Insightsthe blog of Porter Hills
May 6-12 celebrated National Nurses Week. Did you get a chance to thank a nurse? Nurses work in a profession caring for people in many ways. When most people think of a nurse they envision someone working in a hospital or passing medications. The truth is that nurses have many roles. As the healthcare industry evolves, we are finding additional ways nurses can be instrumental in healing or helping people maintain their health in the community. Through collaboration and creativity, healthcare professionals and insurance agencies are finding new ways to have nurses assist physicians in the practice of promoting good health. Nurses function as the eyes and ears, as well as the right hand for many physicians. It is important to know what resources are available to you and what your insurance covers.
We are aware of the nurses in the hospitals but how can nurses help you in the community?
After an acute illness or surgery, people are often weaker than they were prior to a hospitalization. Although most of us want to get home as soon as possible, sometimes that is not the best solution. In order to ensure a successful recovery, a brief stay in a rehab facility is often the best course of action. Nurses that work in rehab facilities are trained to assess any wounds you may have and care for them. They are aware of how medications should be administrated and the possible side effects that may need intervention. The nurses in rehab can assess you clinically to ensure your recovery is progressing as expected and intervene if it is not. Most insurance will cover a temporary rehabilitation stay, but the criteria for coverage varies depending on the insurance.
Long Term Care and Assisted Living:
Moving yourself or a loved one from home into a long term care or assisted living setting can be a very difficult decision but at times it is a necessary one. When a person is no longer able to safely live in their home, long term care or assisted living are often the best options. Decades ago, “nursing homes” developed a poor reputation and people are often very resistant to making this transition because of that reputation. A lot has changed in the long term care and assisted living setting. Our society has recognized that our elders need and deserve to be in a nurturing environment that will provide safe and reliable care. Many laws have been established to ensure this happens. Also, the industry as a whole has recognized the need for person centered care which had led to the creation of various program design to keep people engaged. In these environments, nurses often become like a member of the family. The nurses in long term care or assisted living setting oversee the safety of the resident and work with the nursing assistants to ensure the resident’s needs are being met. They also administer medications and assess the effectiveness of the medications. Most Assisted Living communities are private pay so not everyone is able to afford this option but long term care is generally covered by Medicaid so long as the person qualifies for the need financially and physically.
When recovery at home is a viable option, having a Home Care involved ensures that you recover safely and to your fullest potential. Home Care services include Nursing, Mental Health Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Social Work and a Home Health Aide in any combination depending on the persons need. Home Care is also generally fully covered by most insurances for an intermittent period of time as long as you are homebound. Being homebound means leaving your home is a considerable taxing effort and your absences are infrequent and of relatively short duration. Most insurances that cover Home Care do make allowance to the homebound status for medical appointments as well as infrequent, unique social gatherings (i.e. funeral, wedding, graduation). Home Care nurses can manage your care in collaboration with your physician and an interdisciplinary team to ensure you have all the supportive services in place needed for your recovery as well as provide education regarding your medications, disease process and management. Home Care is often referred when a person leaves the hospital or rehab stable but not fully recovered. Some Primary Care physicians or even specialist will refer in-home care if they feel their patient needs closer oversight of their condition in order to prevent an unnecessary hospitalization. Home Care nurses can provide teaching regarding disease processes and management, perform wound care and draw blood in the home. Nurses can also teach patients and family members how to administer IV antibiotics, tube feeds or IV hydration fluids in the home. Home Care nurses educate people regarding their medication regimen and how to manage their medications. Mental Health nurses can work in collaboration with your Primary Care Provider or psychiatrist to ensure you have adequate coping strategies and the right combination of medications if you are struggling with depression or other mental health complications. If needs are identified that surpass the scope or length of what Home Care services can provide, the team works with people and their families to create a long term plan and find resources that can help once Home Care is complete.
A newer tend in healthcare is the role of a Case Manager within a physician’s office, a community resource agency or an insurance company. The Case Manager would oversee and coordinate care in collaboration with Primary Care Physicians, specialists, patients, families, insurance companies as well as other agencies that may provide services to meet a patient’s needs. The Case Manager ensures there is timely communication between providers, ensure records are kept up to date and accurate. The Nurse Case Manager’s goal is to identify problems early, before they are out of control resulting in serious health complications or hospitalizations. The Nurse Case Manager often will make phone calls to check in on people, especially after a hospitalizations. Nurse Case Managers can provide counseling and education regarding diet and exercise. Some visit the home periodically to perform assessments and ensure adequate services are in place to allow a person to remain at home.
Regardless of your need you can be confident there is a nurse that can help you on your path to recovery or help you maintain a healthy lifestyle.