DorlandHealth

The ongoing series called A Passion for Practice continues with a look at a community clinic in Arkansas

An unfortunate circumstance is all too common across America today. Single working parents whose employers do not provide health insurance are struggling to get by and routinely must choose between food, school supplies and taking care of their own health. According to the latest U.S. Census report, more than 47 million families are in this position. For those who live in the South Midtown Little Rock, Ark., area, there is hope. Specifically, there is Shepherd’s Hope Neighborhood Health Clinic, a community clinic developed by a small group of physicians and nurses who, in helping with various volunteer projects like helping renovate schools and helping working moms with yard work and home repair, had the idea that a health clinic also was needed. They reached out to two churches — Oak Forrest Methodist and the Fellowship Bible Church Little Rock, and began a community project.

VOLUNTEERISM AND CONTRIBUTIONS

Oak Forrest Methodist, located in South Midtown, had a small, vacant run-down house. Bulldozing the house and
building a new structure was considered, however the group decided the structure could be renovated to house the clinic. Members from the Fellowship Bible Church, a suburban place of worship, met with members from Oak Forrest Methodist and together created a plan to develop the clinic.

The business model was sparse and the plan of action simple. Volunteers from the churches and community were enlisted. Assignments were created to renovate the building and secure donations of necessary equipment and supplies. Lab services and MRIs would all be donated. The clinic’s staff would be entirely volunteer-based and everything needed would be donated except the telephone, Internet and utility costs. These expenses would be covered as a division of the church budget.

IT TAKES A COMMUNITY TO RAISE A CLINIC

The day came when the doors of Shepherd’s Hope Neighborhood Health Clinic opened.
Operating one day a week from 6-9 p.m., the clinic has already served more than 580 patients — many of them more than once. The patients’ average age is 27 and many are Spanish-speaking. The clinic has an abundance of metabolic syndrome patients. There are more than 200 volunteers, a group that includes physicians, nurses, nurse practitioners,
pharmacists, physical therapists, receptionists, interpreters, greeters, cleaning personnel and IT/computer support staff. Additionally, support from local university nursing, medical and pharmacy schools has been significant. The clinic frequently has students on short community internships observing and assisting Shepherd’s Hope’s professional staff.

Patients are asked for a $5 donation at registration, but if a patient cannot make the donation the fee is forgiven. No one is ever turned away. Pharmaceuticals are donated and dispensed at no charge or prescriptions are written for generics when possible and patients are directed to the pharmacies with deep discount programs. We assist those needing long-term pharmacy support through applications to various patient assistance programs.

In response to demand, Shepherd’s Hope has added a monthly GYN clinic. In addition, there are diabetic education classes which have been well-attended. To address the ongoing need for counseling and spiritual support, Shepherd’s Hope has licensed counselors and pastors who are available to assist as needs arise. For patients with specialty care needs, the clinic’s physicians have developed relationships with specialists who agree to see patients at no charge.

PERSONAL FULFILLMENT

As a nurse and one of the staffing coordinators for the clinic, I can say I have never had more challenges as a case manager, nor have I ever had more of a sense of fulfillment. A few brief outlines of patient outcomes are:
• A young woman concerned that she had an STD came for treatment. She entered scared to death and left armed with treatment, knowledge and reassurance.
• A truck driver was unable to get a job because of high blood pressure. He became a regular over a couple of months, changed his diet, took his medication and came in one day with a huge smile to report that he had a job.
• A 36-year-old type 1 diabetic presented with a blood glucose level of 580. He felt he could not afford insulin so hadn’t taken it. He was depressed, overweight and didn’t understand how much better he could feel and how much longer he could live. With treatment, encouragement and accountability, he is much improved.

These patients are just a tip of the iceberg. At Shepherd’s Hope, we’ve seen everything from gluteal infections, hyperthyroidism, depression and anxiety to GERD, life-threatening coronary problems, cancers and back strain. The clinic also performs many back-to-school physicals. All patients are afforded quality time to spend with the staff members who are dedicated to meeting their physical, emotional and spiritual needs. As issues of overlapping professional
expertise arise, staff members will consult around a table in the kitchen where traditional territorial boundaries of the various professional disciplines dissolve and the focus is patient support.

There are a growing number of clinics such as this, perhaps also in your community. Some have a paid staff and some operate as this one does at an all-volunteer capacity. For fulfillment of your nursing, social work and case management skills, I would encourage you to check into the opportunities for practicing within one of these clinics.

Jeanne Boling, MSN, CCM, is a case management consultant for Global Wealth Management Inc. and vice president of Mullahy & Associates LLC, a provider of education and consulting services for direct-to-consumer case management.
[ This e-mail address is being protected from spambots. You need JavaScript enabled to view it ]