As a former ICU nurse, working in community health never crossed my mind. I was used to patients paralyzed and sedated, mechanically ventilated, and requiring titration of multiple IV drugs to support them. How would I transition to a community health setting?
Fast forward to about five years ago, when a need arose for volunteers to staff a clinic in my community, I said, “Sure, tell me more about that.” I had been away from a clinical setting for many years, working as a clinical editor
. I thought to myself that this could be a good way to dust off my skills. Not only did I dust off some skills, but I learned a whole new set of skills!
While much of the health care world had advanced during my time away from the bedside, our small clinic had not, and it remains like the “old days” of paper charts and actual patient education handouts.
My community is not what I thought it was.
I have learned so much working in community health – about patients, the community where I live, and myself. As a married white woman raising three children in a home with a yard, enough food and resources, and family support around me, I did not know the diversity that is right outside my door. Did I not see it? Was I too focused on my own life?
When I step inside the nurses clinic, my world opens up. Most patients don’t speak English. Some have only been in this country a few days. Some run out of food before they have money to buy more. Some have left family members behind. Some children have travelled long distances alone to be greeted by family or friends in this country that they’ve never met. Everyone has a different story.
The patients need us.
In our clinic, we manage chronic conditions and treat acute illness, perform school and work physicals, and administer some vaccinations. We refer to specialists and provide some medications (and if necessary, find alternatives or pharmacies that can provide what patients need at the lowest cost to them). I have learned that often patients must choose between food and medication because they can’t afford both. Sometimes we need to get creative to help them manage those decisions.
One of the greatest needs is education. One of the first patients I met had come in fearful that they had breast cancer. They didn’t know that the ‘lump’ they were feeling was actually a rib. Another patient had been taking penicillin
purchased from a local grocer for a wound on his foot. Of course, the additional layer to this needed education, is that it is mainly done with the help of our talented interpreters.
In the five years I have been there, we have added a registered dietitian to our staff which has helped greatly with nutrition education. We also have a pantry that we stock with donations and incorporate education about healthy food choices with options for them to take home with them.
On a normal day, we can’t simply tell a patient to follow up with neurology or that they need an x-ray. A lot of what we do is helping them navigate the available services with limited funds or resources. Fortunately, our relationships and network with certain pharmacies and providers is very helpful. And while we don’t charge for any of the care we provide, I am amazed at the generosity and gratitude that we are shown by those we care for. From cash donations to baked goods and flowers, we all feel appreciated for the work we do.
How I have changed.
I understand that there are different perspectives that make up my community and I now truly see all the people in it. Everyone is working hard in various roles – from the restaurants and hotels to landscaping and construction – trying their best to make a life for themselves and their families. It bothers me that I didn’t see this so clearly before, but I am grateful that my eyes – and my world – are now open.