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Interview with Mary Kane, RN, nurse/manager of the HOPE program HCDC: To begin with, Mary, is there anything that you would like to tell the readers about yourself? MK: I have been a Registered Nurse for 30 years. Most of my career has been working with the elderly and Visiting Nurse Agencies. I worked in the Greater Boston area, on Martha’s Vineyard, on the Caribbean island of St. Croix and here in the Berkshires. I live high in the hilltowns, in Peru. HCDC: What led you into nursing and into working with elders? MK: After high school I attended nursing school at Boston City Hospital and worked there for 12 years. Then I had the opportunity to move to Martha’s Vineyard to work as a Visiting Nurse. Later, I was back on the mainland working for the Quincy VNA. By this time, I had learned the benefits of being able to help people to stay at home and to bring the resources, therapies, meals-on-wheels, home health aides and more into the home. For me, this is the rewarding part of the work. HCDC: Does isolation or loss of independence strike a chord in you or your life? MK: I think most people want to be independent, to live safely and not be perceived as a burden in any way. HCDC: Mary, you could have triple the salary working in a hospital. What keeps you driving endlessly from one isolated rural elder to another? MK: The reward of seeing people remain independent and the opportunity to see patients as people rather than as illnesses or conditions. As nurses we see the whole spectrum of ways of helping and we respect the elders. We really learn “true histories” from them. HCDC: Home care nursing is very intense. How do you approach the measurement of an elder patient’s need for institutional care, if and when that point comes? MK: When all available resources have been applied and the home environment is still unsafe. Medication oversight is also a big issue. Mild dementia does not preclude successful independent living, but extreme conditions can be dangerous when alone. HCDC: How do you view this huge responsibility? MK: Not lightly. I confer with the patient, the family and the doctors. My predecessor was particularly adept with this issue and I talk with her. HCDC: Does that point change from one medical professional to another? MK: Nurses see the whole picture from the viewpoint of being in the home. We may see progressive deterioration over the course of time. Our visits then increase in frequency. Sometimes the changes are actually with family members themselves who may color the situation. It requires evaluation. HCDC: Do you work with Hospice teams? MK: Fortunately, not at present. I wouldn’t hesitate to involve Hospice when the need arises. At that point the patient would no longer be a HOPE participant as Hospice has its own dedicated staff. HCDC: Where do you feel the duties of a physician and those of a nurse divide? MK: I am part of a team to bring input to the doctor’s attention, especially for medications. I help the patient make sure that they can live safely and independently in their own home. HCDC: Would you like to see the creation of a home care agency specifically for the Hilltowns? MK: That would bring more resources to the individual participant. Sometimes the outside referral agencies cannot provide services reliably enough, because of the distances involved. HCDC: Do you feel it would be a popular service and be well received? MK: Yes. HCDC: Do you carry your own life to work or consciously make a separation? MK: Yes. There is no separation. HCDC: Do you have a good idea of just how appreciated you are? MK: Well, it’s my job. HCDC: Thank you, Mary. |
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