Jane Washburn has her hands full, to say the least. As the new public health nurse for St. John, she is responsible for covering all of the Department of Health functions, including providing services for everyone ranging from babies to the elderly.
Washburn, who grew up in Massachusetts and did her nurses training in Boston, realized she wanted to live in the Virgin Islands on a 1999 sailboat trip in the British Virgin Islands.
By day two I was having the captain call ashore to change my flight and book a hotel, said Washburn. I was going to apply for a job reselling time shares.
Reality sunk in, however, and Washburn returned home to tie up loose ends.
I said, oh, let me be a grown-up, she said. I spoke to someone on the phone who used to live down here, and he told me to find a cheap place to stay and just pound the pavement.
Three weeks later, Washburn sold her house, handed in her resignation, and came to St. John to work in the time share industry.
I can talk to anybody, and I thought itd be a different change of pace, she said. Unfortunately, I didnt have that sales ability. I decided that I wanted to get back into nursing.
Acclimated to Culture
In hindsight, that was probably the best possible move, she said. Through nursing, I could get more acclimated to the way of life, the culture and the entire ambiance of living down here.
Washburn was working with Continuum Care, providing hospice services to families on St. Thomas and St. John, when the public health nurse position became available.
Giving Back to Community
I said, this is a great way for me to continue to give back to the community, through the skills and the experiences that I have, she said.
The public health nurse position on St. John is much different than on St. Thomas and St. Croix.
The St. John public health nurse is very different than the other islands, in that its the only nurse that does what all of St. Thomas has different departments for, said Washburn, who began working as the public health nurse on March 20. So, it will be everything from maternal child health, up to age three, to family planning, immunizations, screenings, flu clinics and community resources.
Washburn, who has done home care in the past, stressed that at her new position, she will not do home visits.
Some of the biggest challenges she faces as St. Johns public health nurse are diabetes and hypertension, which are prevalent in the territory.
The challenge is to embrace peoples cultural differences, and to respect them, said Washburn. Youve got to facilitate folks to a better way of health without trying to change their culture, which I think a lot of continental folks do. They can be good intentions, but they are not well-received.
Sometimes Washburn has to do a little detective work to figure out how to best help her patients out how to best help her patients, she said.
When people come to you and say theyre not taking prescribed hypertension medication, its too easy to say that theyre non-compliant, she said. The job then becomes mine as a detective, to find out the reasons theyre not taking their medication.
A person may not be taking their medication because they cant afford it, they are having side effects, they are illiterate and cant read the instructions, or because they dont feel sick and dont see the need to take medication.
The big huge one is, but I dont feel anything, nurse, so why should I take it? said Washburn. The reason they call hypertension the silent killer is usually by the time you do feel something, youre in the hospital.
Another reason people dont take their medication is because they think, if I die, I die, said Washburn.
I dont have problems with that, but the reality is, they often times have a catastrophic stroke, and there is a great impact on the family of someone who cant take care of themselves because of that stroke, let alone feed themselves, she said. Once youve done all you can do, then you kind of have to step back and say, as long as you understand all this, God gave you free will. It doesnt mean that I dont go home and agonize over it.
Washburn hopes to be able to help teach people in the community to take care of their health on their own, she said.
The reality of public community health is that our focus needs to be not on doing it for people and creating dependence, but on helping patients become advocates of their own care, she said. To me, its like raising your childif youve done a good job, your child should be able to balance a checkbook, do their own laundry and eat something more than pizza. I want to give people the responsibility of facilitating their own care, and let me be the rudder to guide them through the system.
Trained by Nurse Browne
Washburn trained under former public health nurse Sally Browne, who praised Washburns broad background and experience.
The person in this position needs to have a very broad background to work from, said Browne. Jane has a lot of experience in home health, as well as other areas. Shes a mature lady and a great asset to St. John.
Washburn credited Browne for her initial success on the job.
Being under Sally Browne gives me enormous credibility, because Sallys been here on island and shes just a wealth of knowledge, said Washburn. I could not ask for a better mentor.
Locals are happy to see a nurse who lives on St. John, said Washburn.
Ive lived here for six years, and been involved with the community, she said. If not my name, then certainly my face is well-known. I think the response Im getting is, we finally have a local to take care of us.
Washburn hopes to educate other health care providers about Alzheimers disease, she said.
One of the things that I loved doing in the mainland was working with elders with Alzheimers, she said. We dont have any support groups, and at a point down the line Id very much like to start something along that line. If caregivers are dealing with members of the community with Alzheimers, the knowledge of what is going on can make the burden a little easier to bear.
People sometimes recognize Washburn for her participation in a certain community groupthe Middleage Majorettes.
I went to a home visit, very professionally dressed, and the wife said, I know youyoure one of those majorettes, said Washburn. She said, I saw you in the parade shaking your booty. Where did you learn to dance like that?
Washburn can be found at the Morris F. DeCastro Clinic in Cruz Bay, and welcomes questions from the community.
As I said in my job interview, I dont have all the answers, I just have to know where to get them, she said. If you get one person who finally understands the importance of taking their blood pressure and starting an exercise program, its a great feeling, because they become your missionaries.