In Petersburg, home health care nurses are crucial to keep people out of hospitals

A person in full PPE talks to a woman sitting on a chair.
Home Health Manager Kirsten Testoni visits Natocha Lyons, 43, who is quarantining at home with COVID, Nov. 24. (Angela Denning/KFSK)

While much of the nation is focusing on the emergence of the omicron variant of COVID-19, the CDC says delta is still responsible for most of the cases in the U.S. That includes an outbreak in the remote Southeast Alaska community of Petersburg.

In November, the town had a spike that saw more than 7% of the town’s 3,000 residents infected. On the front lines of this outbreak was a team of home health nurses, going door-to-door treating patients.

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Kirsten Testoni is one of those home health nurses. She manages a team of eight.

“You come in with sort of a plan but your day goes from zero to 60,” Testoni said.

Three years ago, there were only two home care nurses in this office. The additional staff has come from other departments: emergency rooms, clinics and long-term care. Lena Odegaard had worked in all of them. She said she likes home health because she can focus on one patient at a time but it’s also challenging.

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“There’s just so many elements you can’t control,” she said. “Whereas, when you’re in the facility, you can kind of restrict visitors and what people are doing to a point.”

Sometimes, there are patients who should go to the hospital but they don’t want to.

“We find that quite often in home health, especially during this pandemic,” Odegaard said. “Sometimes there’s a little bit of a resistance.”

Many times the nurses will transport patients to the hospital themselves or they can call an ambulance.

People sit in an office.
The Home Health office is located in an apartment across the street from the Petersburg Medical Center. (Angela Denning/KFSK)

Stephanie Romine says home health is different than her many years working in the hospital.

“You never know, you can walk in and find someone on the floor,” Romine said. “You really don’t know what you’re walking into a lot of times.”

Many hospitals have home health departments but it’s different in a rural town like Petersburg, says Jared Kosin. He heads the Alaska State Hospital and Nursing Home Association.

“You’re going to have almost, in some respects, a more nimble health care system because everybody knows everyone,” Kosin said. “When we’re in a crisis like this, can we meet this problem head-on before it becomes a bigger problem and requires hospitalization?”

During this latest delta surge in Alaska, it’s been crucial to keep people out of the hospital — not just Petersburg’s local clinics, but also keeping people from getting medevaced to the bigger hospitals in Anchorage.

Plus, it’s a more personal way to receive care. This team in Petersburg is planning on keeping up this level of home health care even when they’re no longer caring for COVID patients.

Testoni visited a small house this week where three people are infected with COVID. She wore two face masks, goggles, a hairnet, a gown and blue rubber gloves.

A woman in full PPE has her hand in a plastic bag in the car.
Home Health Nurse Manager Kirsten Testoni prepares to treat a person with COVID in their home. (Angela Denning/KFSK)

Natocha Lyons, one of the patients, answered the door. Lyons is 43. She was in a black sweatshirt, her blond hair pulled back.

“Sorry my house is not cleaned,” Lyons said when Testoni arrived. “I don’t have any energy.”

In the last week, she had been to the ER twice.

“I was so bad and so weak I couldn’t even get up to go pee at one point. I had to have help from my son,” Lyons said.

Home health drove her back and forth to the hospital. She received oxygen, IV fluids, monoclonal antibody treatment and steroids.

“If it wasn’t for the home health people I wouldn’t have made it because I was too weak to drive myself, I was too weak to even walk, I was too weak to do anything,” she said. “It’s been very scary for me.”

Like many Petersburg residents the home care team has been caring for this month, Lyons isn’t vaccinated. And she hasn’t changed her mind even after two trips to the ER. But Testoni never pushes the issue.

“That’s not our role,” she said. “We don’t do that. We are going to take care of people regardless of what their choices are.”

As she walked back to the car, Testoni said her job isn’t to convince patients of anything. It’s to meet them where they are. And so far, that’s been enough to keep them alive.

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Angela Denning is a reporter at KFSK in Petersburg.

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