Showing us the money

August 6, 2006 -- Today the Quad-Cities Online site posted a short but very good story by Dawn Neuses about occupational health nurse Pam Rudsell, who works for the City of Moline (Illinois). "City of Moline saves thousands with on-site 'Nurse Pam'" focuses on the money Rudsell saves the city. She provides a wide range of wellness care, including screenings, vaccinations, and preventative education, as well as handling most workers compensation visits. The piece demonstrates the inherent value of a public health nurse practicing in a workplace setting. It is marred slightly by the assumption that care beyond Rudsell's expertise necessarily requires a physician, rather than Rudsell's nurse practitioner colleagues. But the piece shows readers why public health nurses deserve their support. This is a critical message at a time when many are struggling for funding. We encourage all nurses to use this kind of cost-benefit analysis to show how their work saves lives and money.

This piece puts the costs savings right up front. It stresses that the City of Moline saved $91,263 in 2005 because Rudsell was on-site to care for its employees, dependents, and retirees. Rudsell cost $84,000, but she provided $175,263.50 in services. (It's not clear how much actually went to Rudsell, since she actually works for contractor Trinity Work Fitness.) The certified occupational health nurse managed 1,506 health visits.

What did the certified occupational health nurse do? She managed 1,506 health visits. She provided over-the-counter medication, changed dressings, checked stitches, blood pressure and cholesterol, triaged injuries, gave flu vaccines, and educated employees on weight control and other key topics. She conducted training in CPR and blood-borne pathogen control. The city's "management services officer," Terese Kimbell, says that Rudsell saves "taxpayer money by eliminating drive time, waiting-room time and office-visit fees to be treated somewhere else." The piece notes that Rudsell handled 66% of the workers comp visits last year, visits that "in the past would have required an in-office doctor visit." The piece does assure readers that if something is "beyond her scope of expertise," Rudsell recommends that the patient "see a doctor." Kimbell stresses Rudsell's value for early detection through measures like prostate and colo-rectal screenings. A quote from "Nurse Pam"--as the employees evidently call her--shows her focus on wellness: "We are always looking at new things to do to encourage employee health."

This a great picture of an effective public health nurse, someone whose holistic, preventative model of care and broad skills help patients and save money. The piece manages to pack a wealth of detail about what Rudsell does and why it matters into a short space. And in the managed care era, when nurses have been seen by many as optional extras, the focus on the huge cost savings is very helpful. Neuses even resists the urge to call Rudsell "Nurse Pam," which in the context of the article would likely have undermined the portrait of a serious professional. The only minor complaint we have is the common assumption that care beyond Rudsell's scope of practice would necessarily have required a physician. In fact, advanced practice nurses increasingly provide comprehensive, cost-effective care that research shows is at least as good as that of physicians.

We thank Ms. Neuses and Quad-Cities Online for this helpful article.

See the article "City of Moline saves thousands with on-site ‘Nurse Pam’" and see the photo gallery. You can send notes of thanks to author Dawn Neuses at    dneuses  @   qconline.com