What happened to Lillian Wald's dream for the VNS?
Lillian Wald was the founder of the Visiting Nurse Service of New York. She started the service to provide care no matter what the circumstances to the poor, destitute and needy in the lower East Side of New York City. There are pictures of her walking or jumping across tenement roof tops to get to those in need. She created this service because no one else would do it and people were suffering. I started my nursing career as a visiting nurse. It began because I had a clinical rotation in nursing school with the Visiting Nurse Service. I was so inspired by this experience, I knew I had to work in this field of public health, helping those who needed it the most. There were visits assigned to me where I had to walk up several flights of old rotting stairs, watch for rats and take an escort to protect me from drug activity and mugging. One time, I was making a visit to a Manhattan project building and ran into several local policeman in the hall. They asked me why I was there because there was police activity in the building. I explained and from that day they always looked out for me. It made me feel safe.
Fast forward to 2010.
My mother-in-law fell at my sister-in-law's house on Christmas Eve day. After the second fall in 12 hours,some disorientation, my sister-in-law took her to the ER. The doctors wanted to admit her over night because her heart rate was abnormal. Being of strong Russian stock and believing people only went to hospitals to die, she refused repeatedly over five hours. Her PCP(gerontologist) talked to her for 30 minutes on the phone but she was firm, NO HOSPITAL. She did agree to follow up with her PCP at the request of her children. Her PCP ordered the VNS to visit her at her home in Brooklyn, NY to make sure she was stable and safe until she could get an appointment.
The VNS refused to visit her because they deemed her unsafe. They made that assessment not in person but over the phone. They informed my sister-in-law because she lived alone and had fallen they weren't going to visit. Let me get this straight: the purpose of VNS now is to take care of people who live with other people, have no real medical issues and make assessments from the office? Is this the dream of Lillian Wald? I called VNS and asked them why my mother-in-law had been refused a visit. I was given the same information with the addition of the doctor hadn't cleared her, and there was a policy stating for liability issues a nurse couldn't visit. I said but the doctor ordered it. Well, the nurse determined the doctor thought it was unsafe. I asked Did the nurse speak with the doctor? No answer. I knew the doctor had not been contacted. The conversation was ended with VNS agreeing to visit after she saw the doctor in two days.
What a sad commentary on our healthcare system. Of all the organizations, I never thought VNS would close its doors to the most needy, sick and neglected for liability issues? An even greater questions is, How can a medical professional make an assessment of safety without actually seeing the situation? Poor Lillian Wald. Her dream is now watered down to help only those who may not be too much trouble or inconvenience.
Posted by HealthCare Whisperer at 1/7/2010 4:21 PM 
Categories: nurse practitioner,elderly,VNS
Tags: nurse practitioner VNS Lillian Wald healthcare elderly
Categories: nurse practitioner,elderly,VNS
Tags: nurse practitioner VNS Lillian Wald healthcare elderly
I am dumbfounded by the amount of parameters and exclusions that have fallen upon our providers.
Reply to this