Home-Care Homecoming
Diana Vaughan remembers treating the severe leg wound of a man who lived in his car on skid row.
Charlene Wilkinson recalls visiting numerous patients in small shacks--with no running water or electricity--in remote parts of the Antelope Valley.
And Rosemarie Moran can’t forget one Christmas Day when she treated an elderly woman with wounds, a middle-aged woman with terminal cancer and a new mother and her healthy baby all within a couple of hours.
“The contrast was so amazing it really struck me,” Moran said. “We treated everybody!”
The three women reminisced recently about their years with the now-defunct Visiting Nurses Assn. of Los Angeles, a nonprofit organization whose mission for nearly 60 years was to serve everyone regardless of ability to pay.
Today at noon at the Odyssey restaurant in Granada Hills, the association will hold its first reunion since folding in 1997 because of financial problems and growing competition from private home-care companies.
Nearly 200 former members--mostly nurses and physical therapists--are expected to attend the event organized by a group of local nurses who worked with the Los Angeles Visiting Nurses Assn. and never lost touch.
“We were like a family,” said Treva Smith-White, a registered nurse who spent 17 years with the association and now works for Kaiser Home Health in Granada Hills. “It was so awful when it went down. It was like losing your mother.”
Vaughan, a former association director who spent nearly 20 years with the organization, said everyone associated with the group took the news hard. Today, Vaughan is an administrator for a Burbank-based home-care agency.
“A lot of people were devastated,” she said. “I was in mourning for a good year.”
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Founded in 1939 by two Los Angeles women, the Visiting Nurses Assn. organized professional home health care for the first time. The group grew dramatically through the years and in the 1980s was known as the largest home-care agency west of the Mississippi.
“They were the pioneers in home care,” said Dr. Shirley Fannin, a former association medical advisor who is now director of disease control for the Los Angeles Department of Health Services.
By the late ‘80s, the nurses association had seven offices throughout Los Angeles County and about 1,200 employees--primarily women--who made nearly 400,000 home visits yearly.
By 1997, however, the number of employees dwindled to about 900 and home visits were down to about 100,000.
The Los Angeles organization survived on Medi-Cal--state-funded insurance for the poor--and private insurance reimbursement in addition to grants from the United Way.
Many patients were indigent or homeless, and the nurses association received no money to care for them.
“They had a reputation for being extremely dedicated, almost angelic, yet their expertise was incredible,” said Barbara Bronson Gray, a UCLA nursing professor who is the editor of Nurseweek magazine. “As a nursing student, I made some rounds with them and I was impressed. It was tough and demanding work.”
The association’s staff performed a variety of duties, including administering medicine intravenously, tracheal cleaning, tube feedings, providing infant care and respiratory therapy, and changing a disabled person’s clothes.
Nurses also developed relationships with patients, often buying food for the hungry and disabled and Christmas gifts for sick children.
“They provided a very special service,” said Nick Rocca, head of social services at the Northeast Valley Health Corp. “It never mattered whether you could pay or not.”
The thousands of patients the Visiting Nurses Assn. of Los Angeles served are probably still getting home care, Fannin said, either through the county, Medi-Cal, private insurance or other visiting nurses groups in the region.
“Those services didn’t just go away because the VNA folded,” she said. “There are many providers out there today.”
But former association officials believe the care, especially for the poor, isn’t as good or thorough as it was when they were around.
“For instance, Medi-Cal pays for one nurse visit to the home of a burned child,” Vaughan said. “They’ll teach the mother how to treat the burns and that’s it. VNA nurses would have made repeated visits. That makes a big difference.”