Community Nurse Project presents to Weston board in preparation for Town Meeting

By Cherise Madigan
©2020 Telegraph Publishing LLC

Public health discussions dominated the Weston Select Board’s pre-Thanksgiving meeting on Tuesday, Nov. 24, with the town’s Emergency Management director, Michael Smilovich, encouraging unity in the face of an uptick in Covid-19 cases and resulting regulations.

Emergency Management director Michael Smilovich tells the Weston Board that residents need to keep following Covid-19 protocols and reach out to those in need.

“With Thanksgiving right around the corner, it’s imperative that we heed the advice from the governor to ultimately decrease the workload on our local and regional healthcare providers,” Smilovich said. “It’s up to us to work as a community and nip this thing in the bud as fast as we can.”

Smilovich said that cases have been rising steadily in recent weeks to create “the highest peak so far.” The state topped 3,762 cases as of Tuesday. The Town of Weston still has face masks and hand sanitizer available for distribution as needed, he continued, and the Weston Volunteer Fire Co. — of which Smilovich is a member — has moved all meetings online following new restrictions on gatherings.

Additionally, Smilovich urged Weston residents to reach out or consult resources available through the state as social distancing measures continue.

“This is an incredibly stressful time for everyone,” Smilovich said. “If you know someone who is going through something, please reach out. The mental health aspect of this has a pretty great propensity to turn into something negative as time goes on.”

One resource available to the community is the My Community Nurse Project, begun by Weston resident Regina Downer (R.N., M.S.) in February. Downer shared her work with the board at Tuesday’s meeting in the hopes of being included in the town’s budget, which will be voted on by residents at Town Meeting in March.

As an advanced practice nurse, Downer provides individualized care to community members in Londonderry, Peru, Landgrove, Weston and Andover. The services she provides can include wellness checks, assessing health needs, assistance with management of medication and health care appointments, patient advocacy for health issues, and assessment of home safety, she said.

Since February, Downer says the My Community Nurse Project has provided 110 home visits, 12 rescue calls with the rescue squad, 14 telemedical visits, 775 hot meal deliveries, and 170 loaves of fresh baked bread to residents in need, many elderly. All of her services come at no cost to patients.

In preparation for seeking funding at Town Meeting in March 2021, Regina Downer tells the board about her work as a nurse who visits those at home.

Supporting her efforts is a six-member board and approximately 20 volunteers, who provide and deliver hot meals or help to pick up medication. Two have been making masks, which the organization has disseminated into the community at no cost.

Having begun her work just a month before the Covid-19 pandemic reached Vermont, Downer says that she has been able to use her cellphone to facilitate telemedicine visits for patients who don’t have those resources available. Most valuable, she says, is the community connection that her organization has been able to provide.

“At the times when Covid was difficult, which it still is, I can see those people through a glass door,” Downer said. “I could deliver a hot meal and they could tell me, the driver or the delivery person if they’re OK or if they’re needing some help.”

Recently, that service became invaluable when a patient collapsed without a pulse upon opening his door for a food delivery from the My Community Nurse Project, Downer says. The volunteer was a doctor and was able to revive the man, who is now recovering.

“I love this community and I love this work,” she continued. “It’s personal, and it’s focused on the patients and their health needs. They are in the driver’s seat, but I help them to get what they need.”

The model is inspired by a similar organization in northern Vermont — the Upper Valley Community Nursing Project — which draws from the parish nurses of centuries past. That model dates back to the early 1900s in Vermont, Downer explained, when nurses sponsored by the church would provide a link between residents, their physician and their community.

Dr. Don Kollisch explains the importance of home visits, especially during the pandemic.

Dr. Don Kollisch, a physician at Dartmouth Hitchcock who also sits on the board of the Upper Valley Community Nursing Project, agreed that such services have become invaluable.

Currently, the services that Downer and other community nurses provide are not covered by Medicare or commercial insurance though they are often necessary in keeping patients from “falling through the cracks,” Kollisch continued.

“During Covid there’s a terrible sense of isolation and fear and these older people are getting some skilled, hands-on care that they find to be reassuring and at times life saving,” he said.

In the Upper Valley, Kollisch said, his Community Nurse Project is a kind of umbrella organization for nine nurses who serve about 275 patients in that region. The project is also hoping to collect data that can document the effectiveness of their work, which will help with future fundraising efforts.

With the exception of two nurses supported by religious organizations, the community nurses in the Upper Valley receive town funds to support a portion of their work. For the services they provide, Kollisch added, many of the nurses make far less than they would at a hospital or private practice.  Despite that, he said, these nurses continue to make an outsized impact.

“What I’ve seen is both improvement in health but also improvement in community cohesiveness,” Kollish concluded, describing the important connections community nurses can facilitate between doctors, patient’s families, and volunteers. “The nurses really do act as the glue to hold things together.”

Town support from Weston will help Downer continue this work, she said, which requires little overhead as she operates out of a donated space in the Londonderry Village Market plaza. The project is largely supported by grants and donations, she says, 98 percent of which goes towards direct services and mileage. Downer is potentially looking to add a second nurse to the program, she said, as her work often takes more than the 24 hours per week she initially allotted.

Though no amount was specified at Tuesday’s meeting, Downer agreed to follow up with a formal letter requesting that the My Community Nurse Project be added to the town budget, alongside recent financials for the program. Without further discussion, the board agreed to revisit the issue.

Little School generator hookup unlikely this winter

The board briefly discussed financials, which appear to be in order, according to Town Clerk Kim Seymour. While a potential culvert project on Trout Club Road presents a looming cost, Board Chair Denis Benson said that the town’s bridge fund should cover the cost if any state funding is provided.

Additionally, Vice Chair Jim Linville explained that a generator donated to The Little School may not be installed this winter after all, due to difficulties with the generator’s propane connection and required permitting. Looking ahead to Town Meeting, the board briefly discussed the need to plan for seating going forward and agreed to review the seating plan at the Weston Playhouse. Though 75 to 80 residents typically attend, Benson said, many are couples of families living in the same household and will not need to physically distance from one another.

The Weston Select Board will meet next on Tuesday, Dec. 8 at 7:30 p.m.

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About the Author: Journalist and photographer Cherise Madigan specializes in writing about outdoor recreation, the environment and travel. She has roots in Manchester and a history of reporting throughout Southern Vermont. Madigan is a graduate of Nazareth College of Rochester, earning her degree in Political Science summa cum laude in 2015.

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