Ms. Parkhill works as a community nurse who provides skilled nursing care in the home for patients and their families, she works as a nurse in the Senior Wellness Program.
Exceptional service can be described as a comprehensive, timely, and proactive approach to meeting the client’s needs. Exceptional staff see the entire picture clearly without rose colored glasses. They frame the processes and outcomes of their service with care, compassion, competency, communication, and collaboration. Ms. Parkhill demonstrates the essence of exceptional service.
Ms. Parkhill routinely sees a 68-year-old gentleman I will call Barney at her Senior Wellness site. Although relatively young, Barney suffers from many chronic illnesses. One week Barney did not come to the wellness session, which was unusual. Andi decided to knock on his apartment door to see if he was okay. He had fallen a few days before and confessed to being in a lot of pain.
The physician agreed to Andi’s plan to order a certified home health aide to assist Barney with personal care, and a physical therapist to improve strength and safe ambulation. Her environmental assessment identified several safety factors that Barney agreed to have corrected.
The plan was implemented; Barney completed his episode of homecare and was discharged without complications. Ms. Parkhill’s nursing instincts assisted her to identify and correct an unsafe situation that allowed this patient to remain living independently at home.
The housing authority called and asked her to visit an 83-year-old woman (I will call her Ida) residing in a senior building. The woman had signed herself out of the hospital against medical advice because she wanted to be home to care for her cats. The apartment was dirty with cat hair and cluttered with empty beer and wine containers. The refrigerator held only expired food.
Ms. Parkhill completed her psychosocial assessment and opened Ida to homecare. Andi set up a plan of care that included social work, therapy and certified home health aide support. But the patient refused anyone but Ms. Parkhill. The patient was alone, with no family or significant others.
Ida developed itching and cellulitis of both lower extremities. Around the same time, Andi began noticing bedbugs in the apartment, and when all treatment of the cellulitis failed, she determined that the bedbugs were the cause of the skin alterations. When she noted bedbugs in other apartments, Ms. Parkhill realized there was a problem and brought the information to her clinical manager. Ida refused to have an exterminator as she feared for the safety of her cats…and the housing authority issued an eviction notice.
Andi called adult protective services but Ida was competent and, therefore, could refuse assistance…which she did. Ms. Parkhill next found a distant relative whom she called, but was told, “We don’t want to deal with her. Put her in a nursing home”. At this point, the bedbugs had infested everything in the apartment; they were on the walls and were dropping from the ceiling.
Andi next called the County Department of Social Services and got help. The social worker and Andi contacted a VNACJ nurse who works for the town’s local social service department. She had funding with which she agreed to purchase new furniture and bedding if the apartment was fumigated.
Andi contacted the humane society who offered to care for the cats, but Ida refused. Andi next contacted a veterinarian who agreed to treat the cats…and Andi would pay for the care. Ida agreed. Andi was able to convince Ida to stay in a clean apartment while hers was fumigated…and again, Ida agreed.
With a plan in place, Andi moved quickly. The apartment was emptied, cleaned and refurnished with the donations from the local social service department. Ida got new clothes, thanks to the generosity of Andi Parkhill who purchased them as a present.
Andi has identified that many residents in the senior building had no family and were dealing with aging issues, in particular the death of many friends in the building. Andi was concerned about the increasing number demonstrating signs of grief and depression. Also, access to everyday support services such as transportation and even how to get new eyeglasses was becoming an issue for many. Together, Andi and the social worker are addressing these issues. The combined role of the nurse and social worker is so effective that it has been maintained and expanded.
These three examples are characteristic of an exceptional nurse who has inspired physical, mental, and spiritual comfort in her clients and the community.