January 9: systolic BP 300!

Hello everyone,

All is well in Pearlington. It is cooler weather today than yesterday. I understand Phillie is having warm weather as well. I know you have read about the "tent" and will have pictures soon. We are working hard to get the health fair organized. The nursing students are excited about doing some "nursing interventions" to really see how the health of the residents are doing (i.e. blood pressures, cholesterol, blood sugars, etc.). We had one resident of Pearlington who was obese, diabetic, and hypertensive who told one of the nursing students that she was not concerned about her blood pressure unless her BP hit 300!!!! Despite the concern of the student, the resident did not think that anything under 300 was bad. She tried to provide education on hypertension, but as an outsider, I think there was a little bit of mistrust. What was an "educational experience" was the fact that there really are patients like this in our country. Our students say they have never seen patients like this with so many health care problems and accepting that this is the way it is and little motivation to improve their health. We want to do so much more but are very limited at this point in time. Now that we have done an assessment of the community, we understand what the needs of the residents are and will be well prepared to come back and do nursing interventions that are sustainable. What is another educational experience, is that these students are in an environment where they have little control over their "patients" - who are the residents of a community. These students have to accept (to a degree) that they may not want to do what the nurses say or do what they are supposed to. It is not like being in the hospital or in home health - where if patients are non-compliant or refuse health care, we can send them home AMA or we can say, we cannot help you if you do not do what we recommend, etc. There is not the "structure" of a health care system that you can depend on. These community assessments provide a very different setting than the students are used to.

Julie and I made some visits to some of the health care facilities in Bay St. Louis, which is about 15 miles from Pearlington. They see very few patients in Pearlington. They did say that the major health care needs were the geriatric patients who have been forgotten and have few resources for them. When we asked a resident what she thought was the "one thing that she thought was needed for the community", she responded a "youth program" because so many of the kids dropped out of school because they were needed to work and their parents said they could get their GED. Now, many kids are out of school, unemployed and the drug problem is escalating.

Another resident we saw was a Vietnam Vet who lost everything. He rode the storm out on top of his trailer. During the eye of the storm, he went out and was walking around to see the damage. He looked up and saw a 20 foot wave of trees, debris, and mud coming toward him and said he knew he was in trouble. He ran to his trailer, by the time he got there, the water was up to his chin. He managed to get on top of the trailer and ride the hurricane but could not save any of his animals. He watched his 2 dogs and cats drown. On top of this, since the storm, he was told that he has cancer as a result of "Agent Orange" from the war. He suffers from PTSD from the war, which has exacerbated since Katrina. He has chronic back pain and suffers terribly. Despite all these problems, he continues to give and give. He cooks for people and helps everyone as he can. He has traveled to other parts of the country telling people about Pearlington to get recovery efforts down here. He unselfishly takes care of others - while his own health deteriorates.

His neighbor - an 86 year old man - survived the storm and just got his home rebuilt 3 months ago (his wife died after the storm). The first night he was in his new home, he fell and broke his back and is now in a nursing home. He is not allowed to go home unless he gets around the clock sitters - which are not available. Neville and the gero faculty, we know that older adults in a new setting can be disoriented and confused. What is even sadder, is that no one found him until the next morning when he dragged himself out on his front porch for someone to see him.

One more story. During the hurricane, a resident said he found an alligator in his home with him during the storm.....he screamed - trying to stay away from him. Finally, he (them man) was able to kill him (the alligator). He said that was the scariest thing of all. Can you imagine that alligator? He was probably just as disoriented and scared as the man and had been beaten up in the storm waters with all the debris like everyone or everything else.

There's not a home here with a resident/family that doesn't have a story. It is amazing. One thing we have noticed is that after the storm, there was a cohesiveness to recover. But now, some people have received funds when other people haven't and it seems a bit unfair. One family had a husband and wife who are 65 and 67 who just retired. They had everything paid off and received little funds and did not qualify for grants because they had property that was paid off, etc. The husband had to go back to work and they had to get a 30 year mortgage to rebuild their home. She said she will be 96 and still paying a mortgage!!!! While some people who were unemployed, and remain unemployed, received new homes, money (checks for $100,000 seem to be coming in Jan.), and benefits that others did not get. This has really caused some resentment and anger within the community.

The community does not have any real leadership to bring the residents together. There is no mayor, no newsletter or newspaper, or anything to bring them together. I was told that the churches (2 of them) even compete for parishioners. The Pearlington Recovery Center has some "heroes" that have worked for the are, tirelessly. They are rebuilding a community center which will hopefully bring back some community activities - like Girl Scouts and Boy Scouts and maybe youth events. One of the residents said they use to have summer vacation bible school - but even these events were never started back after Katrina.

So the students are really being challenged. We have asked them how could they be nursing leaders in this community? What could they do for the community if they wanted to initiate an intervention and make it sustainable? How do you involve the community in projects when they feel very depressed, hopeless, and distrustful? And Julie's favorite question: if Governor Hayley Barbour gave you a million dollars, how would you use it for this community? What would you do? How would you improve the health conditions of the people of Pearlington? What health policy issues could improve the health and welfare of the residents of Pearlington?

Thanks for reading.....would love to hear your comments or questions. Maybe you can give us some insight from our postings.....

Norma