ABOUT

The Upper Valley Community Nursing Project (UVCNP) is based on a holistic philosophy of nursing that dates back to the mid 19th century. It was a time when nurses focused on the health of individuals, families, and groups within a specific community.  

It was also a time when the care of individuals was driven by need and not by reimbursement. 

The focus of the UVCNP is the health of older individuals in communities drawn together by commonalities such as location, religious affiliation, social connections, or fraternal association.  

GOALS
The overarching goal of the UVCNP is to add a health professional to the informal network of volunteers already providing care for elders. We aim to help elders remain independent and living at home and to facilitate the placement of a nurse in a community where she or he can best address non acute needs of elders at home. The most familiar example of a Community Nurse (CN) caring for elders is the Parish Nurse. 

 BENEFITS
The target population for this project are elders who are aging in place and may need additional support from a CN—a health professional knowledgeable about problem solving and the health care system. Elders will benefit from the CN’s personal appreciation of the their life circumstances. Elders will also benefit from the CN’s knowledge of community resources and case-management skills. An added benefit is the nurse’s added ability to work as part of a team that includes volunteers committed to supporting elders as they age in place. The CN will complement and enhance other community initiatives as well as more traditional health care services (Visiting Nurse Associations).

WHAT IS A COMMUNITY NURSE?
A CN is an licensed clinician who is a member of a particular community and who has years of healthcare experience. He or she may be paid by the community or may volunteer time. He or she  will not provide hands-on nursing care, but will assist the elder and family members in seeking additional care if needed, and in helping to provide continuity of care. 

HOW  UVCNP WORKS
To help reach our goals, the UVCNP will :

• Locate and investigate the best examples and characteristics of successful community nursing practices
• Partner with the interested communities to create a road map for the development of a community nursing program which addresses existing volunteer initiatives, current practice, legal, ethical, and regulatory concerns
•  Explore with local community the possibility of participating in a pilot project which engages and supports nurses to provide CN services to designated communities
• Establish a formal system of support to provide ongoing information, educational opportunities and clinical discussions with the CN to minimize the professional isolation often associated with this work
• Identify appropriate outcomes that measure effectiveness of the UVCNP
• Initiate discussions about research projects that might emanate from the UVCNP
• Establish a mechanism for communities to obtain assistance in searching for funds to sustain individual CN programs.

Lillian Wald, founder of American community nursing (portrait by William Valentine Schevill)

A COMMUNITY NURSE ROLE
An elderly woman, a member of a church in the Upper Valley, lives alone in a home she has owned for many years. She has no family in the area. The pastor is concerned because she had not been to Sunday services, and because she had been complaining of shortness of breath and discomfort in her chest radiating up into her jaw. The nurse recognizes these symptoms as possibly cardiac in nature. She requests the parishioner’s permission to call the MD so she can follow up on medication changes if they are necessary.  She also agrees to call the family in California. She sets up an appointment with the primary care physician and arranges for Meals on Wheels to start coming to the woman's home.