This particular board room at PruittHealth in Norcross resembles a stomping ground for big-business negotiations; the kind of place where executives pitch proposals and interoffice politics run rampant.
But that’s where the similarities end, as the vibe here is closer to a master sergeant rallying her troops for a day in the field. PruittHealth’s home health department senior vice president Mickey Thomas minces no words. Team members, ranging from an office administrator to in-the-field RNs, focus as this veteran nurse speaks with the strength of a leader. With more than 40 years in the field and 30-plus in home health, Thomas unhesitatingly explains the often harsh realities of being on the job. PruittHealth’s field employees can find themselves in nail-biting situations, sometimes even fearing for their own safety.
Yet, despite candidly revealing the challenges, Thomas conveys the passion and compassion she and her cohorts maintain each day. Although her Masters in business and Bachelors in nursing make her suited for management, Thomas says she adores home health. And as a PruittHealth employee, she keeps a set of scrubs in the office closet just in case she’s needed in the field.
Thomas, who spent a good chunk of her early career as an ICU nurse, first entered the world of home health care in 1983. A friend in the midst of starting her own home care agency approached Thomas. When first asked about coming on board, Thomas says she balked. The grit of the ICU appealed to her, and the thought of working with the elderly in a home care setting sounded less-than appealing.
“Then I walked in and fell in love with (home care) patients,” Thomas says. “I felt like a real nurse. I wasn’t just interacting with a patient for five minutes, passing a pill and having to see a gazillion other patients. I truly was an angel of mercy. I knew I could make a difference.”
Through the years, she found herself making a difference in a variety of settings. She’s worked for mom-and-pop home agencies and larger corporations. Thomas even served as a surveyor for the Joint Commission.
“I’ve been a field nurse, a supervisor, an administrator,” she says. “I’ve done all of the jobs up and down and in between.”
Thomas has been at PruittHealth for nearly two years. Overseeing daily operations in Pruitt’s home health sector, Thomas focuses on several primary goals. Recruitment and retention of “very special people,” she says, remains an important part of her job. And growing Pruitt’s home health business continues to be essential.
“If there’s no money,” she explains, “there’s no mission.”
She says her main objective, however, is to make sure everything they do in the home health department has a positive outcome. For example, when a home care nurse completes a clinical task, Thomas and her team need to examine how it makes a difference in that patient’s life.
“If we do a certain type of intervention,” she elaborates, “I have to make sure it’s working. If it’s not, we have to do something different.”
For someone to become a part of Thomas’ team, it takes a certain type of professional. Thomas took time to explain the qualities needed to succeed in the world of home health:
On what an in-the-field job entails:
“In home health, we’re a certified home care agency so we (offer) physical therapy, occupational therapy, speech therapy, social work services, and nursing, which is both RNs and LPNs. We have home health aids, and we have registered dietitians. So we cover the gamut of what a patient may need. We do everything including educating patients and caregivers, hanging infusions in the patient’s home, wound care, and lots of medication management, because that seems to get a lot of people in trouble. We deal with chronic types of illnesses, so we get lots of people with congestive heart failure or end-stage lung disease COPD. We see a lot of total hip replacements, knee replacements, and deal with lots of therapy. We’re asking them to welcome us into their home and to be a guest with them so we do a lot of patient-centered things. We do a lot of work with the patients about the future. Our episodes of care are about 60 days. By the end of that 60 days, they need to be able to comfortably call a doctor. They need to be able to know when they’re in trouble medically and how to get extra help.”
On what kind of person fits in the home health field:
“You really have to function independently out there. So, we’re always looking for someone with a minimum of at least a solid year and some medical surgical experience, if at all possible. You need a more mature professional that can be very comfortable when being faced with a lot of information and having to make a decision. There’s not a doctor down the hall to ask. You literally have to know what you’re doing. You have to be very creative. Not everyone has fancy equipment, and you can’t run down the hall and get something. I’ve got home health patients who are hanging infusion bags on a curtain rods in the living room. Sometimes you see people making medication dispensers out of muffin tins. You may have to teach people how to make their own saline. There’s a lot of creativity that has to occur.”
On the misconceptions of home health care:
“I think people get misinformed. They think it’s easy nursing. You go to the patient’s home, and you’re having cookies and crackers, and coffee and tea with a patient. It’s not like that. Sometimes you might walk into the situation where you have to say, ‘Put the guns away, put the drugs away or I’m not taking care of mom.’ We run into some very significant situations that have to be dealt with . . you might have some very unusual and sad situations. So, it takes a rather unique individual to fit into home care.”
Tiffany Harris
PruittHealth home health care RN
While working in skilled nursing at a 256-bed longterm care facility in Connecticut, Harris longed for a more individualized nursing scenario.
“Once you actually finish school, become a nurse and go to work,” Harris says, “you realize you can’t give the amount of care and the quality of care that you would personally want to give.”
For the past year and a half, Harris has been striving to deliver her preferred level of care in the home health environment. Working for PruittHealth, she finds herself going into homes focusing on the specific needs of patients. Depending on what the respective physician orders, Harris might be teaching and training a patient and their caregiver how to use a feeding tube or other specialized equipment. Her next stop might be monitoring the healing of a wound. Another visit may focus on something else entirely.
“For some of these people, I’m the only other face they see once, twice or three times a week,” she says. “t’s like working with your grandmother or grandfather. Most of the time, they’re teaching me something, instead of me teaching them.”
Leisa Oliver
CNA, Visiting Angels
Instead of playing with toys and frolicking in the yard with the neighborhood kids in her hometown of Montezuma, a young Oliver had other playmates. With her mother’s permission, the 12-year-old would walk to the nearby nursing home and befriend the residents.
Although she can’t quite pinpoint the reason, Oliver says nurturing relationships with the elderly made an everlasting impact on her life. While it helped instill in her a strong sense of compassion, the experiences simultaneously gave her an understanding of mortality at a young age.
Fast forward to adulthood, and Oliver’s career as a USDA inspector left her unfulfilled. At 28, she sought out her certified nursing assistant certification and eventually began working in a hospital environment. Several years later she found herself back in the nursing home environment. During this time she also become a certified phlebotomist, a wound care tech and a restorative aid.
For the past six years, Oliver has been working in home care, a place she says she feels spiritual called to be. Currently employed with the Tucker-based branch of Visiting Angels, a non-medical home care provider, Oliver primarily services one client.
From 9 a.m. until 4 p.m. each weekday, Oliver spends time with 93-year-old Eleanor Quinn. While Quinn’s daughter and son-in-law are at work, Oliver makes sure her client is properly fed, performs her daily exercises and enhances her day-to-day life.
“I make sure she’s not going to be confined to her bed,” Oliver says. “I want her to go out with a bang, and continue to enjoy life.”
This includes walking up and down a flight of 14 stars with Oliver’s assistance, spending time in conversation, and critiquing films and sports.
“She keeps me going,” Oliver says of Quinn. “I love her ambition. It’s something for me to look forward to everyday. I tell her, ‘When I get this young, I want to be just like you.’”
Quinn echoes the admiration. “When I hear her come in the house, I feel at ease,” says Quinn, dressed in a zebra print top, her red nail polish catching a ray of sunlight. “It brings me security. We share a sense of humor and have a good time together. I didn’t know where she came from, but it was a good thing for me.”
Both Oliver and Quinn share a laugh before grasping hands.
“If you don’t have heart and you can’t love your client,” Oliver says, “you can’t do this job.”
Shameeka Nealy
CNA, Advantage Private Home Care
“Working with the elderly is the highlight of my day,” says Nealy.
In 2000, after becoming a certified home health aid in Binghamton, New York, Nealy says she realized she thrived in the nursing home environment. Two years later, Nealy became a certified nursing assistant.
In 2014, after 12 years at various nursing homes in New York, Nealy sought warmer southern weather and moved to the Atlanta area. She soon transitioned from working in the nursing home environment to home care.
“I left the nursing home to do home care, because it’s more of a hands-on experience and more personal,” she said. “You really bond with the clients.”
Nealy’s responsibilities include assisting her client in the activities of daily living, from eating to bathing. Yet, it’s the interpersonal relationships, she says, that keeps her inspired in her work. Her current client, 87-year-old Sam Wood, shares his love for mathematics and storytelling . And when Wood takes his afternoon nap, Nealy dives deep into her nursing studies in order to help further her healthcare career.
“If someone is interested in (non-medical) home health, I would start off by asking yourself why,” she says. “It has to be something that comes from within. I always tell people if you don’t have patience, it’s not the job for you.”
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