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Nurses tell of tattered health system - Access to care is still inadequate, they say

Times Picayune, 5/8/07

By Kate Moran
Times Picayune
May 8, 2007
Six local nurses said Monday that mental distress is omnipresent in New Orleans these days as residents feel helpless to secure rebuilding grants, find doctors and schools and otherwise navigate life in a fragile city.

During a roundtable discussion sponsored by the Registered Nurse Response Network, the nurses also said that patients without health insurance are forced to go months without basic care and often show up at charitable clinics with their health on the skids.

Alice Craft-Kerney said care for the uninsured is so fragmented that the first patient who showed up when she opened the Lower Ninth Ward Health Clinic in March had to be taken away in an ambulance.

"She was just that ill," she said. "Patients don't know where to go, and they let their illness deteriorate."

Several of the nurses who spoke Monday had harrowing experiences during Hurricane Katrina.

Charles Jarreau, a former intensive care nurse at Memorial Medical Center, was stuck at the hospital for four days after the storm. When he was helping others evacuate, he was pinned between a helicopter and wheelchair and suffered a ruptured spleen and bruised rib.

"There is no therapy and no medication that can take that away," Jarreau said.

For all the horrors they saw during the storm, the nurses were frustrated that the health care system remains crippled nearly two years after Katrina.

Anne Mulle, a nurse practitioner at the Common Ground Health Clinic in Algiers, said patients are arriving with advanced diabetes because their access to family doctors is limited.

If their condition is so poor that she has to send them to the hospital emergency room, they often reappear at the clinic the next day because the wait for hospital treatment can last hours on a busy day.

Mulle said the hospitals, themselves overwhelmed and understaffed, often refer patients to clinics such as hers because they will treat patients regardless of their income or insurance status. But the doctors and nurses at Common Ground are volunteers, and they cannot meet the demand for care. Mulle said the clinic always has to turn patients away.

"We are keeping people out of the emergency room, but at the end of the day, we are just a Band-Aid for a much larger problem," Mulle said.

With the health care system in tatters, several of the nurses have taken it upon themselves to restore health care to a recovering community.

Nurse Patricia Berryhill retired after riding out the storm at University Hospital, where she worked in the high-risk obstetrics unit. She said her lifelong friend, Craft-Kerney, drafted her back into the field to help start the clinic in her flooded house in the Lower 9th Ward.

"You never retire from nursing," Berryhill said. "You'll retire one day when you're six feet under."

These days, nearly all of the patients she sees have a mental health issue that complicates the physical ailments they present to her -- often cases of diabetes or hypertension exacerbated by poor access to care. She said many are stressed out by impediments to rebuilding, including the slow process of obtaining Road Home grants.

Craft-Kerney said she was appalled that more psychiatric beds were not available in the city nearly two years after Katrina. She said the fallout was nowhere more apparent than in the case of Terry Burton, a mental patient shot by a National Guard soldier who mistakenly believed he was brandishing a rifle.

"If you have a mental health problem, at best you go to jail," Craft-Kerney said. "At worst, you get killed. I don't understand why, almost two years after Katrina, we do not have more mental health beds."

Another nurse, Celeste Lewis of River Oaks Psychiatric Hospital, said health providers are themselves under tremendous stress -- a result of what they witnessed during the storm and the challenges of providing care in a recovering city.

"There is a feeling of shame among nurses who have to take medication for their depression," Lewis said.

The group that sponsored the panel, the Registered Nurse Response Network, came together after Katrina when nurses were frustrated about the slow federal response.

RNRN grew out of the California Nurses Association and the National Nurses Organizing Committee, and it sent more than 300 nurses to Louisiana, Texas and Mississippi after the storm.

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