John Modrzejewski, FNP-C, a family nurse practitioner in Green Valley, Ariz., has experienced a diverse range of nursing roles during his 23 years of nursing. Yet even after logging hours as a flight nurse, working at the Arizona Department of Corrections and serving on a hospital’s nephrology floor, he was still surprised when his brother invited him to join his team – at the Green Valley Fire Department.
Dan Modrzejewski, John’s brother, is a battalion chief at Green Valley Fire Department. While completing his master’s thesis in science and technology at Arizona State University in Tempe, Ariz., Dan conducted a study revealing that in more than 1,600 cases of patients transported to a hospital in Green Valley, more than 25 percent could have been treated at home. The study resulted in the first-of-its-kind Fire-Based Urgent Medical Services Program, a mobile urgent care unit where nurse practitioners field emergency calls alongside firefighters, providing care where and when people need it most.
The program is a part of the growing “community medicine” healthcare trend aiming to better address health-related issues, reduce costly emergency room visits and help lower expenses for patients and communities. Treating patients in their homes is much more cost-effective and easier on patients than taking an emergency vehicle to the hospital. According to Dan, a hospital trip and emergency room visit to the nearest Tucson hospital can run from $3,000 to $4,000. In contrast, a visit from a nurse practitioner and home treatment is roughly $300 to $400.
The Fire-Based Urgent Medical Services Program has four nurse practitioners who are available to make house calls 50 hours a week, and will increase to 70 hours a week in April 2016, according to John. They treat patients who call 911, but cannot visit their primary care physician or urgent care due to financial, mobility or other issues.
Although his role is unconventional, John said he received a warm welcome into the Fire Department.
“In the firefighter world, core values include community and teamwork,” he said. “I immediately felt like I was part of the Fire Department team. The services I provide positively impact the unit and make it stronger. We have another resource to quickly and effectively care for patients.”
Katie Sayre, RN, MA, registered nurse and dministrative division chief for the Green Valley Fire District Fire-Based Urgent Medical Services Program, believes that having nurse practitioners provide care through the program is an optimal way to provide needed cost-effective healthcare to the Green Valley community.
“We work in a retirement community where the average age is 72 and increasing,” said Sayre. “As our residents age, they are less mobile, more afraid of losing control, and more isolated. This program gets us into the patients’ homes, where they are more comfortable and have their customary support systems. This service may not work in all geographic areas, but in Green Valley it’s satisfying to know that we are able to provide healthcare to people in their homes and save them trips to the urgent care center or emergency department waiting room for a problem that doesn’t require that level of care.”
The nurses field a wide variety of conditions including respiratory problems, dehydration, diarrhea, minor wound infections, simple fractures and sprains, mild skin burns, rashes, cuts requiring stitches, tests for strep, flu and prescribing antibiotics. Additionally, the team can schedule house calls through the nurse practitioner telephone line at the station.
John explained that when answering an emergency call, the fire team will arrive and evaluate the situation. If the patient does not require emergency transport, the nurse practitioner can dismiss the team and assume care of the patient.
“By caring for people in their homes, the amount of time I have with each person is extended,” said John. “I can see patients in the comfort of their own beds.”
Although the program is only a year old, it is already inspiring national conversations about how nurses can play a vital role in fire departments. In March, Dan will travel to Washington D.C. to present the program to the American Society of Aging, leading discussions with the Centers for Disease Control and the Center for Medicare and Medicaid. The Fire Department is also in the midst of working with insurance companies to approve credentialing and support providing care.
The Green Valley Fire Department is just one example of how nurses are stepping out of their traditional roles to make significant impacts in the wellbeing of populations.
“This program shows our community that nurses are willing to step out of regular roles and boundaries to give people the best care that we can possibly give,” said Sayre.
To learn more the program, visit www.gvfire.org. To see footage of the Green Valley Fire Department nurse practitioners in action, check out this news clip from a Tucson television news station, KGUN9-TV.