Visiting Nurse Association History

The Visiting Nurse Association of Southeast Missouri (VNA) began serving the six Bootheel counties of Mississippi, Scott, New Madrid, Stoddard, Pemiscot and Dunklin on August 23, 1973. Our name in the beginning was SEMO Regional Home Health Agency. We were young and we were eager to serve.

The agency was born from a need in the community first recognized and acted upon by the directors of these county Health Departments. They saw a need for broader health services at a low cost and set about providing it. They felt there must be a better way to improve the health status of the general population of the Bootheel of Missouri without sacrificing quality of care or increasing the cost. Many illnesses required lengthy periods of recuperation that were either keeping people in the hospital for an extended period of time at great expense, or caused individuals to return home prematurely resulting in a return to the hospital for possibly an even more costly stay at a later date.

So, together they applied for and received a grant from the state of Missouri for the necessary funding to start a home health program in southeast Missouri. Within one year, their program had become so successful that it could continue without further government support. These leaders became the first board of directors and continued to guide and support the program they fathered well into their retirement years ~ some, until their deaths.

In the early 1980’s, VNA Community Services, an In-Home Homemaker/Chore and Personal Care Program was added to the Home Health Nursing and Therapies Program. Residents who were not ill but were aging had been forced into nursing homes simply because they could no longer maintain themselves in their own homes. Our society was continuing to expand out and away from the nuclear family so much so that adult children lived too far away to provide routine support to aging parents. Still, with a little support several times a week, these seniors could safely continue to reside comfortably in their own private homes. The cost was nominal and the rewards great. What better place to spend your days than in your own home?!

In April 1985, SEMO Regional Home Health became known as the Visiting Nurse Association of Southeast Missouri (VNA) so as to make our not-for-profit status more widely known and to tap into greater community awareness of the services available through the Visiting Nurse Association of America’s (VNAA) awareness programs. VNA has maintained a long history of cost containment, spending funds on patient services over advertising. Until recently, VNA purchased no advertising except a small bold listing in the yellow pages of area phone books. Unfortunately, numerous individuals went without services for lack of knowledge of all that was available to them and community leaders currently serving on VNA’s boards have emphasized the importance of at least some awareness advertising. Still, the bulk of VNA’s finances and energies are directed towards patient care.

It was in 1985 too that three more counties were added to the VNA service area: Cape, Perry and Bollinger. An office was opened in Cape Girardeau and the Chaffee office was moved to Cape shortly afterwards. Soon after, Butler and Madison counties were added at the request of those residents. This brought the number of counties served to eleven.

In August 1985, VNA Private Duty Program was born. Nurses were assigned shifts for the first time to care for a child on a ventilator at home. Up to this time, Home Health Nurses entered the home, staying as long as was necessary, to assess a patient’s condition, provide the teaching and care needed to promote improved health and then left the family caregiver to carry on with the care that had been initiated. Patient independence along with regained good health was the goal. Now, Private Duty Nurses, began staying up to 24 hours per day with patients facing long-term acute care needs, providing them with total care: nursing, medication administration, therapeutic exercises, personal hygiene and grooming, meal preparation, laundry and assistance with other household tasks. Thanks to VNA Private Duty and the resources of the Missouri Medicaid Waiver Program, infants and children with birth defects were given the opportunity to come home from the hospital despite continuing health care needs. Families were able to stay together. They were taught how to provide the care their child needed in the safety of home. They learned much and they learned well. Years later, many of those family caregivers became nurses too. Many of those children now live fruitful lives despite the odds against them at the start.

At the time VNA began providing private duty services, there were no local agencies available to give this level of care. VNA not only offered quality private duty care at a fraction of the cost of outside providers but also did so while realizing a modest profit. This was the ideal solution to the problem of funding “charity” care for uninsured or under-insured patients who needed health care. Remember, intermittent health care provided in the home is the most cost effective form of health care for anyone not requiring continuous 24-hour assistance.

Most VNA “charity” patients fall into the middle-income bracket. They are often young families. They are too young for Medicare, earn too much to qualify for Missouri Medicaid, and have too little insurance to cover long-term health care needs. Civic and church organizations have always been generous in their support of VNA but the need often outdistanced their generosity. Private Duty Nursing is not a source of continuous funding as the cases are less frequent than most others, but it is an honorable means to an honorable end. Many of the nurses serving our private duty patients depend on other full-time work to support their families as most private duty cases come and go quickly. They are a dedicated group of nurses.

All through the years, VNA nurses have cared for those recovering from illness, injury or surgery alongside those sharing their last days with their families. In 1993, VNA Hospice officially sought and received accreditation for the VNA Hospice program. This meant that we could offer the patients facing a terminal illness even more support and caring than ever before. Now our social workers could help the families and friends as well as the patients. We could provide the medication, supplies and equipment that would make these patients more comfortable in their own homes. We could stay longer and come back more often. We could offer spiritual support and volunteers that are not available otherwise. We could continue support to these families for a full thirteen months after the death of their loved one. We could do so much more than ever before. We do.

In 2000, a branch office was opened in Poplar Bluff and Ripley, Carter and Wayne counties were added to the service area. Most recently, Reynolds County is beginning to receive homemaker/chore and personal care services.

More recently, in the spring of 2003, VNA Home Medical Equipment and Supplies was born.  Designed to allow greater independence and safety for those recovering at home from illness or surgery and to improve the comfort of hospice patients, medical equipment and supplies are delivered and serviced throughout the fifteen county VNA service area.  Diabetic testing supplies and ostomy supplies are also available. Because VNA has a certified lymphedema specialist on staff, a new line of support wear was added to the VNA supply line.

In June 2005, VNA changed from an on-line documentation program to a more up-to-date, less restrictive system which allowed all clinical staff to document patient care from the patient's home using a small, palm-top computer with greater communication capabilities. This new system allowed the patients' physicians access to their home care records.  Now, physicians and all clinical staff caring for a patient had the same information readily available at their fingertips.  Patient confidentiality remains password-protected.

In November 2005, VNA improved communication among the offices by installing IP Telephony.  This meant that staff could be reached by outside callers by simply "dialing" an extension from any VNA office.  No longer were we asking families and referral sources to call another number to talk to the person they wanted.  In-house, staff could also communicate more easily from office to office.

In March, 2006 VNA initiated a TeleHealth program for all of southeast Missouri using Honeywell's HomMed Home Monitoring System.  Use of this device allowed VNA nurses the opportunity to assess their patients EVERY DAY instead of only a few times each week.  Patients are taught how to apply a blood pressure cuff and push some buttons to check their blood pressure, heart rate, oxygen saturation, weight and answer a few specific "yes" or "no" questions every day.  A nurse monitors their results which are sent to VNA Central Station over the phone lines. Prior to each office visit, their physician receives a trend report of their progress making those office visits more productive.  Trend reports can be sent to the physician as often as desired.

VNA staff numbers have grown much over the years. Many have come and a few have gone. Most have come, joined the family of VNA caregivers, and continued to give daily to individuals and to families across all of southeast Missouri. All have left a permanent mark on the hearts of patients and co-workers. All are dedicated to giving only their best to those entrusted to their care.

Our difficulty now is not in providing care; it is in letting those who need us know that we are here. After 30 years of service, we still hear over and over again “I wish I had known about your services when ….” We were here then. We are here now. We will be here when you need us. You can indeed feel better just knowing VNA is here.
 

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