Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 2, 1993 TAG: 9304280443
SECTION: NURSES PAGE: 10 EDITION: METRO
SOURCE: By SARAH COX
DATELINE: LENGTH: Long
Barbara Zicafoose, an adult nurse practitioner with the Veterans Medical Center in Roanoke has helped set up the Women's Health Clinic there. She is the coordinator for the clinic, as well as the nurse practitioner coordinator for the VA's day unit. The women's clinic is a nurse-run center for health screening and preventative guidance.
"In late 1991, several nurses were interested in women's health and in exploring what could be provided at our facility," Zicafoose said. According to Zicafoose, there were no programs centered on women's health issues at the center.
So she formed a task force, proposed the clinic, and on June 28, 1992, it opened. There is a physician available for consultations, but the clinic is run by the nurse practitioner and RNs. Zicafoose said they take a holistic approach toward medicine and offer screenings for oral, breast, cervical and rectal cancers as well as hypertension and osteoporosis. They also provide counseling on lifestyle changes for disease prevention.
"I personally feel that the image of nursing in the community should be enhanced. The public doesn't fully comprehend what nurses do, particularly in advance practice,"said Zicafoose. She said that many times, her patients comment, "I didn't know you could do so much."
Zicafoose said, "They're surprised and relieved because they don't have to wait for a doctor. And they have displayed significant confidence in us, especially because we take the time to educate them about the medicine they're taking, and its advantages and disadvantages. I've been a nurse practitioner for 12 years, and as people become more aware of what we do, we'll have a positive impact upon health care because we do a lot of collaborative practice. We provide a more holistic approach - our attempt is to see the en tire patient and family environment, and in that way, we're cost effective. We've had several women who haven't been to doctors in several years - one hadn't been in 10 years," she said.
Zicafoose said that often, cost prevents women from making routine doctor visits. This clinic, she said, gives them a cost-effective option. And many prefer women primary care givers.
"That's not being chauvinistic - they just like seeing a female. It's made them feel more comfortable; they feel freer to talk to a woman. And sometimes, they tell a nurse practitioner things they wouldn't tell a physician," she said.
Zicafoose said she has also discovered that at times she is confused with an LPN. "Nurse practitioners have masters degrees and are certified as a nurse practitioner by the American Nurses Association, and licensed in their state," she explained, adding that in Virginia, they also have to have a collaborative practice with a physician.
Jeannie Garber is another nurse with an untraditional role. She's director of Gill Memorial Hospital. She said she often fields comments such as "director of what?"' or "I didn't know a nurse could do that" or "Well, when you used to be a nurse . . . "
She's still a nurse. She said she tries to explain that she didn't leave nursing behind, but that being trained as one allowed her to move into another part of health care she really enjoys, where she can have more of an impact.
Garber was originally hired as director of nursing. Gill Memorial has a vice president, so Garber's duties include risk management, development of the hospital budget, directing the quality improvement process and direct management of the anesthesiology, employee health, surgery and staff development departments.
Garber sees the change in nurse roles due in part to the change in nursing education.
"As nursing education levels increase, there are more opportunities," she said.
Garber said nurses are now receiving more diverse educations, such as masters of business administration or public health, and many times, nurses with an administrative focus get degrees in other areas.
She also said that nurses are not as passive as they used to be. Once, they took orders from physicians and carried them out. Now, they work collaboratively with them, they explore the family and social dynamics that may effect recovery, and they make suggestions for aftercare.
Because there is more reliance on nurses and more responsibilities for them, hospitals, she said, are being forced to spend more time educating newly graduated RNs.
"In almost every level of nursing, teaching is a very large component of the role. Usually they initiate teaching, follow up on teaching, and support a physician's teaching." she said. And in order to do that, nurses must be well educated themselves.
"There is still the old image of subservient nurses who give baths and medicines, and many still have the old image of men giving orders and females carrying them out," she said.
Garber said the infusion of males in the nursing field - many have pursued this career because of salary changes - has also helped change the image of nursing. The nursing career is now perceived as more stable, with more opportunities, where the pay is pretty good.
by CNB