May 6-12 is National Nurses Week, a time that reminds us to celebrate the transformative power that nurses and members of nurse-led care teams have on the lives of so many vulnerable Americans. For the chronically ill, the very young and very old, the isolated, the depressed, the homebound -- anyone who suffers the limitations of illness, injury or age -- these expert care providers weave a vital safety net of health and hope.
As president of Partners in Care, a licensed, not-for-profit agency that provides certified home-care assistance throughout the New York metropolitan area, I have seen again and again how an expert pair of eyes and a caring set of hands can make all the difference in the world.
Let's begin with one 96-year-old patient, who sits in a child-sized chair in her Staten Island bedroom and recites the story of when she almost died. "There were big white steps, red roses, angels coming to take me along with them," she says in a hushed voice. "Then Simon Peter came, with his long beard and his cane, and brought me back down. When I opened my eyes, I saw doctors, police, everyone wanting to know what's wrong."
It happened a couple years ago. Seriously ill with congestive heart failure, hypertension and glaucoma, short of breath and ankles swelling, she had been cycling in and out of the hospital. Now, thanks to a nurse-led team of home care providers from the Visiting Nurse Service of New York, who visit regularly and call every other day to check in, the patient has lived safely at home for the last two years. Her daughter echoes the gratitude of millions of Americans when she says, "My mother's left me in charge of making her decisions, but it's hard. Having a nurse to call on for advice has helped me -- and her -- so much."
Weathering the Storm, Weathering the Everyday
Never was the power of home- and community-based care teams in greater evidence than during Hurricane Sandy, which devastated swaths of housing across some of New York City's most at-risk communities. Home care workers -- nurses, home health aides, social workers -- were among the first to enter flooded, sandswept neighborhoods in the Rockaways, climbing scores of flights of stairs, knocking on every door, hauling food and water to elderly residents. "Everyone said, 'Oh, thank God somebody's here!'" recalls nurse Rimma Mulady. "You should have seen their eyes. They had been locked inside their apartment without electricity or elevators."
It doesn't take a storm, though, for nurse-led teams to spring into action. Stop by the fifth floor of an upper Manhattan public housing complex most any afternoon at 5:00 and find, in addition to good neighbors, a health team rotating in and out to care for a 79-year-old patient who has been in fragile psychological health since her daughter was killed last year. The team includes nurse Claudette Bourque, who made sure she was there when the patient was told the devastating news, and recently drove across the Bronx to help the family release balloons in the daughter's memory. It also includes home health aides who are "like members of the family," and a social worker and behavioral health therapist who help the patient battle depression.
Or join nurse Kristen Kramer on her twice-weekly treks to the fifth-floor walk-up of a 66-year-old patient whose diabetes, arthritis and heart disease keep him from traveling the streets of the city, which he did for years as a cab driver. She checks his vital signs, monitors him as he checks his blood sugar, prepours his 20 different medications, oversees or assists with wound care, and generally ensures that he is eating right and feeling well. If he has questions between visits, he calls Kristen or his doctor, with whom Kristen is in frequent communication. A home health aide helps with cooking and other activities of daily life. Thanks to this team, the patient, who has no family in the city, is able to age in place (a place so eclectic and beloved that it was featured in the New York Times).
By getting to know their patients so well in the places where they spend virtually all their time, home care nurses are able to detect even the smallest culprits that could spell big trouble. One recent afternoon, a patient's daughter called in the nurse practitioner, Lisa Montalbano, because her mother's blood pressure was rising stubbornly. Sitting next to her patient in the small bedroom, Lisa discovered the problem: a tiny pill on the floor, which had been dropped instead of swallowed. Lisa quickly got her patient back on the medication and back on track.
National Nurses Week is welcome reminder to acknowledge the highly-skilled, attentive and compassionate nurses and other health professionals who keep our homebound elders living and aging at their best. They are transforming everyday life for so many in our country -- a commitment they take to heart every single day.
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