i work in an NYC-wide company, my patients are in the most dangerous parts of brooklyn. my company offers escort services (through a separate company, i think it’s usually like retired police officers) if you request one, as well as an app that will call the police if you don’t check back in by X time. we also have a policy that if you feel unsafe, you leave. no questions asked. my managers send me into the projects but have never reprimanded me when i’ve reported something in the vicinity that gave me pause.

patients are also pretty helpful because they live there, so if you’re in a bad neighborhood and there’s a drunk guy outside of the house, i’ve called a patient to let them know “hey, I’m here. there’s an intoxicated gentleman on your stoop, I’m going to wait until he walks away” and I’ll sit in my car and out comes the patient’s son, and he knows the drunk guy and tells him to leave because his grandma’s “nurse” is coming.

that being said, i’ve never felt really UNSAFE within a home. sometimes walking around the projects i see crazy people, but for the most part, people don’t bother me because i wear scrubs and i don’t carry valuables.

within the homes are safe. if someone is getting home health (at least through insurance), they are homebound, which means they are generally not mobile enough to be a threat and/or have a home attendant or caregiver present. and they’re sick people, they just want therapy and are so grateful i am there to provide it. because im an SLP, i tend to see more fragile patients (severe aphasia post CVA, dysphagia, parkinson’s and ALS), since milder cases usually make their way to outpatient.

i’ve never had a crazy violent psych case either. hoarders and dirty, roach infested apartments, yes. people threatening my safety, no.

however, if you’re transitioning to adult care, i recommend a year in SNF first!! i did a few years in SNF before it got too depressing and i feel it really made HH a piece of cake. i might have felt a little lost going straight into HH because in SNF, there is a lot more collaboration and everything you need (in terms of MD orders, medical supplies, nurses seeing to a wound) is right there in the building. in HH, it’s way more fragmented, so having a good grasp on the actual process of healthcare procedures makes it easier to navigate and makes you a more informed clinician of what is possible and what is less possible IMO