Twin Cities public health nurses at your doorstep: Building health through relationships, from babies to seniors

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Natasha Solovieff said one of the most enjoyable parts of her job is “meeting all the babies.” Solovieff is a public health nurse in the family health department at the Minnesota Visiting Nurse Agency (MVNA). She spends her days driving from the suburbs to the inner city of Hennepin County to meet pregnant /parenting teens and young moms in their homes and schools, helping them to navigate the sometimes complicated maze of pregnancy and parenting.

In her Southeast Minneapolis neighborhood, Darla Wexler makes rounds in her Subaru station wagon, visiting clients who are some 50 years older than Solovieff’s youngest clients. Wexler has spent the last 22 years as an outreach nurse with the Living at Home/Southeast Seniors Block Nurse Program. Regardless of the age of their clients, both of these nurses have a similar goal in their work: to connect with each client in their environment to best support their lives – physically, emotionally, and socially.

Their work as nurses may seem obvious. As nurses, they do take blood pressures and heart rates, assess physical and emotional health, but both nurses also build relationships. It is in these relationships that both are able to tackle some of the substantial issues that can also affect long term health and well being.

Solovieff offers support, education, and answers to challenging questions: I planned to drive and go to my prom, now what? How will I provide for this child? Do my parents think I am a failure? What’s happening to my body? Is my child developing normally? How do I get the dad more involved? Is my life over? Do I have post-partum depression?

Wexler is often able to plan proactively for her clients by noticing small changes in memory or health status, changes in ability to care for one’s self and/or home, and identifying needed resources.

The goal of the Southeast Seniors program is to enable seniors 65 and older to stay in their homes independently and safely for as long as possible. The program provides nursing services, volunteer home visitors, and the Intergenerational Project — pairing kids at Marcy Open School with local seniors for creative projects, monthly blood pressure clinics, and community education talks. A resource coordinator helps to connect seniors to community resources, such as a chore service, meal delivery, and transportation. Wexler has been seeing Mildred Janesich for ten years. Janesich said that she appreciates having Wexler available as a constant and trusted source of support.

As our nation continues to grapple with the best way to pay for the rising costs of healthcare, the long term benefits and cost savings of both of these programs are significant. Both programs use multiple funding streams to provide services (grants, state and federal dollars, fundraisers/donations). A 2011 Wilder Foundation study showed that the MVNA Nurse/Teen Mom program resulted in a myriad of positive outcomes; teens were more likely to access prenatal care, babies had high rates of insurance coverage (99%), and more moms were enrolled and attended school regularly. The Nurse Family Partnership, a national nurse/first time mom visiting model shows that every dollar spent in the program provided $5.70 in benefits to society and long-term reduced women’s use of welfare. While Solovieff doesn’t formally work in the Family Partnership program, MVNA does have a dedicated group of nurses in Minnesota who do.

Wexler believes strongly in the Block Nurse model “If we could have this model in every neighborhood we [would] save Medicare and the health care system so much money. It identifies the health issues early, it’s eyes and ears into seniors’ homes.” The program harnesses the knowledge and resources of all of the community in supporting seniors. Wexler tells a story of a neighborhood mechanic who knew his customers well. A normally sharp and independent elderly woman came into the shop for her yearly spring maintenance, but forgot how to put the car in drive when she came to pick up her car. She sat in the car until the mechanic came to ask what was wrong. The woman asked, “What is P, D , and R ?”, referring to the park, drive, and reverse functions of the vehicle. The mechanic drove the woman home, instructed her not to drive the car, and immediately called Southeast Seniors for help with the confused customer. Southeast Seniors saw the woman in her home the next day and helped to keep her in her home safely for three more years following the incident. “Every month that they are kept out of nursing homes keeps people happier and healthier at home and saves the system money,” said Wexler. In 2007-2008 all MN Living at Home/Block Nurse Programs resulted in 1326 delayed or averted nursing home admissions and saved an estimated $41,751,233 in potential nursing home costs.

Solovieff said, “I always appreciate how these young girls let me into their lives I am constantly impressed that how given a chance to be heard, really heard, how talented, creative, full of life, and smart so many these teenagers are that is uplifting to me”. Both Solovieff and Wexler use the power of relationships, trust, and their knowledge to improve health and lives, one person at a time.