"If you are going to be compassionate, be prepared for action."
-- Bishop Desmond Tutu
When a massive blizzard brought near-record snowfall to the Eastern Seaboard on a Saturday this past January, most of people in the path of the storm were not thinking about wound care. But our homecare workers were. Because we know that for people like Mr. B, who has poor circulation from diabetes and lives alone in the Bronx, a troublesome wound on his foot could turn into a trip to the hospital unless proper care was taken.
That's why a team of nurses from the Visiting Nurse Service of New York--some of whom were not even scheduled to work that day--traipsed on foot across the Bronx in fast-falling snow to knock on doors and deliver compassionate care to those who needed it but could not leave their homes. Mr. B has neuropathy, numbness in the hands and feet that is a common symptom of diabetes. He relies on his visiting nurses to dress and clean his wound on a regular basis, to prevent it from becoming infected and possibly leading to amputation.
Although the care coordinator had let him know by phone that his nurse would arrive for her regular appointment, though maybe a few minutes late, Mr. B gave a great smile of surprise when she showed up, shook the snow off her hat and gloves, and got to work, making friendly conversation and dressing his wounds "like it was just another day."
In Queens, where buses stopped running at noon and a foot of snow had already fallen, Mrs. T never imagined that the physical therapist would make it to her apartment. But her physical therapist knew that interrupting the routine they had established together could derail the excellent progress she was making towards getting back on her feet after a stroke. So he, along with more than a dozen VNSNY physical therapists across the city, made regular rounds despite the blanket of snow, 40 mile an hour wind gusts and crippled public transportation.
"VNSNY is a lot like the Fire Department of New York--running towards where they are needed, not away from it," says Joseph Gallagher PT, DPT, Director of Operation Support Services. "When other people are heading home to wait out the storm, our clinicians are heading out into it to make sure patients get the care they need. Homecare takes a special person. To me, they are a group that, like the NYFD, can be called 'New York's Bravest.'"
To that, I would add, "New York's Compassionate." Home health care is a field that demands compassion, commitment and a certain doggedness, as our corps of field staff and those who support them demonstrated in the Blizzard of 2016, providing a flurry of care to those most vulnerable in a snowbound city--those who are elderly, ill, injured, homebound.
Homecare providers evidence this spirit day in and day out, whether traveling by bicycle to see a dozen patients in a day on Manhattan's Lower East Side in brutal summer heat, visiting teenage mothers and their newborns in the South Bronx into the night, or checking on a patient with congestive heart failure just before bed to make sure she had a good day.
To harness this compassion, commitment and unwavering spirit into truly successful and scalable home health care, it takes organizations that care enough to put the patient first and create sustainable systems for training, staffing and care delivery, to make sure the compassionate care gets where it needs to go, efficiently and effectively.
Nothing tests these systems more than a citywide natural disaster. During and after the devastation of Superstorm Sandy, VNSNY's Emergency Response team coordinated the efforts of thousands of staff and clinicians. More than 5,000 nurses, aides, social workers and other staff overcame power outages, flooding and lack of public transportation to see patients, making sure they were safe and had supplies. In the city's hardest hit areas like the Rockaways, our clinicians --often on foot, walking miles, climbing dozens of flights of stairs--were often the first ones to reach and help those who were homebound. This included the ill and injured, as well as the "newly homebound" by crippled elevators and flooded streets.
And we partnered with other organizations to reach the city's wide-ranging vulnerable populations. We helped NYU College of Nursing check on aging faculty members in cut-off high rises, the New York City Housing Authority (NYCHA) make sure its 3,000 residents in Red Hook were safe, and the Department of Health canvas in the Rockaways and Coney Island.
The Visiting Nurse Service of New York was indeed founded on this powerful combination: personal compassion and a larger, organization-wide commitment to deliver that compassionate and vital care where it was needed most. Lillian Wald, one of the nation's first public health nurses, began her work going door to door, tenement to tenement, on the Lower East Side to help women, children, the aging, the vulnerable, the overlooked. To amplify the impact of her individual care, she created an organization in 1893 that would be driven by the same mission: providing essential care to New Yorkers at home and in their communities.
During Sandy, one of my colleagues who handled much of our agency's storm-related efforts, said, "I am confident that Lillian Wald was looking on from above, nodding and saying, 'Yup, you got it right.'"
I can imagine Lillian Wald looking down and nodding, too, during the January blizzard, when a hospice nurse spent two hours on the subway traveling from Jackson Heights, Queens, to Brooklyn, to provide palliative care to a young mother in the storm. And when a home health aide, covering for another who was snowbound, put in extra hours after a full shift to care for a man with Alzheimer's and recovering from a stroke--to the great relief of his anxious and exhausted 95-year-old wife. "They sent me an angel," she said.
As the saying goes, "Neither snow nor rain nor heat nor gloom of night stays these couriers from the swift completion of their appointed rounds." That is as good a description as any of what compassionate care looks like when the snow falls, when the waters rise--whenever there is a need.