House Calls: Joan Warren, RN, has spent 40 years in home health in Clallam County

Joan Warren, RN, has been working in home health in Clallam County for the better part of 40 years, including the last 21 years with Olympic Medical Home Health.

Born at Olympic Memorial Hospital and raised in Port Angeles, Warren’s journey to becoming a nurse began during her senior year at Port Angeles High School with an after-school job at Peninsula Children’s Clinic – the clinic was located in the shadow of the hospital, near where the Medical Office Building now sits.

“That really piqued my interest in nursing,” Warren said. “Seeing the RNs working in the clinic and the interesting things they were able to do to help patients.”

Shortly thereafter, she enrolled in Peninsula College’s nursing program.

“I graduated from high school on a Friday and I started the prerequisites for nursing…Monday at Peninsula [College],” Warren said.

Within a year of graduating from Peninsula College, she began her home health career with Clallam County Home Health in 1982.

She joined Olympic Medical Home Health in 2001 and was promoted to Director in 2014.

“Olympic Medical Center is a wonderful place to work,” Warren said. “And that’s why I was excited to be hired 21 years ago, and why I’m still here and why I’m going to stay here until I retire. It’s ethical business practices, wanting to do the right thing for patients and for staff. It’s a mutual respect for everyone. And the support we receive here in Home Health from OMC is invaluable.”

Warren oversees a Home Health staff of about 80 employees, including about 35 RNs who make house calls to patients’ residences from Neah Bay and Queets on the West End across the Olympic Peninsula to the Jefferson County line in Diamond Point.

“I have a fantastic staff,” Warren said. “I’m so proud of the work my staff does…We’re all over the county.”

Olympic Medical Home Health providers in-home nursing, physical therapy, occupational therapy, speech therapy, wound care, social work and more for nearly 400 patients.

“Our goal is to keep patients safe in their home as long as they possibly can stay there, because that’s really the best place for people to be,” Warren said. “We want to support that and keep them at home if we at all can.”

Olympic Medical Home Health is among a shrinking number of hospital-based home health agencies. It’s a partnership that Warren says makes Olympic Medical Home Health a more robust and resilient agency, while supporting clinical staff so that they can focus on their patients.

“The support we get from OMC just makes us a stronger agency,” Warren said.

At some home health agencies, visit nurses are responsible for faxing referrals, working with a patient’s insurance provider, calling patients to set-up intake appointments and other clerical duties, in addition to patient care. That is not the case at Olympic Medical Home Health.

“We’re here to help our clinical staff to be able to provide the best care they can for our patients,” Warren said. “We do all those things so that the patient is ready for staff to see.”

Warren relates that when traveling home health nurses come to Olympic Medical Home Health, they are often pleasantly surprised by the support they receive.

“One of the things they [traveler RNs] all tell me is, ‘I’ve never worked at a home health agency before that had this much help for us,’” Warren says.

Olympic Medical Home Health employs per diem nurses, who appreciate the flexibility to be able to make visits when they are able to arrange childcare, or in some cases, serve as the overnight on-call nurse for established patients.

While each Home Health visit nurse receives an assigned number of visits each day, there is more flexibility to the schedule than what is found with inpatient nursing, according to Warren. Visit nurses with kids, for example, can be assigned two or three visits for a morning. They can complete their rounds before returning to be with their kids and finishing their paperwork in the evening when their spouse comes home.

Warren says that nurses who demonstrate creativity, strong computer skills and an outgoing personality usually excel at being a Home Health visit nurse.

“You have to make a connection with a lot of different people out in the community, whether it be the patient or their family or their caregiver or their provider,” Warren said.

During patient visits that usually last about 45 minutes to an hour, Home Health visit nurses perform a range of technical nursing tasks such as wound care, chest tube management, IV’s, catheters as well as navigating social issues. Visit nurses need to exercise creativity and flexibility in setting up sterile fields for their equipment. Home Health visit nurses provide status updates for patients’ providers who are not able to make their own assessments in the patients’ homes.

Warren says the focused time spent with patients is one of the most fulfilling aspects of the job.

“It’s the patient connection,” Warren said. “You have time with one patient at a time. There are no call bells going off. There’s nobody out in the hall way, saying, ‘Hey, I need you.’ You walk in that patient’s house and you have uninterrupted time with that patient.”

In addition to visit nurses, Olympic Medical Home Health staff also encompasses physical therapists, occupational therapists, speech therapists, wound care specialists, social workers and more. Olympic Medical Home Health meets the needs of homebound patients where they are – in their own homes – providing care for patients with needs ranging from chronic illness to acute injury requiring in-home physical therapy.

“I like the holistic approach [in home health],” Warren said. “We look at really every facet of the patient’s life in their home, what nursing care they need, what medical care they need, what their social needs are. We really make a difference in people’s lives, and that to me is, is exciting.”

Warren is one of six kids, five of whom were born in Port Angeles after her parents moved here from Minnesota in 1946. Warren’s father fought in World War II, and after returning from Europe, he decided he wanted to move on from his family’s wheat farm. Warren’s father decided to follow his brother to Port Angeles, where he had been stationed in the Coast Guard.

“My parents always told me, “This is the promised land,’” Warren says. “This is such a wonderful place to live. They were absolutely right. We have beautiful outdoor areas. We have a wonderful community. It’s a wanting to give back to the community that’s taken good care of me and my family for many, many years.”

Warren, in turn, has, in one form or another, cared for the community – often in their own homes – for 40 years – and counting.