I started working for Continuum Home Health almost two years ago. Although I have had some experience caring for patients outside of the hospital, most of my time as a nurse has been taking care of inpatients. Home health care nurses are unique. They work independently and are very resourceful. They meet patients where their needs are and identify barriers to health. They walk into homes where patients live in a variety of different socioeconomic conditions and patiently assess, support, educate, and applied their skills and knowledge to ensure that their patients are safe and reassured.
I met Sarah because I work with Continuum's pediatric population. I had the opportunity to meet with Sarah during the health system's annual performance evaluation period. I very quickly realized how different it was for Sarah and her colleague colleagues caring for pediatric referrals in eleven counties. As I interviewed Sarah, I heard the stories of several patients with complex, complicated needs.
Sarah went to see J a 10-year-old with a new ileostomy. J's mum has mental health problems that profoundly affect the family. J has siblings and loves her mum. Sarah arrived a little late one day as she had had to drive a long way between appointments and the previous appointment took longer than usual. J's mum would not let Sarah in because she felt that it was disrespectful to be late. Sarah knew how important it was to assess J and to reinforce teaching, so she carefully and respectfully apologised and made a promise to Mum to be on time in the future. Unfortunately, J has not been to school all year and because of the stress in the household does not eat enough. Not surprisingly, J is anxious and depressed. Mum struggles to care for herself and her children and has little support. On the occasion when Mum was upset because Sarah was late, Sarah spent an hour and a half listening to her. Sarah has reached out to as many resources as possible for this family. Sarah is creative in trying to maintain a good relationship with Mum in spite of many challenges.
Sarah sees many families who are refugees, and she has had to surmount the many different language barriers taking into account family experiences and culture. She is cognisant of the global and current events that have led these families to the USA. On one occasion Sarah arrived at a family home where they were all dressed up to go out and celebrate the Muslim holiday of Eid al-Adha. The patient Sarah was there to see has type 1 diabetes, so Sarah asked him what he planned on eating and how he was going to use insulin in this situation. Even though when Sarah arrived, she was unaware of the holiday and the family plans, she adjusted and helped them make decisions about food choices and insulin dosing.
Last week, Sarah told me that she went to see a 15-year-old and his family in order to complete some paperwork. He did not require skilled nursing at the time. Sarah went to complete the paperwork because she and the family were familiar with each other, and he needed physical therapy. When Sarah arrived, it became apparent that the patient was actively dying. Mum was distraught and many decisions needed to be made quickly. Sarah spent some time offering support to Mum and listening to her. This was extremely challenging and quite stressful, but Sarah stayed and adjusted to what the family needed from her. After that visit Sarah composed herself and went, to meet a newly arrived refugee family who had many needs and lacked many resources.
Sarah is a professional, skilled, and knowledgeable clinician. She is resourceful and adaptable. She earns the trust of the families that she meets in order to form a team that addresses the unique needs of each family group. She makes a positive and calm impact on her patients and their families.
These are just a few examples of Sarah's daily work and I think they demonstrate compassion and kindness in a professional package. Not only that but although Sarah works alone, she is in constant contact with colleagues and members of the multidisciplinary team caring for these patients.