A Visiting Nurses' Emergency
The holidays put more stress on a system that is short-staffed and overworked.
Thursday, December 27, 2001
Nurse Joanne McCarthy wants to talk about 90-year-old Charles Seaver''s swollen leg, but he''d rather reminisce about his glory days as a jock.
"Have you been on antibiotics?" asks McCarthy, an R.N. and a certified wound nurse with the Central Coast Visiting Nurse Association (CCVNA).
"I use to play golf, football, baseball. You name it, I played it," Seaver says, "but I''d rather talk about my son." He motions to a bowl of baseballs sitting on a shelf that belong to his son, N.Y. Mets Hall-of-Famer Tom Seaver, and a signed photograph of the pitcher''s 300th win.
McCarthy wraps Seaver''s legs with an "Unna boot" to treat his veins and prevent blood and fluid from pooling in his ankle. She recommends that he lie down often with his foot above his heart. She tells him walking short distances is good for his health.
"I can show you the bed I was born in," he says, adding "I usually walk around the block every day."
He winks at McCarthy. "You''re a gem."
VNA nurses come to Seaver''s Pebble Beach home at least twice a week. Today is McCarthy''s first visit with Seaver. She''s here at Seaver''s case-manager nurse''s request. As a certified wound nurse, McCarthy is always on the road, traveling through CCVNA''s coverage area of Monterey and San Benito counties. She usually visits four or five patients'' homes every day.
"Thursday is Monterey, Tuesday is Salinas, Wednesday is Hollister and King City whenever they need me," says McCarthy, an 11-year VNA veteran.
McCarthy''s one of about 155 CCVNA nurses, therapists, social workers and other clinical staff that travel city to city, at all hours, seven days a week, 365 days a year, holidays included.
Last March, VNA added a King City location to its hubs in Monterey, Salinas, Hollister, Pacific Grove and Seaside. The trouble is, VNA can''t hire nurses fast enough to fill its offices and make the necessary 70,000-plus home visits each year.
Everyone feels the nursing shortage, says Margie McCurry, VNA''s development director.
"We are desperately in need of nurses," McCurry says. "It''s an international problem. Once upon a time, if America was short of nurses it would run over to China or the Philippines [to hire nurses]. Now they do not even have enough nurses."
McCurry says the future looks dim. The average age of American nurses is 46-a bad sign that the shortage will worsen.
On a weekly basis VNA posts between 25 and 30 job openings for clinical positions. "Some positions have been unfilled for many months," McCurry says.
She tells a story about the March opening of the King City office. VNA offered a $5,000 sign-on bonus. No one even applied.
Nursingschools aren''t turning out the numbers they used to, and women these days don''t flock to the profession like they used to, when it was one of a select few "women''s jobs" outside the home. Factor in the high cost of living in Monterey County and low nurses'' wages, and the problem grows exponentially.
"Hospitals here locally are also having nursing shortage problems-that means they want to discharge patients faster. So we get them sicker and we get them faster."
Additionally, visiting nurses face other challenges that hospital nurses don''t. They seldom visit homes in pairs or more, meaning that there''s no one standing by ready to give a second opinion.
"You have to be a seasoned nurse," says McCarthy, who before joining VNA spent 16 years as a hospital nurse. "You have to be experienced in assessment skills, experienced in determining interventions."
Plus, visiting nurses have to feel comfortable in several different homes a day.
"You''re not in a hospital," McCarthy says. "You''re on their turf."
Currently, VNA staff visit about 260 patients every day in Monterey and San Benito counties. Each patient is assigned to a case-worker nurse to supervise care. Clinical specialists are also available, as are physical, occupational and speech therapists, social workers, and medical teams specializing in cardiology and pediatrics. VNA also offers five adult day programs at locations in Seaside, Monterey and Salinas, and a hospice program available to terminally ill patients in their own homes, in nursing homes and residential care facilities.
"Our nurses see patients of all ages, really, McCurry says. "Young children, middle-aged businessmen with heart attacks, women with hysterectomies that are at home and need care. We also do prenatal care."
One of the VNA leaflets in the shape of a bookmark bullet-points VNA services, locations and phone numbers on one side. On the other is a crayon drawing by a little girl named Natalie who dots her "I" with a heart. The picture shows a happy elephant smiling in the sun, surrounded by friendly bumble bees and a lady bug. "Thank you for these wonderful people," it reads.