Home Health Nurse Reflects on 25-Year Career and Impact of COVID-19


By Katie Noonan, RN of Hallmark Health VNA/Home Health Foundation

Home HealthI didn’t always aspire to be a nurse. My mother was a nurse, and although I admired her and what she did, I didn’t think I had the stomach for it.

That is, until the summer I took a job as a nurse’s aide. I was attending UMass Amherst with no major chosen when I began working at a nursing home. I started to think this is what I wanted to do, but I couldn’t get into the nursing program. So I moved home with the intention of applying to the Malden School of Nursing, which had one spot left that fall. I graduated in 1984, and worked in telemetry and the ICU at Malden Hospital until 1994.

When Malden Hospital was getting ready to close, I was working per diem and ran into a woman who was managing the Malden VNA which merged with Hallmark VNA. I hadn’t had a great home care rotation in nursing school, so I didn’t know if I’d like it, but the more I did it, the more I loved it.

It’s hard to believe I’ve now been a nurse for 36 years, with the last 26 years in home care. There have been so many changes, but I still love seeing how people live and how I can take care of them in their environment. Home health is a lot different than caring for patients in the hospital, where you have more time and resources to help them. Home health has so many facets to it, you wouldn’t even believe it.

Sometimes you encounter sick people whose caregivers are very elderly. You may be dealing with difficult patients who are noncompliant, and you need to figure out how much you can change the situation to be helpful while respecting their autonomy. You go into really messy houses and other difficult situations because patients’ home lives can be very dysfunctional. Also, you’ve got to love dogs.

I had a favorite patient, a quadriplegic who has since passed away. You try to set boundaries, but some patients become very special. You can’t help it. Some people need you more because they don’t have much support.

There have been a lot of changes in home health due to COVID-19, and patients are experiencing a lot of anxiety. We review their symptoms over the phone prior to each visit so we’re not walking into an exposure situation without being aware of it. We also run down what they can expect from us before we come into their home. A lot of it is allaying fear and reassuring them we practice good hand hygiene, wear masks and gloves and maintain proper technique in general.

I try to see my patients with COVID-19 last so I can go straight home afterward. Even though I’m wearing full protective equipment, I put a garbage bag by their door so when I’m leaving I can carefully remove my protective equipment and put it inside the bag to be disposed of. When I get to my car, I properly wash any equipment that was with me using a new pair of gloves that I then put in a bag in the back seat and throw away when I get home. Maintaining good technique has always been important in home care, but now so more than ever.

It’s a scary time for everyone. My husband and kids worry for my safety, but I’m prepared and careful. I’m a home health nurse because I recognize there’s a need for everyone to receive the care they deserve. I don’t judge others, but what if all clinicians said I don’t want to take care of anyone with COVID-19? I just hope it passes and we all move forward and learn from it.

As a home care nurse, I’m also seeing patients recovering from COVID-19. One nice moment was with a woman in her 80s who was 14 days post-diagnosis. Her temperature was flat and she was presumed recovered, and she and I both said, “Isn’t this wonderful? You survived it!”

Another memorable patient was a man I had sent to the hospital with shortness of breath. I had seen him feeling frightened. Now he’s home from the hospital and I’m caring for him again. He feels better, and a lot of his nasty stomach and respiratory symptoms have disappeared.

I know I’ll be seeing a lot of patients diagnosed with COVID-19 in the future who are getting off ventilators and going to rehab. They’re still so sick that I haven’t encountered them yet, but I’ll be ready when they need me.

My fellow nurses and I really appreciate all the support from the community. It has kept all of us going. I wasn’t able to attend the caravan led by the Haverhill Fire Department and Trinity EMS at High Pointe House (the hospice and palliative care residence of Merrimack Valley Hospice in Haverhill) in April, but I saw the video on YouTube and I thought it was wonderful.

It’s so nice that people are acknowledging everyone who is making an effort to keep this world going: healthcare workers, employees in grocery stores and take-out restaurants, truck drivers and food and package deliverers. Because so many wonderful people making the effort, a lot of heartwarming stories are coming out of this, which is exciting to see. With that said, my heart goes out to people who have lost someone, or become financially destitute or otherwise suffered immensely from this.

As a nurse, I’m solution-driven. My attitude is we’ve identified the problem, so now what can we do? I trust that the appropriate scientists are working on developing a vaccine and treatment, and I’m hopeful that we’ll all emerge from this with lessons to return to a simpler life, and enough knowledge to respect pandemics and be better prepared in the future. Life will be different, but in some ways, I believe it will be better.

My advice for others during this uncertain time is to please wear face masks and not question it. Don’t discard your gloves on the street, and don’t judge if you see a home care nurse going into a house wearing full personal protective equipment.

We’re as anxious about COVID-19 as everybody else, but we’re fully trained and prepared to deal with it – each day at a time, and each patient at a time.

About Home Health Foundation

Home Health Foundation, which includes providers Circle Home, Commonwealth Nursing Services, Hallmark Health VNA, Home Health VNA, Home Health VNA of NH, Merrimack Valley Hospice and York Hospital Hospice as part of the Wellforce Health System, provides essential home health and hospice care in all the places patients call home. Together, these agencies are leading the development of a new era of innovation, with a relentless focus on transforming home-based care. For more information, visit HomeHealthFoundation.org.

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