Caring for the Caregivers: An Introduction to Nurses House

Peggy Dryden, RN, MSN, MBA

Disclosures

November 04, 2003

Editor's Note

This nurse's story is a departure from our previous eLetter interviews. We are pleased to introduce readers to Nurses House, with an interview with Susan Fraley MS, RN, (Figure 1) the Executive Director of Nurses House. Nurses House is a national, charitable, nonprofit organization that has been in existence for more than 80 years. Nurses House provides short-term financial assistance to nurses in need. Susan Fraley has chosen a rewarding career that focuses on caring for other nurses. We hope that you will share this article with other nurses and health professionals to help raise awareness of the organization's mission of caring for the caregivers.

Cathryne A. Welch, former Executive Director of Nurses House, and Susan Fraley, Executive Director, Foundation of NYSNA/Nurses House.

Question: Hello, Susan. Could you tell the readers about yourself and how you became involved with "Nurses House?"

Response: I have been a supporter of Nurses House for the past 3 decades. In 2001, I accepted a full-time position as Deputy Executive Director for the Foundation of the New York State Nurses Association, which has managed Nurses House since 1996. Thus, my role includes the management of Nurses House.

Since my appointment, I have learned much more about the growing volume of nurses in need and the growing financial challenges required in meeting that need. Nurses House, a charitable fund dedicated to helping nurses in need, continues to be a refuge for the caregivers. In January of 2003, I became Executive Director of both the Foundation of NYSNA (New York State Nursing Association) and Nurses House.

Question: Nurses House has an interesting history. Would you give our readers an overview?

Response: In 1921, Emily Holland Bourne, an admirer of nurses, bequeathed money to establish Nurses House. In the early 1920s, Nurses House was an actual house on Long Island, New York (Figure 2). Nurses, who were always referred to as "guests," sought respite in the recuperative environment of the house. During this time, nurses were less well compensated; there were fewer benefits and very long hours. A number of nurses came to Nurses House because they were simply fatigued and needed respite. (Families of the nurses generally did not come, but visited on certain days.)

The original 1920s Nurses House, located in Babylon, Long Island, New York.

Some nurses were suffering from the aftermath of diseases such as tuberculosis. Others needed time to recuperate following surgery prior to returning to work. Although we do not have accurate records about numbers of nurses, we know that the location was well used for approximately 30 years.

Nurses House was sold in 1959. An investment fund was created to support RNs in financial need as a result of injury, illness, or disability. The term "guest" was retained, although there is no longer an actual house. (Figure 3 shows the Nurses House offices as they exist today.)

The Veronica M. Driscoll Center for Nursing, 2113 Western Avenue, Guilderland, New York -- Nurses House offices.

Question: As Executive Director, what are your future plans for Nurses House?

Response: While in my role with the Foundation, my plans for the future are to make Nurses House become all it can be. For example, Nurses House is struggling to attract sufficient donations to meet ever-increasing needs of nurses. We are approaching different corporations for support and promoting fundraising ideas nationally through our Ambassador Program. Ambassadors are nurse leaders who support Nurses House and who make presentations to various organizations and groups, attend nursing conventions, and promote fundraising activities. We are also encouraging individual nurses to initiate fundraising activities. We can provide a model to assist people in a variety of activities.

In addition, we have suggestions for Nurses Week to increase visibility for Nurses House and raise funds in honor of the nurses in a given location. We are seeking volunteers to write grants on behalf of Nurses House. Most recently, we have started a campaign "A Dollar From Every Nurse." (For information, see the Nurses House Web site. If every nurse in the country donated just $1.00, Nurses House would have approximately $2.3 million.

Question: How do nurses in need learn about this resource? How can RNs request help from Nurses House?

Response: Nurses learn about Nurses House from friends, colleagues, state nurses associations, libraries, the Nurses House Web site, various print publications including the Dolphin newsletter (a Nurses House print publication), grants, national and specialty organizations, solicitations, and by having been a previous guest. Since the original Bourne Endowment stated that recipients are to be RNs only, a qualified nurse must be currently licensed or eligible for licensure -- this includes nurses who have had to surrender their licenses or have let their licenses become inactive. Student nurses, however, are not qualified.

Nurses seek help for many different issues. In 2002, for example, guest health problems included 23% musculoskeletal/connective tissue disorders, 18% psychiatric issues, 18% neurologic disorders, 16% malignancies, and 13% substance abuse; others included pulmonary problems, endocrine/metabolic problems, and pregnancy. There were 24 guests throughout the categories with back injuries, back trauma, arthritic conditions, and motor vehicle accidents. (Some of these were not the primary diagnosis.)

Most grants given by Nurses House provide short-term assistance to nurses and serve as a bridge for guests until they can obtain other sources of financial assistance and/or they are able to return to practice. Grants are also given to nurses whose income has been reduced or eliminated because of the need to care for a family member. In this situation, the nurse may not be the individual who is ill, but who has encountered hardship due to the illness of a family member.

Financial assistance is given as a grant and not a loan; there is no requirement to pay funds back. Assistance is not provided to family members. Nurses House does provide advice and referral on obtaining additional nonmonetary support for the purposes of resolving some of the person's problems. Applicants to Nurses House must demonstrate that they are RNs, even though their license may reflect inactive status.

Question: How does an RN initiate the application process?

Response: The process begins when the applicant contacts Nurses House electronically or by telephone and requests an application. No referral is necessary. Guests are then asked to provide information about their financial circumstances. They must also provide a health status report. All information is strictly confidential. Because of the need to triage resources, Nurses House does not provide debt reduction for guests, particularly if the debt existed before hardship was encountered. In many instances, however, Nurses House does help defray mortgage or rent payments temporarily to avoid eviction.

Presently, there are approximately 8 qualified applicants for every 1 person served. The entire application process can be slow, although there is some opportunity for small emergency grants. Some sensitive questions may be asked. Our goal is to make sure each application is complete prior to sending it to the Service Program Council. The application is then submitted to this Council, which is made up of nurse volunteers and Nurses House supporters. The Council is responsible for making the application decisions.

Question: As Executive Director, what would you describe as Nurses House's "brightest" moments? I know the readers would appreciate hearing about any success stories or rewarding experiences.

Response: Nurses House has had many bright moments. For example, a nurse was married to an abusive, alcoholic husband. Despite great financial and emotional distress, she finally obtained a divorce. Shortly following the divorce, she discovered she was pregnant. She was barely managing but was working every day and "getting by." Her pregnancy then became complicated and she was forced to stay out of work for 3 months before the delivery date. She fell behind in mortgage payments for 2 months and was threatened with foreclosure. Nurses House took care of 1 month of the mortgage. The nurse had a successful pregnancy, delivered a healthy baby, returned to work, and is doing well.

In another situation, 2 nurses (husband and wife) each developed different, chronically disabling conditions. Nurses House bridged the gap by paying for COBRA (continuation of health insurance) and for medications not covered until disability coverage took over. Nurses House also assisted this couple in navigating the healthcare system. Although both nurses are chronically ill, they are now financially secure and doing as well as could be expected.

In another instance, a nurse suffered a sudden myocardial infarction with complications. He lived in hospital-subsidized housing and the hospital was going to evict him. Nurses House intervened with rent support and actually interceded with the hospital authorities on his behalf. He has now returned to work at the hospital but in a different role.

Another example is of a nurse who had successfully completed a substance abuse program and who was eligible to reinstate her license. She did not have the funds for a license or for other educational requirements and had lapsed making payments on her car insurance. Nurses House paid the licensing and educational fees and 2 automobile insurance payments so she could go to job interviews. She has since returned to work full time.

A number of guests have overwhelmed us with their desire to help Nurses House in return. A former guest, after giving an educational presentation for which she received an honorarium, donated it to Nurses House because she believed that Nurses House had made such a difference in her life. Another guest, who was appreciative of the assistance provided by Nurses House, wrote a beautiful poem about earthly angels that we published in the Dolphin.

Several former guests have sent letters explaining how Nurses House has helped them. One nurse described how she was living in her car before coming to Nurses House. Nurses House assisted her in finding a low-cost but acceptable place to live. Nurses House provided the deposit and rent money she needed until she could get back on her feet.

Another guest survived a severe cardiac problem only to be diagnosed with cancer several years later. Nurses House provided payment for medication not covered by insurance and certain basic living expenses until she could return to work. While undergoing subsequent chemotherapy and radiation (and being unable to work), Nurses House provided her with funds for rent and food until she could return to work. She is now recovering well and believes that Nurses House positively changed her life.

We also assisted a nurse who lost a child in a fire by helping her obtain a grave marker and some other details related to the child's death that brought her some comfort.

Nurses House was designated as the national repository for nurses and their families in need following the events of September 11, 2001. Unfortunately, I cannot describe any specific outreach efforts because of confidentiality. However, the outpouring of appreciation for Nurses House was again overwhelming. As a result, several nurses who have recovered from their illnesses or disabilities related to that event have reached out to other nurses in need. Many former guests provided information to other nurses in need. Former guests arrange fundraisers, and many donate small financial gifts to Nurses House honoring a friend or colleague as an alternative to giving them gifts.

Question: What are your day-to-day activities like? How do you view your greatest contributions? What are the greatest challenges you face as Executive Director?

Response: Day-to-day activities include processing a large amount of paperwork in great detail. As described, the members of the Service Program Council, who are appointed and elected (but not paid staff), determine which applicants are eligible to receive funds. Nurses House staff must provide a complete packet that accurately describes the needs of the nurse-applicant and what is needed to resolve those needs. Many times, we have received telephone calls from a potential guest who simply needed advice rather than financial help. We make every effort to put these nurses in touch with other resources or someone who can advise them.

I work a great deal on fundraising and creative planning. I would like my greatest contribution to be obtaining sufficient funds to help all the nurses who apply in legitimate need. The greatest challenge for Nurses House is increasing funding to meet the expanding need. Corporations that formerly gave substantial donations to Nurses House are now giving only a fraction of what they provided in the past, or nothing at all. Individual donations are down as well. I am optimistic, however, about the future of Nurses House because it is a wonderful organization that fills an important void.

Question: How can other nurses become involved in the organization? In addition to financial support, what kind of support does Nurses House need?

Response: There are numerous ways nurses can and do become involved. Direct financial donations (see the address below) are always needed and appreciated. As mentioned, we are presently engaged in a campaign encouraging every nurse in the United States to donate one dollar to Nurses House. We have also issued a state-to-state challenge. Nurses can mobilize individuals, groups, and organizations in their state, send the contributions to us as they are received, and we will track the progress of each state. Nurses can also encourage others to give donations in honor or in memory of a nurse. Additionally, nurses can undertake a fundraising activity. We have model protocols to assist them. For information, email Nurses House at: mail@nurseshouse.org.

Nurses can volunteer for Nurses House in a variety of ways including: offering to write a grant proposal, donating case management services, or, for nurses who are attorneys, providing pro bono legal advice for the guests. We have information available on various Nurses Week activities to not only raise funds for Nurses House but to increase awareness.

Nurses can request information to distribute to other nurses and, in many cases, depending on location, it is also possible to arrange for a presentation on Nurses House. Nurses can seek corporate gifts from companies supportive to nurses, such as equipment and supply vendors, uniform suppliers or manufacturers, and other organizations that are in a position to help. We can provide information about how to do this fundraising as well.

Thank you, Susan. For more information about how you can become involved in Nurses House, visit http://www.nurseshouse.org/. Questions and comments may be emailed to Susan Fraley, MS, RN, Executive Director, Foundation of NYSNA/Nurses House, at: mail@NursesHouse.org.

Donations to Nurses House can be sent to: VMD Center for Nursing, 2113 Western Avenue, Guilderland, NY 12084. Please call 518.456.7858, ext 25, Nurses House Secretary or ext 27, Director of Development, to request brochures, seek guidance for fund raising, volunteer, or offer suggestions.

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