Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 2, 1993 TAG: 9304280442
SECTION: NURSES PAGE: 14 EDITION: METRO
SOURCE: By SARAH COX
DATELINE: LENGTH: Medium
Melinda Simpson, project director for the Roanoke Adolescent Health Partnership for Roanoke City Teens, and a registered nurse, can tell you that.
She works - collaboratively - in a partnership between city schools, city housing authority, the city health department and Carilion Health Care. The project, said Simpson, was to serve teens in their own setting, and in conjunction with the Teen Health Center at Hurt Park.
The teen clinics will open for the 1993-94 school year in Patrick Henry High School and William Ruffner Middle School, and answer the health care, nutritional and case management needs of students.
A nurse practitioner will see the teens, said Simpson, and a physician will be available. A counselor will rotate between the three sites, following through on all referrals. And the focus will shift from "fix-it" to preventative health care, according to Simpson.
Simpson said in order to carry this plan out, teachers, students, parents and counselors all will be involved. Proactive, rather than reactive, classroom education will be scrutinized. This comes, in part, from Carilion's reaction to seeing so many teens through the emergency room. "There is nothing for teens," said Simpson.
But through this health partnership, there's more than ever: There's the collaborative efforts that will involve community, health care and the school system. Simpson said one of the reasons behind this kind of organizational set-up is to find out if the community wants certain services. This comprehensive program will involve a host of community agencies, and they will focus on "the cause of the problem, rather than the symptoms, and to do that we need to use referral sources," she said.
There will be less duplication of service when all are involved, and therefore a cost savings. "The more we can educate and prevent problems, the healthier we can be as a nation. We have great technical advances, but we don't utilize them. We don't have a preventative focus. We have a fix-it focus. Collaborative means taking the team approach rather than hit and miss without communication. This is just the beginning of our using collaborative practice," said Simpson, who has been a nurse for 11 years.
"As we see the benefits, we'll see more and more use of it. And once we get out of a rut and step back and look at health care overall, we'll see collaborative practice as the way to go."
Nancy DeVilbiss Wilson might agree. Her job as a family nurse practitioner with West Salem Family Practice and Immediate Care (a satellite clinic of Lewis-Gale) is indeed one of collaboration with the other primary care givers, who are physicians, at the clinic.
Wilson, who has a masters in community health nursing and experience with community-based clinics and a teen crisis center in Minnesota, moved to Roanoke in 1986 and worked for the Roanoke County Health Department. She is used to collaborative practice, used to calling on others' expertise, and certainly used to lending her own.
Now, she runs the immediate care clinic while the physicians run the family practice clinic on the other side.
"I take care of walk-ins with acute problems - ear and bladder infections, stomach pains, minor injuries and sore throats," Wilson said.
"I work collaboratively with family practice doctors, and we work side by-side for the patients. I have really enjoyed that," Wilson said.
She said her right to prescriptive authority has taken a big burden off the physicians, and that most of the pharmacists "have been really comfortable with that. The more doctors work with nurse practitioners, the more comfortable they are with allocating. It will be a cost-effective measure, and it's going to be a good job opportunity [for nurse practitioners.] We are not substitute doctors. We incorporate into our nursing practice some medical practices, but try to include preventative health measures," she explained.
Wilson added that four years ago, the physicians at this satellite clinic solicited the nurse practitioner job through hospital administration, "and they depend on me to manage the more minor problems, so they can manage more major ones," she said.
by CNB