Climbing into her car each morning, Marsha Ramsey, RN, knows she has a full day ahead. As a Traditions Health home health care nurse, she makes old-fashioned house calls of sorts. Every day is different, and a single phone call can topple her schedule or send her out at 10:30 at night to see a distressed patient. But one thing always stays the same: Marsha loves her job.
Let’s follow a typical Tuesday as she makes her way throughout the Oklahoma area, helping her patients stay as healthy—and as independent—as possible.
*Patient names have been changed to protect their identities.
Stop 1: 8:00 am appointment with “Ken”
Every day, Marsha leaves her home in Oklahoma, by 8:00. Each visit starts with a complete assessment, including checking her patients’ vital signs. “I want to make sure nothing is going on that I need to call the doctor about right then,” Marsha says.
Her first stop is with Ken, a new client with diabetes. Because people with diabetes are more likely to have foot problems due to reduced circulation and nerve damage, examining feet is on Marsha’s checklist. And it’s a good thing. Because she sees that Ken has a toe that needs attention. So, she gets him in to see his doctor, who, she learns, later admitted Ken to the hospital with gangrene of the toe.
Stop 2: 9:30 am appointment with “Bob” and “Marlene”
Bob and Marlene’s herd of dogs greet Marsha at her next stop. “I deal with dogs–some friendlier than others–all the time,” Marsha says.
Bob has a colostomy and feeding tube, so Marsha talks with him about his diet. “Education is important because he can’t eat just anything,” Marsha says.
Marlene has dementia, which can make it challenging for patients to stay in their homes. That’s why Marsha closely monitors her condition each visit. “We try to keep people at home as long as we’re able because it’s amazing how much better they do,” Marsha says.
Marlene’s at risk for bed sores because she’s mostly in her chair and bed, so Marsha checks her skin condition carefully.
Stop 3: 11:30 am appointment with “Betty”
Betty has breathing problems caused by chronic obstructive pulmonary disease (COPD). A bout with COVID-19 worsened her condition, and Betty doesn’t like using the supplemental oxygen and inhalers she needs. “I explain that while she might get away without using her oxygen for a while, eventually, her condition will get worse,” Marsha says.
Because Marsha has spent time each visit educating Betty about why she needs the oxygen and inhalers, “she’s slowly getting better about using them,” Marsha says.
Stop 4: 12:45 pm appointment with “Roger”
Roger likes to stay busy, sometimes busier than someone with heart failure and COPD should. “He doesn’t realize how easily winded he can get,” says Marsha.
She also checks Roger’s medications, makes sure he’s taking them, and explains why they’re important. Roger also has dementia. Living at home with his wife, along with support from his home healthcare team, helps stabilize his condition.
Stop 5: 2:00 pm appointment with “Nancy”
After back surgery, Nancy doesn’t really understand what she can and can’t do as she recovers at home. Because Marsha is also a case manager, she sets up physical therapy for Nancy as part of her recovery plan.
Marsha explains that although Nancy will have to be careful with how she moves, spending too much time lying down will make her body stiffer and weaker. Marsha talks with Nancy about her pain level and how over-the-counter and prescription medications are helping.
Stop 6: 3:15 pm appointment with “Carol”
Carol counts on dialysis and home health care to manage her kidney failure. Checking Carol’s medications is crucial too. Her kidneys don’t break down the medications as they should, and it’s easy to overdose. After spending two hours sorting through Carol’s medications on a previous visit, Marsha contacted all of Carol’s doctors to verify what she should be taking and cleared out what she shouldn’t.
Stop 7: 4:30 pm appointment with “Marge”
Marge needs many medications to manage her high blood pressure, coronary artery disease, and heart failure — sometimes too many.
“She was taking three different statins (cholesterol medicines),” Marsha says. “So, I called her doctor to verify what she should be taking.” Home health nurses are often the only ones with a patient’s complete medical record.
Marsha sets up most of her patients’ weekly medications. But Marge still fiddles with hers, so Marsha asks family members to check them during the week too.
Stop 8: 5:45 pm appointment with “Bill”
Finishing her day with Bill, Marsha spends time checking his medications and just talking with him. He has frequent syncope (blackout) episodes that can be caused by heart issues or even dehydration. Confined to his home, he—like all her patients—looks forward to Marsha’s company every week.
Marsha gets home feeling fulfilled.
“I know home health nurses make a difference,” Marsha says. “Some days I’m helping a patient bathe or cooking for them because the family member who was to come help never showed up.”
But even on her hardest days, Marsha wouldn’t trade any of it. “I love seeing the patients and watching them get better,” she says. She also loves knowing she can make sure patients get what they need. “Traditions Health puts them first.”
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