Phyllis West comes to the door, happy to see Mrs. Barnes, and ready to have her blood pressure checked on the front porch.
“I didn't even know I had high blood pressure until Denise came along. She made me make a doctor's appointment right then and there,” Mrs. West explains. “She takes good care of us.”
Mrs. Barnes, 39, is a registered nurse for St. Rita's Medical Center, but her office is in a local community center. Her patients live in a 22-block area near downtown, and, for the last five years she has been there five days a week to help them get to the doctor, to get flu shots and cholesterol checks, to have their children's immunizations updated, and to listen.
“If somebody's sick, somebody's in the hospital, somebody has a baby, we tell Denise,” Mrs. West said. “We don't know what we'd do without her.”
In a unique program that parallels what local police departments across the country have been doing with community policing, three registered nurses from St. Rita's Medical Center are taking health education and prevention to neighborhoods where as many as half of the residents do not have medical insurance. The door-to-door services are free.
“Police are returning to the grassroots and we wanted to return nursing to the grassroots too,” Mrs. Barnes said.
Deb Walters, former manager of community health and outreach services at St. Rita's, said it was in fact the community policing model that set the wheels in motion for the neighborhood nurse program. She knew that to have an impact on residents' health, the hospital needed to consider all the factors that affect health - from crime in neighborhoods to a lack of transportation. She met with police officials who were willing to work with the nurses.
“I said, could we partner to truly impact those factors that influence the health of our neighborhoods,” Ms. Walters said. “People don't feel comfortable going out and walking to reduce their weight or their risk of heart and lung disease if they don't feel safe on their front porch. Let's get a nurse into these neighborhoods working with the community police officers so we can talk to folks, find out what barriers exist.”
The neighborhood nurses jump in to help with any issue that affects residents' quality of life, whether that means helping with alley clean-ups on a Saturday morning or guiding people in need of specific services through the maze of social service agencies.
Not all of what the nurses do sounds like traditional nursing, but since the neighborhood nurse program started in 1996, it has made some impressive strides.
Two years after Mrs. Barnes became the first neighborhood nurse, visits to the hospital's emergency room by residents of the Riverside North area where she works dropped 18 percent. When the second neighborhood nurse, Janis Sunderhaus, was hired in 1999 to work in the Dr. Martin Luther King, Jr., area on the city's south side, visits to the emergency room by residents in that area dropped 22 percent, said Mark Skaja, St. Rita's vice president of mission services.
The nurses help residents find - and see - a family doctor, frequently at St. Rita's MED-CARE Health Clinic, which provides reduced or no-cost health-care services to low-income residents.
Before the neighborhood nurse program, it was not uncommon for residents to go the emergency room for anything from a child who needed to be checked for lice to a baby with a cough or fever.
Mrs. Barnes recalled one woman who had been to the emergency room 44 times in a year. A year after she found a doctor for her and began keeping tabs on her, the woman only made five trips to the ER.
The nurses carry a pager and a cellular phone. Some residents don't have telephones, so the nurses sometimes use their cell phones to set up doctor's appointments for them right on the spot. Otherwise, it might not get done, Mrs. Barnes said.
Megan Swanson Bailey has been assigned to four income-based apartment complexes in the city's north end since January.
She has set up a table in the parking lot and done blood-pressure screenings, anxiety screenings at her office, and brought the hospital's mobile unit to a local McDonald's parking lot where kids could get immunizations for school.
The nurses have helped police with an annual bike-repair day, where some 140 kids brought their bikes in to be inspected and fixed. One little girl didn't have a seat on her bike; and a boy's bike had no brakes.
On Monday, Mrs. Barnes talked to incoming kindergarteners about poison prevention at the police division's Safety City program. Mrs. Bailey taught a Heart Power class to youngsters, stressing the importance of good nutrition, exercise, and living tobacco-free to an audience young enough to have an impact.
All of the effort is an attempt by the Roman Catholic, not-for-profit hospital to fulfill its mission of reaching out to those in need.
“This is a great example of our mission in action,” Ms. Walters said. “We do things that aren't necessarily revenue-focused. We do things that help the community, that help the neighbors, and that help the community where we stand.”
Mr. Skaja said other hospitals and health-care groups have inquired about the neighborhood nurse program, but he knows of no others that have one.
Ms. Walters, who now works as an internal consultant to St. Rita's, said the program has far exceeded her expectations.
“It was a little ahead of its time, I guess, but there was quite a focus across health care to do more community health improvement,” she said.