When to Call Your Home Health Agency (and When Not To)

It's 8 PM on a Saturday. Something doesn't seem quite right - maybe more pain than usual, or swelling that looks worse, or just a bad feeling you can't explain.

Do you call the on-call nurse? Wait until Monday? Go to the ER?

I've taken thousands of after-hours calls as a home health nurse. Here's how to think through these situations.

Call 911 for These (Don't Call Us First)

Some situations are emergencies. Don't waste time calling the home health agency.

Chest pain or pressure, especially if it spreads to your arm, neck, or jaw. This could be a heart attack.

Difficulty breathing that's severe or getting worse rapidly.

Signs of stroke: sudden face drooping, arm weakness, speech difficulty. Time matters - don't wait.

Severe bleeding that won't stop with pressure.

Loss of consciousness.

Severe allergic reaction - throat swelling, difficulty breathing.

Suspected overdose.

For these, call 911 immediately. You can let us know later.

Call Us for These (Even If It's After Hours)

Here's what warrants a call to the on-call nurse:

Fever over 100.4, especially if you're recently out of the hospital or have a wound. Fever can indicate infection.

Wound changes: significant increase in redness, new or increased drainage (especially if it's colored or smells bad), wound opening up.

Pain that's different or worse than what you've been experiencing. Not just discomfort - real pain that concerns you.

Medication questions that can't wait - you're not sure what to take, you missed a dose and don't know what to do, you're having what might be a side effect.

Falls, even if you don't think you're hurt. We need to know, and sometimes injuries aren't immediately apparent.

Mental changes: sudden confusion, disorientation, behavior that's not normal for you.

Concerning symptoms: significant swelling, dizziness, vomiting that won't stop, inability to keep food or medicine down.

We'd rather get a call that turns out to be nothing than have you wait with something serious.

These Can Wait Until Your Next Visit

Not everything needs an immediate call.

General questions about your care plan or what to expect.

Scheduling changes - need to reschedule a visit, questions about timing.

Non-urgent equipment issues - the walker has a squeak, you're running low on supplies but not out.

Questions about what you can or can't do - exercise, activities, diet.

Updates that aren't concerning - you're feeling better, exercises are going well.

For these, write them down and bring them up at your next scheduled visit, or call the office during regular business hours.

When You're Not Sure

This is the hard one. Something seems off but you're not sure if it's worth calling about.

Here's my rule: if you're worried enough to wonder whether you should call, you should probably call.

We'd much rather answer a question and reassure you than have you worried all night. And sometimes what seems like nothing turns out to be early warning signs of something important.

When you call the on-call line, describe what's happening as specifically as you can: what you're noticing, when it started, how it compares to normal. The nurse will help you figure out whether it's urgent.

How to Make the Call Useful

Whether you're calling during business hours or after hours, have this information ready:

Your name and date of birth (we have multiple patients). What's happening - be specific. When it started. What's changed from normal. Your current medications. Any vital signs you can provide - temperature, blood pressure if you have a cuff.

The more specific you can be, the better. "I have chest pain that started an hour ago and feels like pressure on my chest" is more useful than "I don't feel good."

What Happens After You Call

During business hours, you'll usually reach the office directly or get a call back pretty quickly.

After hours, the on-call nurse will assess what's happening and decide on next steps. They might:

Give you guidance over the phone - take this medication, ice the area, watch for these specific changes.

Arrange for someone to come see you sooner than your next scheduled visit.

Recommend you go to the ER if the situation warrants it.

Reassure you that what you're experiencing is normal and doesn't require immediate action.

Either way, the call will be documented and communicated to your regular nurse.

Don't Avoid Calling Because You're Embarrassed

I've had patients apologize for "bothering" me with a call that turned out to catch a developing problem early.

Never apologize for being concerned about your health. That's what the on-call line is for. We're not annoyed when you call - we're glad you reached out instead of sitting at home worried or ending up in the ER when a phone call could have prevented it.

The Bottom Line

911 for emergencies. On-call line for concerning changes that shouldn't wait. Office line during business hours for routine questions.

When in doubt, call. We're here to help, and we'd rather hear from you than not.