Let me count the ways—to make a home visit.

As a home health nurse, I made visits in Chicago, Washington D.C., and right before I retired, in the areas surrounding Raleigh, North Carolina. I didn’t climb over the roofs in New York City, nor did I ride a horse or a bike. Unlike the nurses in the Visiting Nurse Service of New York City (1893), or the nurses in the Frontier Nursing Service in Kentucky (1925), and more recently, the midwives depicted on the TV show: Call the Midwife, I drove a car.

One of the handicaps I had in driving a car back in the 80s was that there wasn’t a GPS. Being directionally challenged, I lucked out when I discovered I could put a compass on the dashboard of my vehicle. And even more lucky that I could calibrate the compass on the straight north and south streets of Chicago. I rarely got lost after that. However, I do remember a time that I almost didn’t make a home visit because I couldn’t find the patient’s home. 

I was going to see a new patient in Chicago’s western suburbs; an area where I was unfamiliar. I had looked up the directions back at the hospital before setting out. We kept a stack of street maps in the chart room. For some reason, the directions I wrote down didn’t work. I stopped at a phone booth (remember those?). That phone booth and the others nearby hadn’t been serviced. No one had come to remove the quarters that blocked the coin insert. My stash of quarters were worthless. I found a gas station attendant that let me use the office phone to call the patient’s home. (N.B. The first staff member to visit a new patient made an entry in the patient’s record with accurate directions to the home).

As much as I felt inconvenienced without a GPS, how did my predecessors, who rode on horseback or bikes or climbed over roof tops, find their patients?

The Chicago winters caused the greatest panic: The windshield wiper that stopped working as I drove on the highway in a snowstorm or the time I tried to make a “careful” right turn on an icy road but the car decided to skid sideways in another direction. I carried a shovel in the trunk to dig my way into a parking space when I visited patients who lived in the city. 

Driving in D.C. could be aggravating. The summer roads crammed with tourists. Presidential motorcades halting traffic. A slight dusting of snow would show the incompetence of drivers from tropical countries. 

While I’m most comfortable driving in big cities, the farmlands of the South have challenged me. After one especially wet spring, I drove into a rural town I had never heard of and parked on the lawn in front of a small wood frame house. I sloshed to the front door. No one was home. I tried to call (I had a cell phone then). No answer. 

Back in the car, I couldn’t get any traction to move. I spun the wheels, digging the car deeper into the soggy ground. After I called my auto insurance company to approve a tow, I called a nearby service station. The mechanic at the other end didn’t recognize my patient’s address. Not remembering the name of the main road, I would have to walk a quarter of a mile to read the street sign. The car door barely opened over the lawn. I ventured into the cold rain, hoping not to lose my footing on the muddy, rutted road. 

The tow truck came quickly after I identified myself as a home health nurse in need of getting to my next scheduled patient.  

The local police chief came along for the ride. He was in the garage when my call came in. He thought he could be of some help in tracking down my location. Would I have had such personal attention in Chicago or D.C.? There are trade-offs. 

I would love to travel back in time and sit with other visiting nurses. I can’t even imagine the challenges they would describe getting to their patients’ home on horseback, or over tenement roofs, or on bikes. I probably would have no cause to complain about driving a car.

Published by Marianna Crane

After a long career in nursing--I was one of the first certified gerontological nurse practitioners--I am now a writer. My writings center around patients I have had over the years that continue to haunt my memory unless I record their stories. In addition, showing what a nurse practitioner does in her job will educate the public about we nurses really do. So few nurses write about ourselves as compared to physicians. My memoir, "Stories from the Tenth Floor Clinic: A Nurse Practitioner Remembers is available for pre-order on Amazon.

10 thoughts on “Let me count the ways—to make a home visit.

  1. A most interesting history. I remember doing a pro and con list when I was changing jobs. Once hearing your story about using a broom to clear snow off a street sign so you could read it made me write “warm office” on my pro list.

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  2. I spent three years doing home nursing. My area was a little rough ( had a bad reputation in the city) However, with my whites on and my blue canvas bag over my shoulder, no one ever approached me, some even pointed me to the apartment of my client!

    Thank you for sharing some Home Health history. I never really thought about how far back it went!

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  3. Lots of time now to think about past experiences. I am reflecting about working with an older Nurse anesthesiologist who was from West Virginia who rode on horseback to visit her patients! She taught me so much about care and LIFE. Thanks for your Blog,God bless Mrs Bradock.

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  4. Hi Marianna, I love your stories. I well remember the days of searching for pay phones and using maps to find patients’ homes. I always carried a HUGE map of the Chicago area with me when making home visits. Sometimes I would open the map onto my lap as I drove and refer to it at stop lights. Early GPS. Winter could be challenging. I remember jumping many snow drifts and driving slick snow covered streets. Summer had it’s own specialties. Making visits to homes with no A/C. Being grateful to cool down in the car afterwards. I knew where every DQ was located in my territory. Sometimes I would sit in a DQ to do my charting and enjoy a cold slushy drink at the same time. Good times. Good memories. Great patients and families. I am so grateful for my home care experiences.

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