No one else has the heart of a nurse. They work in the trenches of medical care, cleansing and wrapping wounds and performing countless other less-than-aesthetic tasks to improve their patients' health and comfort. But they do much more than that. They smooth sheets. They dispel fear. They smile. They listen.
Registered nurse graduate Nikki Mann is a nurse practitioner, and wouldn't trade her job for any other. But hers is unique, because it fulfills her dream of making house calls to homebound elderly patients.
After completing her RN at USF in 2003, she qualified for the prestigious graduate school program at St. Louis University, completing her master's degree as a geriatrics nurse practitioner in January 2007. Spending nearly four years as an extended care specialist with a skilled care and retirement community in Fort Wayne, she got to know the residents and the unique situations involved in geriatric care. But she wanted more. More contact. More control. More compassion.
"I always wanted to make house calls, and when I mentioned it, one doctor laughed at me. But I really wanted to bring that back," she said. "Geriatric patients have so many unique issues impacting their health, and I wanted to make some decisions of my own for my patients."
She eventually met collaborating physician Dr. Jerry Michael Benfield. He had observed emergency admissions of homebound patients whose conditions had deteriorated. The needless and costly suffering sparked his business idea of making house calls to homebound elderly patients. He created MD2U, for which Mann now operates a satellite operation in Fort Wayne.
She made her first MD2U patient visit on Sept. 1, and loves it. Traveling to patients simplifies the process and creates lower overhead so she can spend more time with each patient. "Seeing 30 to 40 a day is too many. There's no time to really look at the big picture. I see a maximum of 10 patients a day and can spend up to an hour with each of them. We talk about a lot more than medicine. We talk about families, pets, kids and what's going on. It's socialization for them," Mann said.
She also gained her longed-for control. "Nurse practitioners can do so much," she said. "We can diagnose and prescribe and refer to specialists. The nursing model is more holistic regarding patient care. It includes the mental, emotional and psycho-social aspects."
Each visit responds to unique needs. "I can see the home and what they're eating. I can look at their meds and call to see if they're filling their prescriptions. It's like a private case statement," she said.
A close relationship with her grandmother helped create the special place in her heart for the elderly. "Given a choice between a younger and older patient, I would prefer caring for an older patient any day. There is a huge difference between younger and older populations. My patients are so grateful for my help, even if I can't do anything to change their condition," she said.
She takes their suffering personally. Her eyes welling with tears, she recalls her first house call. "My first patient moved here from out of state with advanced Alzheimer's Disease. She's on hospice care now. When the family looked at me and asked if they were doing the right thing by keeping her at home, I could look them in the eye and say yes, absolutely, she would have died by now otherwise. It's hard to let them go, but she's home and not in pain. This is right. This is how it should be," she said.
Another, a 90-year-old, has also stayed in her home, with Mann's help. "She's had a few setbacks, but she's happy, at home, loves her cat, does her thing and doesn't want or need a nursing home." Still another survived cancer and now is caretaker for her husband. "Older people just don't give up," Mann said.
Jane Love, in her late '80s, is wheelchair-bound with arthritis. She loves her caregiver. "Nikki has seemed like one of my granddaughters," she said. "It is just absolutely wonderful. I hear of other women who have trouble getting an appointment with their doctor. She has so much more time for me."
Mann applies a quiet, simple philosophy to her much-loved and aged patients. "The house call is meant for the nurse, I think," she says.