Seemingly everywhere across the Island, the Vineyard’s two community health nurses fulfill a wide mandate. In private homes checking on the welfare of newborns and housebound elders, participating in monthly wellness clinics at group sites, at diabetes and Parkinson’s support groups, nurses Lila Fischer and Lori Perry provide public health services and educational programs through a contract between Island Health Care and Island boards of health. Working together, these two “job sharers” make approximately 75 wellness visits and approximately 75 well-baby visits per year, according to Kathleen Samways, chief clinical officer at Island Health Care Community Health Center, who supervises this public health program.
Edgartown Council on Aging outreach worker Victoria Haeselbarth is full of praise as she describes her dependence on the public health nurses (PHNs) as “invaluable in providing services to our growing community of elders, providing … updated lists of individuals who may need nursing support. Some of these individuals have mobility or cognitive issues, live alone, and are unable to drive. Lila and Lori can be depended upon to reach out to these older adults, paying them home visits if needed.” For example, the COA worker continues, “they visit the home of someone requiring regular ear cleanings, without which the person could become dangerously deaf.” The nurses recently reached out to a mobility-impaired person who suddenly experienced difficulty walking.
“Many communities around the country don’t have public health nurses that serve in the capacity that ours do,” explained Haeselbarth. Illustrative of that claim are statistics put forth by Zippa nursing recruitment agency: “There are over 29,814 community health nurses currently employed in the United States,” they write. Pit that number against the latest U.S. population figure of 332,403,650, and one will grasp just how lucky the Island community is to have this rare service.
Expounding on Haeselbarth’s theme, Lila Fischer says, “I feel privileged to live and work in a place that values the importance of its residents’ health, and takes fiscal action to support initiatives that benefit the well-being of the community.”
Coming from a well-known farming family, Lila did a bit of farming herself as a young woman, with her aunt, Eleanor Neubert — long a pillar of the Martha’s Vineyard Agricultural Society, which runs the Ag Fair — before setting out on a path to become a healthcare worker. Trained as a midwife at Maternidad La Luz in El Paso, Texas, Lila went on to practice midwifery in Uganda and Mexico. Next came a bachelor’s of science degree from the accelerated nursing program at University of Massachusetts in 2017, sponsored by a Martha’s Vineyard Vision Fellowship.
Lila described her pleasure providing well-baby care to a young couple “newly moved to the Island from abroad. They had no social networks in place” after the birth of their baby. “I was able to go to their home and provide loving community support in the potentially isolating time of becoming new parents. I was able to stock their freezer with meals from Island Grown Initiative’s (IGI) meals-to-go program to help support them during this time of transition.”
Collaboration such as this between the Public Health Nurses Program and IGI is often key to good outcomes. Collaboration abounded during COVID, as Samways pointed out: “During COVID, our partnership with the boards of health really strengthened, and IHC, the PHNs and the town health agents, in partnership with Quest Diagnostics, stood up the TestMV PCR asymptomatic test site for what has turned out to be 22 months of continuous service to the community.
“Countless COVID contacts have had gentle, caring guidance and advice on quarantine and isolation from Lori and Lila. This support extends beyond phone contact — some contacts had no way to get to the store or place to go to quarantine, and received assistance from public health nurses for food delivery and connection to social supports.
“Other PHN activity during COVID included participation on the weekly Community COVID Group as Island Health Care and the public health agents took the lead to participation on the Community Ambassador Program bidirectional languages call weekly, to insure connection to the Brazilian-Portuguese-language members of the community and public health nurse connections to the vaccine bus, which make regular trips to the Island.”
The community nurses are probably best known for their monthly wellness clinics at libraries, the Stop & Shop Pharmacy, Councils on Aging, and the Food Pantry, as well as on Island Elderly Housing campuses. Participants get their blood pressure checked on a regular basis, and this seemingly routine procedure can provide a surprise. “Once I identified a client who had never before had hypertension,” recounts Lila. “They ended up contacting their doctor, who had them come to the hospital later that day, where they received life-saving surgery. Otherwise they may have never known of the condition.”
Dedicated support groups
Support groups for those with diabetes and Parkinson’s disease meet regularly with the community health nurses, often at Howes House, where Up-Island Council on Aging outreach worker Bethany Hammond describes the work of the Parkinson’s disease group: “The structure of our group is three co-leaders: a nurse co-facilitator (Lila), a social worker co-facilitator (me), and a patient co-facilitator. Lila’s role as our nurse facilitator is to provide medical insight, from treatments to research, to medications, etc. She is there to help guide the group and answer any questions that might pertain to the more medical side of living with Parkinson’s disease. If ever a group member proposes a question she does not have an answer for, she is always very quick at researching the topic and reporting back.”