Lorain County Home Visits

 More than anything, my capstone experience at the Lorain County Health Department has taught me the importance of health promotion and disease prevention. Working in the hospital, we become accustomed to treating disease in order to bring people back to a healthy state. However, this is a mere glance into the patient journey. The home is where most people fight to overcome barriers in the hopes of maintaining their health.

Over the course of the past four weeks I have been on multiple home visits. Most of these visits are run through a program called the Bureau for Children with Medical Handicaps. This Ohio program looks to financially aid families who qualify for diagnostics, treatment, or service coordination. During annual visits, health department nurses go out to children's homes to assess their progress, received medical care, family environment, and current needs.

My first visit was to a little girl who suffers from a newly discovered condition known as POTS - postural orthostatic tachycardia syndrome. This condition's main manifestation is orthostatic intolerance causing lightheadedness and fainting. Symptoms began for this young girl when she was five years old and it took the family three years to finally receive a diagnosis. Because she is prone to fainting, she must be observed at all times. (For instance, she was once going down a swing-set slide when she fainted and fell down the slide and broke her ankle.) Although her condition has required multiple hospital admissions for pain management, broken bones, and general sickness, her most important medical care is home maintenance which allows her to go to school and make new friends; she just wants to be a normal kid.

In the hospital we often fail to recognize that the patient's journey outside the hospital walls is just as important, if not more so, than the short-term care provided within. As future nurses we will make discharge plans and perform discharge teaching. However, most nurses are never directly involved in the actual care process after discharge; they don't understand the importance or the educational need for home health maintenance. This experience has taught me just how important it is to focus on life at home and home care when dealing with hospitalized patients. Although we have an obligation to perform hospital duties, we need to understand that this environment is only temporary. Teaching patients the necessary tools to prevent readmission and maintain their health at home is most definitely a better strategy for long-term patient success.