St. Louis University: Access to Compassion

HILLSBORO, Missouri, Feb. 1 -- St. Louis University issued the following news release:

The door wouldn't open for another 45 minutes but already the line was 12 deep. A 33-year old man needed a hepatitis A shot so he could start his job at McAlister's Deli.

A 25-year-old woman with a family history of hypertension was feeling lightheaded and wanted her blood pressure checked. A 56-year-old man needed antibiotics for his recurring pneumonia. 72-year-old woman wanted a physical because she'd been feeling a bit "off" following the 20th anniversary of her daughter's death.

Although their needs were different, the patients had one thing in common - they were either underinsured or uninsured. No insurance, however, did not translate into no care today. The patients were waiting in line at the Health Resource Center (HRC) on north Kingshighway Boulevard where they could get free care provided by Saint Louis University School of Nursing faculty and students.

"I'm not working yet so I don't have insurance," said Dwight Williams, who came to the HRC for the hepatitis A vaccination. "I heard this clinic could help me out until I get coverage so I got here early. It's good to have a place to go when you're in my position. It's good to know people care enough to help out."

Medicine students established the Health Resource Center in 1994 and have been providing free health care to area residents nearly every Saturday since. Because the demand for care is so great, the School of Nursing sought to open a clinic during the week. HRC co-director and second-year medical student, Anh Ta, helped the nursing school with the logistics; and Jane Tucker, M.D., assistant professor of family and community medicine, volunteered to serve as collaborating physician.

The half-day nurse-run clinic offers physical exams and treatment of acute illnesses in adults and children; TB tests; hepatitis A vaccinations; pregnancy and STD screenings; lab tests; and screenings for diabetes, hypertension, cholesterol and lead.

"Providing care to underserved populations is part of our Jesuit mission and we infuse that mission into our students," said Joanne Thanavaro, D.N.P., A.P.R.N., A.G.P.C.N.P.-B.C., A.G.A.C.N.P.-B.C., D.C.C., F.A.A.N.P., associate dean of the Graduate Nursing Education program and one of the founders of the Thursday clinic. "The clinic is an opportunity for students, as well as faculty, to experience the personal reward of community engagement and service."

Taking the Lead

Six volunteer undergraduate nursing students serve as clinic leads. They are responsible for staffing the reception desk, taking vital signs, collecting patient histories and administering vaccinations. They also draw blood and take specimens to SSM Health Saint Louis University Hospital, where the lab work is performed free of charge. The leads call patients whose results are abnormal and schedule follow up visits.

Rachael Johnson, 22, a senior from Wheaton, Ill., is a lead who has volunteered at the clinic since it opened in July 2016.

"We always talk about health care disparities in St. Louis and the struggle for underserved people to gain access to care," said Johnson, a member of the SLU Student Nurses Association (SNA) executive board. "This is an incredible opportunity to fill the gap. It's not about volunteering just so you can put something on your resume. It's giving back. Every day I leave the clinic I feel as if I've made a difference in a few peoples' lives and that feels really good."

Johnson also said the clinic gives her experience in looking at the whole person when providing care.

"They're coming to us for medical care but they might have unmet mental health needs or basic needs," she said. "If their basic needs aren't met, their medical needs probably aren't going to be met."

Providing care to underserved populations is part of our Jesuit mission and we infuse that mission into our students.

Joanne Thanavaro

To help patients meet those needs, the HRC employs a social worker, who helps patients tap into community resources; and an insurance navigator, who helps patients apply for Medicaid and get connected with medical homes at federally funded community health care centers. Student volunteers from the Doisy College of Health Sciences provide nutritional counseling and students from the St. Louis College of Pharmacy are available for questions about medications.

The undergraduate nursing students are overseen by students from the Nurse Practitioner program, who, in turn, are supervised by nursing faculty.

Stacy Marriott, an NP student from Springfield, Illinois, volunteered with AmeriCorps for a year in the same neighborhood in which the HRC is located. She volunteers at the clinic, in part, to fulfill the clinical requirements in her Health Assessment course.

"Volunteering here teaches you to think outside the box," she said. "You have many needs and few resources so you learn to work with what you have. You find creative ways to help your patients."

Twenty-one-year-old Jordan Mekus, a senior and a member of the SNA executive board, said volunteering at the clinic enhances her sense of responsibility.

"If we weren't here, the patients might not get the care they need," she said. "They look to us more as nurses than students and I take that responsibility seriously."

Life Changing Experience

Martha Kemp, 21, a senior from Geneva, Ill. An another clinic lead, was getting ready to close the clinic one Thursday afternoon when the volunteers chose to squeeze in one last patient.

"She came in because she was having abdominal pain and she learned that her life was about to change completely," said Kemp. "We told her she was four-to-five months pregnant. She was so upset. She didn't have the resources to take care of herself much less her baby. We had to talk her through it because it was all so overwhelming. You can't say everything will be OK because maybe it won't. We just had to help her in that moment, which I think we did. I'm so glad we didn't turn her away."

Kemp said she learned a lot about communicating with patients from the NP student who broke the news to the woman and helped her process the nformation. Thanavaro said role modeling is a secondary benefit to volunteering at the clinic.

"It's important for our undergraduate students to have contact with our graduate students and to work alongside one another," she said. "The hope is that our undergraduates will develop a better idea of the role of the NP and this may encourage them to further their education."

Mekus, Kemp and Johnson said volunteering at the clinic has inspired them to become lifelong volunteers. Kemp, who is a nurse technician on the labor and delivery unit at a local hospital, plans to remain in women's health. She sees herself as volunteering at other free clinics and with international missions. Johnson wants to work in the NICU and maybe volunteer at Nurses for Newborns.

"I've had a privileged life," said Johnson. "My needs were always met. I didn't take that for granted but this clinic has opened my eyes to the scope of unmet needs and the number of people who do without. I not only feel a desire to help, I feel an obligation to serve."

The HRC always can use more volunteers. If you're a student, faculty member or alumni interested in sharing your gifts with the clinic's patients, contact Dr. Thanavaro at jthanava@slu.edu. The clinic is open Thursdays from 8 a.m. to noon.