agency already visits, you do not have to give it up. Many patients keep the agency for its nursing and therapy and add a visiting clinician for a wound or medical follow-up that is not improving as hoped.
The important piece is communication. Tell the agency who else is visiting, and tell the visiting clinician which agency you use. With your permission, Gateway helps share updates so the physician who directs your care sees the full picture. Our page on doctor house calls explains the other clinicians who may visit, including physicians and podiatrists.
Getting started
Call 314-325-0126 or leave your name and phone number through the request care form. Please do not enter medical details in the form. When you call, we ask for a ZIP code and where the patient lives, and we confirm visit availability by location and care setting. We cannot promise timing.
A medication list, insurance cards and recent hospital or specialist papers make the first visit more useful.
When to call 911
Visits are scheduled and Gateway is not an emergency service. Call 911 for chest pain, trouble breathing, sudden confusion, a serious fall or bleeding that will not stop. For other changes, such as a wound that looks different, call the treating clinician’s office.
Common questions
Is a nurse practitioner a doctor?
No. A nurse practitioner is an advanced practice nurse with graduate training, and some hold a doctoral degree in nursing practice (DNP). That is a different path from a physician. In many cases an NP can examine patients and manage care. Ask the treating practice what a given NP does.
Does Gateway provide home health nursing?
No. Gateway does not provide home health services, and it is not an agency. We arrange medical visits by partner clinicians, and we work alongside the agency you already have. If you want an agency, our guide on finding a home health agency lists what to ask.
Can a nurse give daily care or stay with my family member?
Not through these visits. Visits are scheduled and purposeful, not hours of daily help. For long shifts or daily personal care, families look at private duty nursing or home care. Our comparison of private duty nursing and home health is a good place to start.
Who decides what happens at a visit?
The treating clinician does. Gateway arranges the visit, gathers records, coordinates supplies and keeps your care team informed, but we do not assess, diagnose or order treatment. If you disagree with a plan, tell the clinician or call us and we will pass your concern along.
Will I know who is coming?
Yes. When the visit is scheduled, you can ask who will be seeing you, and we tell you what to have ready. If you want a family member to join in person or by phone, say so when you schedule.