When Laurie Harding helped found the Upper Valley Community Nursing Project a decade ago, the group worked with three nurses in three communities.
Now the nonprofit organization that Harding started with the late Dr. Dennis McCullough works with 11 nurses in 17 communities and serves close to 250 people, doing home visits or telemedicine appointments to help bring health care to people where they live.
This year the board hired its first executive director, Janet Hunt, and its first nurse manager, Kristin Barnum. Harding is also stepping down from the board.
“I needed to commit to stepping aside for the good of the organization,” Harding said. “They need new people with a new vision or different ideas about the vision that we have.”
Hunt and Barnum both work part-time. Hunt began working with the nursing project board in 2020 on a transition plan.
“Laurie’s the encyclopedia of the Upper Valley Community Nursing Project,” Hunt said. “It’s been a huge evolution for the board to have different leadership and to grow as a board.”
The organization helped establish a new nursing program in West Windsor and Reading, Vt., and is in talks with several other towns to create new programs.
The nursing project helps cities and towns set up their own community nurse programs. The towns or groups hire nurses themselves, setting out what hours they will keep and what their responsibilities will be.
The UVCNP also hosts gatherings for the nurses to talk about their roles and also maintains a database where nurses can enter information, including patient outcomes, that can then be used to apply for further funding.
“I think the mission has stayed pretty constant, to really promote this form of nursing in order to fill some gaps in the health care system that don’t take care of these issues that the nurses are doing,” said Ellen Thompson, who chairs the board and served as the Lyme parish nurse from 2012 to 2018. “I think every community that has one and has experienced it are very interested in maintaining it and keeping it moving forward. I hear, ‘I don’t know how I managed before having the community nurse helping us.’ ”
Community nurses do more than help patients understand their medication or go over their home to improve fall prevention. They also help patients navigate an often-complex health care system and figure out what health issues mandate a visit to the emergency room. During the pandemic, community nurses helped patients get familiar with telemedicine and using technology to connect with their families, sometimes providing their own devices for patients who do not have one.
They “became a lifeline for a lot of people who were isolated and alone,” Thompson said, checking in regularly over the phone or in-person, socially distanced and outside when the weather cooperated.
“It’s a free service, and it’s a safety net for the community,” noted Barnum. “Many folks, they’re not sure: Should I call the doctor? Should I go to the emergency room? I think the pandemic overall has heightened awareness of care at home and different models of care at home, expanding beyond the Medicare and Medicaid programs.”
Community nurses do not operate in a silo: They work with area visiting nurse associations and hospice care providers, in addition to physicians. They also serve as a lifesaver for people whose health insurance won’t cover at-home nursing care. One change that Harding has noticed in the last decade is that more health care providers refer their patients to community nurses if they do not qualify for further care through insurance.
More people are aging at home because they do not want to — or can’t afford to — go to an assisted living facility or other retirement community.
“People can’t always have the luxury to be able to do that, and consequently there needs to be more support for people who are going to age in the community, for their caregivers as well as the individuals,” Harding said. “And right now we’re not doing that very well now, the health care system isn’t doing that very well.”
Because community nurse services are free, they are not bound by billing regulations. They can spend as much time with patients as they need to, without trying to put a price on the time.
“I think it’s an idea whose time has come,” Thompson said. “Our population is aging, and the issues they face are not going to get easier. With a community nurse … we can make a plan, and the person wouldn’t be alone as they try to navigate all this.”
Liz Sauchelli can be reached at esauchelli@vnews.com or 603-727-3221.
