Making the Rounds with a Home Care Nurse

Meet Jennifer M., native New Yorker, mother of two, and home care nurse. Jennifer has been with VNSNY since 2006; she now works as a per diem nurse in Nassau County, but she spent years working as an acute care nurse in Queens. Here’s how Jennifer spent one recent morning.

First Visit: A Hospice Patient and His Wife

Jennifer’s day began at an assisted living facility in Kew Gardens, where she checked in on people like Harold* and his wife Marlene*. Harold developed type 2 diabetes about 20 years ago. Over the years, he gave himself insulin injections and tested his blood sugar every day. Through managing his disease and eating properly, Harold stopped needing insulin. And when his son developed diabetes, Harold coached him on managing his disease.

Harold was in hospice, but Jennifer still visited him and Marlene daily, taking their blood pressure and monitoring their blood sugar levels.

Second Visit: Encouraging a Patient with Diabetes

Jennifer’s next stop was to see Matilda*, a Guyanese immigrant living in Richmond Hill. This Queens neighborhood has a large population of immigrants from Guyana. Type 2 diabetes is epidemic among them—in fact, data suggests that adults born in Guyana have a death rate of 58 per 1,000,000 from diabetes, compared to 34 per 1,000,000 for US-born adults—a rate that’s almost 60 percent higher.

When Jennifer met Matilda three years ago, she was non-compliant. She was not taking her insulin and her A1C (average blood sugar levels) was high. Jennifer took a long time explaining, training, and building trust before Matilda started taking her insulin once a day. In addition, Jennifer educated Matilda’s family, so they could help her.

On this and every visit, Jennifer praised Matilda, pointing out her successes and encouraging her to be even more in charge of her disease. Recently, for example, Matilda mentioned that eating sweet plantains had spiked her blood sugar. Jennifer asked questions to get to the bottom of it: How many pieces did she eat? Did she adjust her insulin? By answering Jennifer’s questions, Matilda realized that it was okay to eat six pieces of plantain, but next time she should limit herself to three.

Third Visit: A Monthly Check on a Man with Quadriplegia

Jennifer’s third visit was to Leon*. When he was 19 years old, Leon broke his neck in a swimming accident, instantly becoming paralyzed. That was about 60 years ago. Statistically, he’s achieved a miracle: Men under age 20 who sustained spinal cord injuries from 1973-1979 had a life expectancy of 29 years. Leon has lived a long and full life as an artist (he paints with the help of arm splints). His many friends visit him, some even coming to his house each evening to make sure he’s settled into bed for the night.

Jennifer visits Leon once a month to change his urinary catheter, but otherwise he stays away from doctors and prefers herbal remedies and alternative medicine—which Leon’s doctor credits with his long life.

Fourth Visit: Helping a Single Mother Stay at Home

Jennifer’s final visit of the morning was to the home of a patient she’s seen for two years. Florence* lived with her mother (who was her primary caregiver) and young son. They recently moved out of Jennifer’s service area, but Jennifer continued to visit Florence every day. Florence was diagnosed five years ago with Neuromyolitis Optica (NMO), a degenerative disorder similar to multiple sclerosis. Patients diagnosed with NMO have a life expectancy of five years.

The disease has taken its toll. Over the years, Florence became paralyzed and lost her vision. She also developed two pressure ulcers as a result of the chemotherapy that was part of her treatment regimen. One ulcer closed after two years of treatment, and the dressing for the other wound needed to be changed every day.

Florence’s home health aide helped Jennifer change the dressing. Next, Jennifer sorted Florence’s multiple daily medications into a pillbox so that no one would get confused—this process alone took 15 minutes! Jennifer also checked on an ingrown toenail, and promised to order new sterile gloves.

As a single mother, Florence’s only wish has been to stay at home to watch her son grow. Home care with VNSNY has allowed this to happen, with 24-hour home health aide services and social workers who work hard to allow her wish to stay true.

* All patient names have been changed for privacy.

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