Superstorm, Super Nurses, Super Inequality

Living in the Pacific Northwest with the return of our perpetual grey days and rain, I do not hear the same level of weather complaints as I usually do. In the wake (literal/multiple meanings) of the devastation of Superstorm Sandy on the East Coast, most people here are grateful for our relatively benign weather.

On Monday, when the storm was hitting Virginia, I called to check in on my elderly father, who is now mostly homebound in hospice. High winds and local flooding were affecting his town in Central Virginia, but he had two nurses with him when I called. One was the visiting home hospice nurse who was checking his health status and making sure he had his medications. The other was his caregiver, a retired Emergency Department nurse. She is a no-nonsense person who walks with a cane and has been known to wave it my father’s way when he forgets to take his medicines. Clearly my father was in capable hands. I could get on with my job of grading student papers. I know firsthand what an important role home nurses play in the daily lives of elderly people and their families. And especially so in times of natural disaster.

I was pleased to see the NYT article “Enduring the storm for homebound patients” by John Leland (11-1-12). He highlights the essential work of the 5,000 nurses, aides, and social workers through the NYC Visiting Nurse Service who have been out providing services to patients around the city during the storm. He quotes nurse Allison Chisholm as saying, “…it’s something you have to do as a nurse. (…) I don’t see this as being a hero. I have a conscience. I have to sleep at night.” Mr. Leland quotes an elderly male patient exclaiming how he can’t get over the nursing service. His home nurse seems to have climbed fourteen floors in the dark to change the dressings on his leg wounds. And this patient adds that he can see how expensive the home nursing care must be. (Presumably covered by Medicare). But Mr. Leland follows with a quote from another elderly patient (a non-retired social work professor) who says, “This service saves a fortune because we don’t have to be in hospitals. They don’t pay these people enough.”

Indeed, that was something that was bugging me about the coverage of Sandy that I have been receiving: not enough attention to the consequences of extreme economic inequities being played out. (The residents of lower Manhattan being referred to as “The Dark People” for one thing.) I am sure that altruism and duty have been major motivators for the visiting nurses, aides and social workers who have provided essential services to people across the socio-economic spectrum. But they—and especially the home health aides who make minimum wage or just above—depend on the income from their jobs to feed, house, and clothe themselves and their families. They simply cannot afford the luxury of taking the day off.

David Rohde wrote an article on this for The Atlantic. In “The hideous inequality exposed by Hurricane Sandy” (10-31-12) he points out that income inequality in Manhattan rivals parts of Sub-Saharan Africa, and only Sierra Leon and Namibia have higher income gaps. I have walked the length of Manhattan many times, but until now had not realized how all of the major public hospitals are located in low-lying, flood-prone, power-outage areas.  The Manhattan skyline was forever changed with 9-11; the Manhattan skyline of light/dark, haves/have nots is perhaps forever burned into our national psyche. Now, to do something about it.