Home is where the care is

Home health nurses give care, serve as doctor’s ‘eyes and ears’

Thelma Summerlin needed to see the nurse a few weeks ago. 


But the 76-year-old Kasilof resident is, for the time being, housebound due to eyesight complications from a stroke that now prevents her from driving to Soldotna for a doctor’s visit.

So, in the middle of a warm, melty, late-April day, Theresa Torrence came knocking.

Torrence, an LPN with First Choice Home Health Care in Soldotna, knows the Summerlin family. She knew Thelma before her husband Ray died of pancreatic cancer two days after her stroke on March 17. And, Torrence knows to go ahead and let herself in the Summerlins’ first entrance, kick off her shoes and knock on the kitchen door.

The check-up started with a hug and a hello.

“How have things been going for you?” Torrence asks eagerly as she sets up her laptop in the living room and Summerlin takes a seat on an over-stuffed couch.

“Have you had any falls?” Torrence asks.

“No, no” Summerlin said with pride.

“Good, good — that’s what we like,” Torrence said.

Torrence continues asking Summerlin about her eyesight, medications, blood pressure, sleep patterns, the pain in her shoulder that might require a follow up visit to the doctor and a number of other routine questions. The living room is filled with plants, pictures, old comforts and the sound of Torrence’s keyboard click-clacking away.

“It is most important now to pay attention to what your body is telling you,” Torrence said.

While the visit might have been ordinary for Summerlin and one of the many Torrence makes each day during her job as a home health nurse, many people might not know there is a segment of the nursing profession that doesn’t live solely in the hospital, said Bekkie Jackson, First Choice Home Health administrator.

“They probably know there is some kind of help that goes into a home setting when people are ill or injured, but they don’t know it is skilled nursing,” Jackson said. “They might think it is home health aides, personal care attendants and that kind of thing. 

“They don’t realize we are going in there and doing IV therapy or we are doing labs. But now they are hearing it more and more because their physicians know.”

National Nurses Week is celebrated starting today, also known as National Nurses Day, through Saturday. While nursing in general can be a challenging and taxing profession, home health nurses have a unique charge. Jackson and her staff of nine nurses are on call 365 days a year, 24 hours a day and cover the area from Cooper Landing to Ninilchik, Soldotna to Nikiski.

Just organizing the thousands of yearly trips staff make to homes across the central Peninsula can be challenging enough, but home health nurses must also navigate tricky road conditions.

“If there is a death at home at 2 o’clock in the morning and we’ve got freezing rain or 30 below, we go,” Jackson said. “We go out on any roads that we have to go on.”

Home health nurses must also learn to cope with being more independent than nurses in hospital settings.

“They are working out in the field on their own and sometimes you have to make judgments fairly quickly on your own,” Jackson said. “Whereas in a hospital setting you always have someone right there to ask.”

Jackson’s staff made a total of 5,848 home visits in 2011 — an average of 487 per month. They work in teams and often line up several visits a day along a route. However, only a physician can recommend a patient for home health nurse services.

“A patient can’t just call and request our services, we have to get that from a doctor saying that there is a need for skilled nursing,” Jackson said.

But, physicians, hospitals and insurance providers see the need for the services with the ever-increasing cost of health care, Jackson said.

“These people are either on Medicare or private insurance for the most part so their insurance companies are very aware of hospital costs and they like it when we can assume the care in the home,” she said.

Besides just being more comfortable and being where people generally want to be, healing at home with a doctor’s permission and a nurse’s aide can have added health benefits, Jackson said.

“They can be with their families, they can be in their own living room watching TV or sleeping in their own bed,” she said. “Our services allow them to do that and so it is often times much more mentally encouraging and uplifting rather than being in a hospital, even though there is a place for both.”

During the time in which a patient is seen by First Choice — usually 60 days at a time unless renewed by the physician — they can become close friends with the one or two nurses assigned to them. Jackson said that also helps with “good continuity of care.”

“When you have been with them through a really hard time … you just get more intimate with them and we get to know them better maybe more than the nurse in the hospital because they are not so long,” Jackson said.

Torrence agreed saying home health nurses could be considered the doctor’s “eyes and ears at home.”

“We get to know them and we kind of know their norms and things,” she said.

Summerlin added, “It is just helpful to have someone different to talk to.”

Torrence goes on to check Summerlin’s vital signs, weight and blood pressure, asking her about a number of other things. She reminds Summerlin to double check her blood pressure once she left. And, after slipping her shoes back on, Torrence promises to return next week leaving Summerlin to continue recuperating.

“I’m glad things are going so well for you,” Torrence said.

Brian Smith can be reached at brian.smith@peninsulaclarion.com.