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NURSES WEEK: Home health care, hospice nurses meet patients where they are - The Sheridan Press

SHERIDAN — Duties of home health care nurses can vary widely, partially based on job duties assigned by employers, but also based on the needs and desires of patients.

Some days, caring for a patient requires trekking through drifted snow to reach a home then dressing wounds and providing medication organization. Other days focus on talking patients through treatment plans or end-of-life care plans. No day, though, is the same.

The home health and hospice nurses employed through Sheridan Memorial Hospital rotate shifts in order to ensure somebody is on call for patients 24 hours a day, seven days per week. The five nurses on staff have a varying caseload, with the total at approximately 10 hospice patients and 35 home health care patients as of late April.

The needs of patients and the workflow ebbs and flows, but Sherrie Reish, who leads the team of home health and hospice nurses, said the staff always stays busy and works as a team to ensure patient needs are met.

“We’re in a unique position to care for patients out in the community,” Reish said. “We develop more personal relationships, even just by the nature of being in their homes. It’s a different side of care than what is presented at the hospital.”

She and her staff added that patients heal better at home, where they are comfortable and tend to get better sleep, than in a hospital setting. They also have the support of family, friends and even pets.

And while some may believe home health care nurses complete tasks like bathing, Reish said she and her staff can provide the same care as nurses in the hospital.

“But we do it, sometimes, with fewer resources or options for materials,” Reish said. “It’s like we’re the MacGyvers of nursing.”

Each of the nurses in the SMH department shared stories of improvising while providing care. They also shared stories of making calls to each other seeking another set of hands or additional supplies.

Combined, the five have more than 90 years experience in nursing, and all said they love the work they do in home health and hospice care.

“I like being that support for them,” nurse Heather Cote said. “To be that person there for them in some of the hardest parts of their life, that’s so rewarding.”

Home health care focuses on curative treatment and care, with the ultimate goal to help individuals care for themselves more independently. Hospice, though, requires a determination from a physician that an individual has six months of less to live. Reish did note, though, that hospice patients have stayed in the program longer and some have even recovered.

“One of the biggest barriers to care sometimes is that people don’t know what hospice is about,” said Casi Morgareidge, a home health and hospice nurse with SMH. “So they wait. But giving us an opportunity to get to know them, to educate about hospice and provide support for families is what we do. We aim to manage symptoms and support families in that end-of-life transition.”

While that task may seem painful, the nurses at SMH noted they often look at it as a calling. “We meet them where they are,” Shannon Stellingwerf said. “We help them and their families through a trying time. If we can help, that’s rewarding. Though we do sometimes have to find a balance between giving part of ourselves to that care and all of ourselves — for our own emotional well-being.”

That help is provided with a small team — which also includes a home health aide and an administrative staff member — and one that hopes to keep growing. The families who celebrate and participate in the care, according to home health and hospice nurse Brenda Perea, are also key to the job, making it fulfilling and rewarding for staff. 

The Sheridan Veterans Affairs Health Care System also provides home health care, though their duties aren’t as broad as those provided by SMH. The home health team at the SVAHCS will do lab blood draws, wound care, organize medications and help arrange transportation to or scheduling of appointments. They also help coordinate care via specialties like physical therapists, dietitians, pharmacists and mental health practitioners who will also visit veterans at their homes.

“It’s kind of an advocate, like a case manager for the family to make sure they’re getting the quality of care that they need in their home to be able to stay as independent as possible and maintain their health and improve it,” VA nurse Kathy Stoffel said.

In addition, by interacting with home health patients more frequently, the SVAHCS staff aims to keep the individuals they work with out of urgent care and out of the hospital.

“By being able to lay eyes on them, we’re really decreasing the amount of time that they have to come up to the hospital so we catch things before they get out of hand,” said Daunee Kennedy.

For both entities, partnerships throughout the community with medical directors, primary care physicians, nonprofits like The Hub on Smith and nursing home facilities are critical for the care they provide.

Each home health care nurse works to ensure the best team of professionals is available and tailors treatment plans to each patient based on needs, desires and medical guidance.

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NURSES WEEK: Home health care, hospice nurses meet patients where they are - The Sheridan Press
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