Alphabet Challenge: W

I’ve signed onto The Blogging from A to Z April Challenge 2021.

The challenge is to blog the whole alphabet in April and write at least 100 words on a topic that corresponds to the letter of the day. 

Every day, excluding Sundays, I’m blogging about Places I Have Been. The last post will be on Friday, April 30 when I finally focus on the letter Z. 

W: West Catchment Area

When I started my job as a nurse practitioner in home care at a Veteran’s hospital outside of Chicago, I had the choice of taking care of patients in the north or west region. The north region was deemed a safer catchment area. The west region, which surrounded Oak Park where I lived, had pockets of crime caused by rampant gang and drug activity. I wanted to be closer to home and stop off for lunch if I was in the neighborhood. I didn’t think twice before choosing the west side. Maybe I thought I was invincible, a city girl used to the gritty streets and boarded up homes. 

I tried to keep my senses sharp and stay alert when I drove through the neighborhoods making my home visits. I kept my distance from the car in front of me in case I needed to make a quick U-turn. I avoided groups of young males loitering on the street corners and always locked the car doors. 

In the long run, it wasn’t just the neighborhood that proved unsafe. Any home I went into could hold danger regardless how dilapidated the outside environs. My close calls, and there were some, depended on the character of those with whom I interacted. 

Still, to this day, I keep my handbag on the floor of the car and out of sight.

Country Music

I’m not writing my second book whose working title was to be “Home Visits.” The Pandemic has cast a spell on my brain, resulting in lethargy and an inability to focus on structuring another book. So, instead, I’ve decided to take each home visit story and submit it to a literary magazine for potential publication as a “stand-alone” essay. I plan to email one of the stories, Country Music, at the end of this week to an online journal. 

Country Music tells the story of three patients that I cared for when I worked as a nurse practitioner in a home care program at a Veterans Hospital outside of Chicago. They were at various stages of dying. In the late 80s, the hospice movement was just taking baby steps into the medical/nursing world. I was learning about dying and death from my patients and their caregivers. 

The locations of the three patients’ homes lined up perfectly for me to make the visits to them conveniently in the same day. This lasted for about three months. On the day of the story, a dreary, rainy day, I show the challenges I faced working with my three male patients and their wives (few women were enrolled in the VA health care system at that time), how each man played the hand he was dealt and how the women dealt their husband’s decline. 

One of the men loved country music. Talking with him about songs and artists, rekindled my interest in the genre. I found a great country western radio station on my government-issued compact car. The earthy, raw lyrics telling of common human emotions became my therapeutic passenger that accompanied me on my home visits. 

While I am editing this story for submission, I find myself checking into YouTube to listen to the familiar songs that supported me so many years ago. This is more fun than writing that second book. 

Home Visits Can Be Fraught With Danger

As I write my second book, which is about the home visits I have made over the years, I am resurrecting memories from my mind and the pages of my journals. Today’s post shows a time when I didn’t use common sense and how home visits can be fraught with danger. 

One day in early fall, on my drive back to the hospital after making all my scheduled home visits, I found myself passing by a patient’s apartment on the westside of Chicago. Since I was ahead of schedule, I decided to drop in, unannounced. I had the time. My patient had a caregiver: a tall, muscular man who always opened the door to the first-floor apartment wearing a long blond wig and thick make-up. Despite his flamboyant appearance, he gave competent care to his charge: a bed-bound, uncommunicative middle-aged man with multiple sclerosis. An exotic array of visitors wandered in and out of the apartment. My patient’s mother, strikingly average looking compared to the rest of the visitors, lived in rooms above her son’s and was often present when I came. However, this day I walked into an unlocked and empty apartment. Only my patient, lying in bed in the darkened bedroom, was present. 

Neither the caregiver, nor the patient’s mother, or anyone else familiar to me entered the apartment while I was there. However, as I finished with my evaluation, a man opened the unlocked apartment door. He wasn’t anyone I had seen before. My patient smiled at him knowingly.

The man removed his jacket and tossed it on the sofa. We introduced ourselves. His eyes moved down my body. Acutely aware of the precarious situation I was in—alone in that apartment with a strange man and unhelpful patient—a band tightened around my chest. 

“I’m just leaving,” I said as I promptly packed up my nursing bag. 

Safely back in my car, my breathing heavy and my hands shaking, I chastised myself for making this impulsive visit. No one back at the office knew where I was. It was a time before cell phones. What If something had happened to me?  I didn’t want to think of that. I never again made an unscheduled home visit. 

Sometime after that impromptu visit, at a nursing conference, I sat fixated as another home health nurse told a story about the time that she had made a scheduled visit. She rang her patient’s doorbell. He didn’t answer. It was later that she found out he had been murdered. And in hearing more detail, she discovered that the murderer had likely been in the house the exact time she was ringing the bell. Good thing the door wasn’t unlocked. 

Home visits can be fraught with danger. 

NURSES REALLY MAKE A DIFFERENCE

 

Betsy, a writer friend, emailed me the story she had read in our workshop since I had to miss the class. She knows I hang on every episode of her life in Ireland where her second child was born and she negotiated the daily vicissitudes of a different culture. In this episode she had left the hospital with her new baby girl. She happily accepted the offer to have a nurse visit her and the baby at home.

Her daughter is in college now but Betsy still remembers how helpful the nurse was—and knowledgeable and reassuring, which, in turn, made me remember the article I read not too long ago by David Bornstein, The Power of Nursing (NYT, May 16, 2012) about nurses who made regular home visits to at-risk pregnant women and continued these visits until their children reached the age of two. The program, Nurse-Family Partnership (NFP), conducted studies that demonstrated the visits improved both child and maternal health and financial self-sufficiency and provided a five to seven point boost to the I.Q of these children. Plus many more positive results.

NFP, which has been around since the ‘70s is implemented in forty states, empirically proves what many of us already know: nurses REALLY make a difference. Training paraprofessionals to do the nurses’ job didn’t yield the same outcomes.

We nurses do make a unique contribution. No one else can fill our shoes.

THE WEIRDEST HOME VISIT

This originally appeared on 08/12/2012. The Weirdest Home Visit is one of many stories that didn’t make it into the first book. I am considering it for inclusion in my second book.

Nursing Stories

When I worked in the home care program at a VA hospital in Illinois, medical students sometimes came along with us nurse practitioners while we made our visits. I enjoyed showing them the reality of delivering care in the patient’s home—where we were guests—the subtle line between suggestion and decree, education and instruction, doing for the patient and letting the patient do for himself.

One afternoon, when I had a female medical student riding with me, I had trouble finding the house. In the day of no cell phones or GPS’s, I stopped at a gas station to call the patient’s wife. Was I being paranoid when she sounded like she was being deliberately unclear?

We finally drove down the well-manicured block in a rather upscale neighborhood. One house in the middle of the block was “protected” by a row of stately cypresses or if cypresses trees don’t grow in…

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