Orpha Bauer, 88, recalls that, as a visiting nurse, she often became part of the patients' families.

There were many cases, for example, when one older person required home-nursing care, and then that person's spouse did, as well. Bauer was a caregiver and an educator, helping patients to learn how to keep wounds sterile, change their dressings, inject insulin, prepare enemas and more.

She still remembers the time when the Visting Nurse Association was located on North Lime Street.

"Then, in 1962, we moved to Janet Avenue," says Bauer, a retired registered nurse who spent 23 years, starting in 1959, working with the VNA.

"It was very rewarding for me and my patients," says Bauer, who had previously served as a private-duty nurse.

Although she was with the VNA for a long time, Bauer wasn't with the association since the very beginning — in 1908.

The VNA marks its 100th anniversary Tuesday, June 3.

'We are nurses and teachers'
Started by a small group of Lancaster women, led by Alice Nevin, who saw a need for public-health-nursing care, the first VNA meeting was held at the Iris Club, 323 N. Duke St., with the intended purpose of helping the "needy sick ones."

When it was initially conceived, the organization was called the Visiting Nurse Association. Now called VNA Community Care Services, the organization has grown and expanded considerably over the years.

As a United Way-funded agency, the VNA of Lancaster has working partnerships with the VNAs in Berks and Chester counties.

According to registered nurse Peg Waller, a cardiac nurse with the VNA, the three most important principles have remained the same.

As she notes, the VNA is still dedicated to providing quality home-health care regardless of ability to pay; promoting individual, family and community health; and preventing diseases by teaching and demonstrating the principles of good health.

"We are nurses and teachers," says Waller. "That is something that hasn't changed."

Meeting diverse needs
Many things have, of course. Mostly, they relate to advancing technology and health care and the changes that come with shorter hospital stays and insurance benefits that only provide coverage under certain guidelines.

Patients are being sent home from the hospital "quicker and sicker." Treatments, procedures and medical care that was once done only in the hospital is being done at home, by home-care nurses.

Waller reports that current home-nursing care can involve teaching patients and family members about wound care, setting up intravenous lines, administering medications, doing catherizations, maintenance for a feeding tube or even preparing for a heart transplant.

She has cared for patients as a visiting nurse for most of her career, 14 of them with VNA of Lancaster. Through those years, she has tended to teens who were in car accidents and suffered broken bones and other injuries. She has cared for young mothers recovering from cesarean sections and expectant moms with high blood pressure and other serious risks that require frequent monitoring. She has worked with middle-aged patients who have heart stents or bypass surgeries. She has cared for cancer patients of all ages, even helping to administer chemotherapy in their own homes.

Many of her oldest patients — and some younger patients, too — require a full complement of services when they suffer a severe illness such as a stroke, combining nursing care with speech, physical and occupational therapies, social work and more.

"Home-nursing care is one of the most challenging and rewarding careers you could ever do," says Waller. "But it's not for everyone."

Compared to nurses who work in hospitals or medical facilities, home-care nurses need to have a certain degree of independence. They have to make quick decisions on their own. Every time they arrive at a home, they never know, for sure, what they will find. And they need to respond with clarity and experience.

Modern-day VNA
The local VNA formally merged with the Lancaster General Hospital Foundation system Jan. 1, 1994. The alliance with LGH was initiated, according to published reports, to give the agency better access to hospital resources.

Today's VNA boasts 40 to 45 field nurses in areas that include cardiac care, medical and surgical care, maternal care and more. They are registered nurses and licensed practical nurses. Most have a good deal of experience. There are also about 20 office administrators, who handle a wide range of tasks, from assessing patients' needs to reviewing insurance.

A visiting nurse might come once a week, twice a week or more often. Insurance coverages limit the number of visits, so it is almost never daily. That means that patients or their family members must learn to handle their own care.

"Teaching is the key aspect of home-nursing care. Visiting nurses need to guide patients and their families in their home care," says Emily Fedullo Booker, who formerly served as VNA executive director from 1989 to 1993.

When Booker first worked for VNA, the offices were located on Fruitville Pike. Later, the VNA moved to the corner of Prince and Lemon streets in downtown Lancaster. That gave the office more visibility, and created more awareness of the agency.

A few years ago, the VNA offices moved to its current 1811 Olde Homestead Lane address.

Booker notes that, as a United Way agency, the VNA has a simple policy that was in effect long before she was director, one that continues today. "No one is ever turned away because they can't afford it," reiterates Booker, noting that coverage is often provided by Medicare or Medicaid, for those not covered by private insurance.

Despite the changes in health care, the mission of the VNA has remained much the same through the past 100 years. Today, however, the team of professionals includes nurses, rehabilitation therapists, social workers and aides.

Teams assess the patients' conditions, teach them about the illnesses and how to manage recovery, make sure they understand their medications and help them learn about treatments and exercises.

Evelyn Nuss, 84, needed VNA care three years ago after she broke her ankle in two places, the result of osteoporosis. The Lancaster resident said she had developed a blood clot from so much sitting and a visiting nurse treated her twice a week for a while. In addition, she received in-home physical therapy and used Meals on Wheels services.

"The nurse who came to see me was the nicest person," says Nuss. "It was wonderful to have her take care of me. I didn't want to go the the hospital. I wanted to be at home."

Leaders in community health
In the century of providing home-health care, the VNA faced challenging years during the Great Depression of the late 1920s and early '30s, and the years during World War II.

During the '50s and '60s, the VNA led the way in community health, establishing the first Well Baby Clinic at Lancaster General Hospital and opening the first clinic for school-age children at the Crispus Attucks Neighborhood Center.

The National League of Nursing accredited VNA in 1968 and the first licensed practical nurse was hired in 1969. During this time, VNA was also certified by the federal government to handle the increased demand for patient services with Medicare, which was established as a health insurer under Social Security.

Today, VNA Community Care Services employs more than 200 staff personnel, including nurses and therapists, and it is the largest provider of home care, annually serving more than 8,000 adults and children in Lancaster, Chester and Berks counties. More than half of the care provided falls under Medicare guidelines.

Donna Murphy, who lives with her mother Anne Murphy, 84, in Ephrata, said her mom suffered a massive stroke in 1995. At first, a VNA nurse saw her daily; then the visits became less frequent.

The nurses suggested ways to rearrange the family's furnishings and to install special equipment to make the home more accessible. They also taught the daughter how to administer her mother's medication and to help with exercises..

"They were wonderful to my mother and me," Donna Murphy says. "I can't tell you how much it helped. Now, when I give my donation to the United Way, I always earmark it for the Visiting Nurses."


Anniversary events
As the VNA marks its 100th anniversary, upcoming events include the following:

•Tuesday, June 3 — VNA will celebrate its Charter Day with a special Alumni Luncheon celebration at Riverdale Manor in East Lampeter Township.

•Friday, July 18 — VNA Night at the Lancaster Barnstormers, Clipper Magazine Stadium.

•Wednesday, Aug. 20 — Berks County VNA Night with the Reading Phillies, FirstEnergy Stadium.

•Saturday, Oct. 11 — VNA Dinner Dance Gala, a fundraiser to be held at Lancaster Country Club.

For more details, call the VNA, 397-8251.
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