This year the Rockland District Nursing Association (RDNA) is celebrating the legacy of its founding nurse, Eliza Jane Steele, a proud native of St. George born in 1898 to Scottish immigrants Walter Steele and his wife Janet Creighton of the Clark Island community. By 1920 Steele was a student nurse at the local hospital and a few years later, following her father’s death from TB in 1921, she and her mother moved to Rockland, having sold their 39 acres of land to John Meehan & Son, the company that operated the mainland quarry on the Clark Island Road. In the 1930 census for Rockland, Steele was listed as a nurse for the Red Cross, but by that time she had also been the chief nurse of the newly established RDNA for a year.
Today, ninety years later, says Tenants Harbor resident and RDNA executive director Peta vanVuuren, RDNA is still an independent agency and is still fulfilling its founding mission of community nursing as established under Steele.
“Eliza Steele is really the vision of the RDNA. To me the important thing is the connection to the community and that the community supports the district nurse, that it is a partnership between local government, other community leaders and the nurses that has survived all these years.”
During the nearly 40 years she led the RDNA, Steele worked with a number of other nurses, most memorably among them Owls Head’s Margaret Torfason, going from home to home, handling the health needs of all ages, doing vaccinations, dealing with outbreaks of infectious diseases, screening public school students, aiding unwed mothers, helping children get admitted to the Baxter School of the Deaf, working closely with local authorities on a variety of public health problems, holding well-baby and dental clinics. She would even go onto local farms to make sure the animals were vaccinated.
“Eliza Steele was also highly respected by many local physicians,” vanVuuren stresses. “If a doctor needed to know about families, about people who really needed services, she was the one who knew. She was their eyes and ears. The idea was you needed good health care for everybody, that people needed access.”
Steele and her colleagues attempted to address a very wide gamut of public health needs in Rockland and its surrounding communities during the Great Depression, World War II and into the 1950s and 1960s, but today, vanVuuren admits, so much has changed in health care, that the RDNA has also had to change to accommodate new health care roles and administrative structures. “It’s a fluid situation,” vanVuuren says. “Everything is constantly shifting. So the local solutions like the RDNA have to keep looking at what is possible and what is sustainable over the long term.”
These days, vanVuuren explains, the RDNA predominantly serves the elderly, signing on clients when a physician orders the service as part of a plan of care. “That’s the population that needs this type of non-acute nursing service. Primarily we’re doing medication ‘pre-pours’ (pre-measuring medications), foot care—afterall, if you are able to put your shoes on and go about your business, you can stay independent—and health assessments.” The medication service, she notes, is an important safety issue. “If several physicians are involved, some medicines being prescribed might conflict with each other. So we are another set of eyes monitoring the situation. We also work in collaboration with others—in St. George, for example, we work with the town’s para-medicine program. The paramedics can do some things and an RN or LPN can do other things.”
At this point, with financial resources allowing only 50 nursing hours each week, the organization is limited to a maximum of one visit a week to each client. “We’re all part time. We have a clinical care director and she has five nursers working with her. What the nurses do is simply nursing. Most of them are also working elsewhere. We match the client with the nurse. Our nurses have over 235 years of nursing experience combined. They are a seasoned nursing staff and love this kind of nursing.”
When the RDNA takes on a client—in St. George they regularly see 13 to 15 people—the commitment is to that client. There’s no limit to how long a client can be with the RDNA if they need the service. The average duration of client relationship is four years, but the organization has clients who have been receiving services for 17 years. The average client age is 81.
In the early days, the RDNA received funding from Rockland’s Community Chest, a precursor of the United Way. These days, vanVuuren says, 60 percent of the RDNA budget still comes from local sources—from the midcoast towns it serves (Rockland, St. George, Owls Head, Thomaston, So. Thomaston, Cushing and Union) and from local donations. There’s also a small endowment. The average fee for a visit is $25, with financial aid available if needed. These fees cover about 17 percent of the budget. Grants are another occasional source of revenue.
If serving an aging population has become a major RDNA focus, as much as it can, the organization also continues Eliza Steele’s focus on the wider public health needs of the communities it has served for these past 90 years. For example, it provides monthly blood pressure clinics in Rockland and Thomaston and it continues to be involved in a bi-annual medication collection initiative it helped launch in 2010.
“To me the medication collection is one of the most rewarding things we do,” notes vanVuuren. The problem the initiative was created to address is that leftover or expired scheduled medications are a hazardous waste that people don’t know how to dispose of. Flushing them down the toilet, for example, or putting them in the garbage poses an extraordinary environmental hazard.
“Initially there was no easy or legal way to get rid of scheduled medications—pharmacists weren’t allowed to take them back and the only ones legally able to take them was law enforcement,” explains vanVuuren. “So the police chief in Rockland and I talked and there were others interested, so based on a model they were using in Brunswick we figured out a way to do the dance of meeting all the regulations involved. Nine years later we’re still offering this free service to the community twice a year.”
Eliza Steele, vanVuuren is certain, would very much approve. —JW (John Falla contributed to this story.)
PHOTOS: Top, RDNA, below, Julie Wortman