ELKS NURSE PROGRAM HELPS 'PLUG GAPS'
Posted: Monday, October 31, 2011 8:21 pm | Updated: 12:12 pm, Thu Sep 12, 2013. PAULA HOLZMAN Correspondent
If you're a football coach and need a player who will muscle the ball downfield no matter what, you go to your fullback.
And that's the metaphor Art Arnold uses to describe Elks Home Service Nurse Deborah Messier.
"Just give her the ball and let her run," said Arnold, who chairs the Pennsylvania Elks Home Service Program in Southcentral Pennsylvania. "She'll get there."
Begun in 1963, the program helps individuals with developmental disabilities, such as cerebral palsy and Downs Syndrome, and their families to get the services they need. And it's free, funded through charitable donations and the Elks' national organization.
For four years, Messier has been providing this service to 131 clients in Lancaster and western Chester counties. At the end of September, she shifted to covering Adams, Franklin, Fulton, York counties because of a move from Lititz to Hanover.
It's not a job for every nurse, Arnold and Messier agree.
But for Messier, the program has meant personal fulfillment as well as professional satisfaction.
"I think I've always been one to love a challenge," Messier said. "I think with children with disabilities, there's always a potential for people to look at that as a hindrance, and I've always seen it as an asset. That child has potential. Whether they're profoundly retarded or borderline developmentally disabled, there are goals that they can achieve to live up to their full potential.
Deborah Messier is shown in a video promoting the Pennsylvania Elks Home Services Program, for which she served Lancaster and western Chester counties. Messier recently moved and has trained Angela Reisinger to take over her territory. (Photo provided by Lancaster Lodge #134)
"I think it was more of a personal motivation in the beginning, where I saw that and I just wanted to be a part of that. I wanted to come alongside of the folks who struggled."
Referrals for the statewide program come through medical care providers, advocacy groups, schools and individuals. Each of the program's 26 nurses, including two who also serve as administrators, cover a particular territory based on population density.
Nurses make home visits - Messier said she tries to personally see at least four clients a day - but also coordinate a lot of care over the phone.
In 2010, program employees drove 332,117 miles to 14,513 home visits across the Keystone State, Arnold said.
The nurses don't provide direct care, but instead act as advocates, teachers, mentors and social workers to connect clients to the help they need. That means everything from accompanying parents to a school conference or doctor visit to fighting insurance-company denials to finding a good lawyer, Messier said.
The long-term goal is to make the clients and his or her family as independent as possible.
"A lot of people were dying from lack of services, literally, and the services were there. But understanding them and finding them was the critical need," Arnold said. "We aren't trying to duplicate anything existing. We were trying to plug the gap for people who couldn't find their way through that maze of existing services."
Roseville Pediatrics, part of the Lancaster General Medical Group, is one of the health care providers that refers clients to the program.
In addition to helping patients and their families better understand and access care, the Elks nurses serve a critical function by making home visits, said Dr. Bonnie Zehr, a pediatrician at the practice and lead physician of its medical home program.
"The Elks nurse can see what gaps in care exist and call us back. … For example, why we're not getting an asthmatic under good control," Zehr said. "They can be our eyes and ears because we're not seeing that situation."
For Messier, signing on with the Elks has meant drawing on many roles she's taken on in her decades in health care.
The New York native and licensed practical nurse has worked in clients' homes, hospitals, institutions, schools and summer camps. Many of these roles have centered on helping individuals with disabilities.
But becoming a home service nurse with the Elks program in some ways has been unlike any other health care job, she said.
"I've noticed some of the nurses we hire, they don't stay, and that's because there's a level of personal, personable service you have to have with this job," she said.
"A lot of our clients, we go into their house and we hug them. It's professional in the sense that we maintain professionalism, but there's also a barrier that we break, and that is we can be close with our clients. We advocate. We work beside them to get them the services they need."
For example, Messier said she helped one client who was attending to the needs of her son, who has multiple disabilities, while also navigating a difficult divorce and custody battle.
"(Her son) has muscular dystrophy, a developmental disability, a trach(eotomy), 18-hour-a-day nursing care, and this mom is all by herself," Messier said. "So I go in and we just start talking, and she starts pouring her heart out. I'm able to give her some resources for legal assistance … we talked about primary care, neurology, early intervention."
Clients can stay in the program for life - there's no age-out date. The majority of Messier's clients are children, but she visits some in nursing homes.
A child's parents or siblings can also have disabilities, which adds another layer to the assistance the family requires, Messier said.
She's had to learn how to function as a social worker, as well as finding her own way through Pennsylvania's sometimes hyper-local and convoluted web of services.
"Sometimes I get frustrated with the system, because I see my clients have legitimate needs, but they're being denied those needs," Messier said. "And now the funding has been cut in the state, in a lot of specific areas that help people like my clients."
But that just means Messier has to "put on my professional boxing gloves."
Messier has been training Angela Reisinger to take over her territory as the Elks home service nurse, taking her along on home visits and demonstrating how to access resources.
A licensed practical nurse, Reisinger said she knew of the program because she has belonged to the Elks for seven years.
"I really like it," Reisinger said. "I just know I'm going to be able to help someone. It's wonderful."
She also knows the job won't be easy.
"It doesn't matter what the needs are, the Elks nurse will try to find a way to help the families, to have their needs met," Reisinger said.
"The Elks nurse has been there to give us direction, guide us, allow us to make our own decisions, and be a friend," an anonymous program client is quoted as saying on the Elks' website.
"Being a parent of a child who isn't like other children isn't easy. (The nurse) gives me hope and encourages me to be strong. I have no family support and don't know what I'd do without their kind efforts."