Biomedical subjects
Publications and source records attributed to S F Zarbock.
"I had felt a deep calling for a long period while I was working on the cardiology floor in the local hospital," remarks Kathy Ford, RN. "When I happened to come across a picture of parish nurse ministries and, after a telephone conversation with one of the nurses who told me what parish nursing was all about, I just knew that was what I was supposed to be doing."
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"Because I'm a hemophiliac, I have always had to be protected. Camp Barnabas was the first place I could put that aside and do anything I wanted." This comment by a 9-year-old boy eloquently captures the spirit and reality of Camp Barnabas, a site that has had camp programs for special-needs children and their siblings for the past year. Camp Barnabas, located near Monett, Missouri, held its first summer sessions in 1994 and 1995 at a nearby camp, Kanakuk/Kanakomo. Camp Barnaba's founders, Paul and Cyndy Teas, were inspired by a Kanakuk/Kanakomo camper with cancer to create a camping experience paced and equipped for children with terminal or serious, chronic illnesses.
Overall, the face of public health nursing has changed dramatically during the past several decades, and perhaps the most significant influence-for good or ill-has been the advent of managed care in this specialized domain of nursing practice. As managed care organizations supplant physicians as the gatekeepers of care, deciding when, in what form, and at what cost care is provided, three major changes have occurred in the home care arena. These changes affect patients, their families, the location of their care, and the roles and responsibilities of the health care team. The home care landscape, regardless of geographic setting, has dramatically changed for all participants. In the continuing effort to reduce the high costs of health care, managed care companies are mandating that patients be discharged from the hospital earlier, shifting care to the home. In essence, the home has become a "step-down" unit of the hospital. Patients are being sent home sicker, with higher acuity levels, and at risk for increased morbidity and readmission rates. Families are taking on more responsibility for care provided in the home. In addition, the role of the visiting nurse has changed. She is now a member of an expanded home care team. She acts in a supervisory capacity more often, must contend with complex clinical problems, and often must oversee the use of high-tech equipment. She is no longer seen as the health care team member who wears squeaky blue shoes and renders all home care from the depths of her little black bag, similar to pulling the rabbit out of the hat. She is the leader of a team that includes numerous professional providers.
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Hospice care is a multidimensional approach to care of terminally ill patients and their families. This care can be given by a variety of persons, in a variety of ways, and paid for by a variety of mechanisms. Hospices are on the brink of moving from infancy into maturity. There is no "one right way." Practitioners and administrators need to be creative in their planning, open minded in viewing options, and flexible in design and execution of these policies.