As pandemic continues, community nursing effort looks to grow in the Upper Valley

  • Hanover Community Nurse Doris Yates, of West Lebanon, left, visits with client Sheila Tanzer, 92, and her son Ned Harvey at Tanzer’s home in Hanover, N.H., Saturday, April 25, 2020. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Valley News — James M. Patterson

  • Hanover Community Nurse Doris Yates, of West Lebanon, right, visits with Sheila Tanzer at her home in Hanover, N.H., Saturday, April 25, 2020. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Valley News — James M. Patterson

Valley News Staff Writer
Published: 4/25/2020 10:11:57 PM
Modified: 4/25/2020 10:11:54 PM

LEBANON — As the role of community nurses has changed during the COVID-19 pandemic, the Upper Valley nonprofit that supports them is looking to add towns to its network.

The Upper Valley Community Nursing Project, which works with community nurses in about a dozen towns, is reaching out to municipal officials and funders in the Twin States to highlight the importance of the nurses’ role during the crisis and to bring in money to expand their efforts.

“We have an obligation to try to scale up to try to kind of surge our capacity to respond to other towns around New England, around Vermont and New Hampshire,” said Dr. Robert Rufsvold, co-director of the Upper Valley Community Nursing Project.

While some people with COVID-19 require hospitalization, most of those who contract the novel virus do not, Rufsvold said in an audio recording posted to YouTube earlier this month. Those who remain at home may require the support of a community nurse to get through their illness and to help avoid transmitting it to others, he said.

In addition, community nurses have ongoing relationships with about 225 of the region’s older adults with underlying medical conditions, who are among those most vulnerable to developing serious illness as a result of COVID-19. Through those relationships, the nurses can help monitor people’s well-being and track changes in their health due to COVID-19 or other causes.

“The last thing the health care system needs right now is a lot of people in the emergency room because there have been complications of their chronic diseases, or they’ve fallen or they have problems with their medications,” said Laurie Harding, a nurse and former state representative from Lebanon who also co-directs the project.

The community nurses, who are employed by parishes or other nonprofit community groups, provide support to older adults by answering questions about medications, monitoring chronic conditions and recommending resources when people need medical or other forms of assistance. The nurses often assess how things are going through home visits and make recommendations about how the home might be improved to avoid falls or to help manage chronic conditions.

“I think it’s a really important role,” said Sally Kraft, Dartmouth-Hitchcock’s vice president of population health.

Before the pandemic, Kraft said D-H was working with Harding and the community nurses, as well as visiting nursing organizations and paramedics, to sort out how best to provide care to older adults in the Upper Valley. Though there are some challenges to coordinating that care, such as privacy and confidentiality concerns, Kraft said she’s hopeful that the pandemic will provide an “impetus to explore how we can deliver care in innovative ways.”

In the meantime as people practice physical distancing, community nurses are helping to “continue that care connection,” Kraft said.

The community nurses’ roles have shifted in recent weeks. They have moved most of their work to phone and email, but they still make some visits when necessary.

Lebanon’s community nurse Janet Lowell has about 30 people she works with on a regular basis. Several are elderly and live alone, some also struggle with mental illness or cognitive impairment. Assessing people by phone can be a challenge, she said.

“Many times what they tell you is not what you find when you go to the home,” she said.

Two of Lowell’s clients were hospitalized recently for what turned out to be the flu. She also counseled clients as they monitored cold symptoms that they were concerned might be related to COVID-19.

“You don’t want to miss something, you know,” she said. “On the other hand, they don’t want to go to the hospital. It’s really a tricky situation.”

Loneliness is another challenge the nurses help manage. Most of Doris Yates’ 25 clients in Hanover are over 85. While they have stayed relatively healthy thus far during the pandemic, they miss the regular visits, Yates said.

“What they really need is ... relief from social isolation,” she said.

Because most of the people she works with don’t have smartphones or tablets, she is connecting with them via the “old-fashioned” telephone in calls lasting from five minutes to an hour, she said. Yates said she would make a rare visit if someone needs help with a telehealth appointment.

Though it’s a coincidence that Norwich’s new community nurse Mary Young will start work May 1 amid the pandemic, Young will be a resource for residents as they try to make sense of all the information available about COVID-19, said Brenda Haynes, a member of the board of the newly formed Norwich Community Nurse organization.

Community members will be able to call Young to help them determine whether their symptoms require medical attention, Haynes said.

“There’s been a lot of just mixed information, and there still is,” Haynes said.

To ramp up their efforts in the coming weeks, Rufsvold and Harding are applying for grants and reaching out to communities.

“The interest is definitely out there,” Harding said.

Nora Doyle-Burr can be reached at or 603-727-3213.

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