“Knowing is not
enough; we must apply. Willing is not enough, we must do”--Goethe
Description of learning experiences in my clinical practice
environment:
I have continued volunteering my
expertise as a registered nurse (RN) in the Free Medical and Virginia G. Piper
Dental Clinics (FMVPDC) offering nursing care for the working poor, the
uninsured, and the indigent populations surrounding Phoenix metropolitan area. In
2011, this clinic saw 13,785 patients and had 160 health care professional
volunteers on staff.
The clinic is a part of the St
Vincent de Paul Society (SVDP) main campus which operates not only the clinics,
but also a thrift store, a food bank, a free community cafeteria, homeless and
victims of domestic violence shelters, an elementary school, youth and young
adult programs for at-risk students , a home, hospital and prison visitation program, and a central processing facility for
donations.
The St. Vincent de Paul Society’s
mission is “to collaborate with others of good will in relieving need and
addressing the causes by embracing all work of charity and social justice “(St.
Vincent de Paul, 2012). According to
recent government statistics, 812,000 people live in poverty in Arizona out of 5,887,000
(total pop.) that represents 16.6 % of the total population and 40% of those
living in poverty have no health insurance (National Coalition for the
Homeless, 2012). This represents approximately 325,000 people who have no
health insurance. Lack of health insurance is at a crisis not only in Arizona
but nationwide. By offering free health and dental care with homeless
sheltering, St Vincent de Paul has indeed demonstrated the leadership necessary
to assist others in need and ensuring social justice and charity.
St.
Vincent de Paul (SVDP) of Phoenix provided homeless services to 141,000 persons
in 2011 and provided free medical and dental care to 13,785 patients.
Additionally, SVDP provided 44,609 home visits, 12,450 visits to nursing homes,
hospitals, and prisons, and provided 282,871 food boxes from the food bank (St.
Vincent de Paul Society, 2012). Additionally,
the SVDP Society of Phoenix has developed a committee to advocate for the poor
at a local, regional, and national level named “Voice of the Poor” (VOP). VOP
has two purposes: to educate members on
issues effecting who they serve and to advocate for change in public policies
detrimental to the poor. By using the
forum, SVDP has provided workshops on Welfare reform and changes in food stamp
legislation. VOP was instrumental in removing the “kidcap” restriction in
Arizona welfare laws, preserving the general assistance for the disabled,
preserving social services for the needy, and raising unemployment benefits for
AZ residents. VOP has also endorsed and were instrumental in passage of AZ Prop
# 303 [which increased tobacco tax to fund AZ Health Care Cost Containment
System (AHCCCS)] and AZ Prop 414 (created a special district to fund Maricopa
Integrated Health System) which both laws have helped to increase the access to
health care for the poor and uninsured.
The funding for this Free Medical and Dental Clinic services
are derived from a perpetual grant from the Virgina G. Piper Foundation and the
Society of St. Vincent de Paul. Additional funding is derived from sustaining
contributions from the Diocese of Phoenix, charitable contributions/gifts,
revenue from donations sold in the thrift store, grants from state and
municipal organizations, federal block grants and the American Recovery and
Reinvestment Act (ARRA).
Examination of my
experiences:
What am I trying to accomplish?
I am applying my skills as a RN in an environment requiring
my services for an identified need within my community which includes ethnically
diverse, underserved, and vulnerable populations in an urban area. I prepare
patients to be seen by the medical provider by obtaining vital signs, chief
complaint, and standardized (per protocol) diagnostic testing. Furthermore, I
triage the patients according to severity of illness or injury so that
resources are allocated judiciously and equitably.
How does this experience affect my interactions with others?
I have synthesized my leadership and organizational skills
to provide efficient nursing care by orienting new nursing staff and assisting
in the redesign of the triage area of the medical clinic. Additionally, I have
created a collegial environment with the social worker and the central referral
center so that consults are processed quickly and providers have a central area
to follow up on referrals and the outcomes of the consultations or hospital
admissions. Furthermore, I have solicited area hospitals to donate expired
medical supplies to the clinic.
How does my understanding of social justice help me appreciate
my role in healthcare?
I comprehend the ideals of social justice— preserving of
human dignity, protecting the poor, promoting solidarity and human equality
which leads to the improvement of the “common good”—supports social justice
causes throughout my community. I make a difference by being a part of the
solution for universal health care and being a part of a great organization by
volunteering my time and lending my expertise as a multifaceted registered
professional nurse to promote wellness, assist with access to care, and ease
suffering. In addition, I have become involved with the Voice of the Poor (VOP) chapter in Phoenix.
Articulate learning
of my experiences:
What did I learn?
The poor and homeless appreciate the services I offer and
are usually relieved after examination and treatment no matter how small the intervention.
Also many are scared and worried about the impact of disease, illness, or injury
will have on their activities of daily living (ADLs). Furthermore, many
undocumented immigrants are suspicious of our activities until after treatment
and discharge. Additionally, there are multiple constituencies with many
agendas in healthcare. Depending on the point of view, the stakeholders may
have conflicting views of how best to use available resources.
How did I learn it?
I learned this through observation by delivering the
healthcare directly and empathizing with the patients. I take time to actively listen
to patients and be their advocate throughout the healthcare process.
Why does it matter?
Part of social justice is providing underserved and
vulnerable populations equitable access to care. By being the advocate, being
transparent, and concerned, one gains trust and appreciation. Additionally,
being responsive and efficient during the triage process creates an environment
of caring, increases access to care for more patients within my community, and increases
the probability of patient compliance to treatment.
What will I do in light of this?
I will continue to provide my services in an efficient and
reliable manner. I will continue to advocate for the poor and disenfranchised
by increasing my efforts in the VOP. Furthermore, the DNP role in in health
promotion will require improving health outcomes; inter-professional
collaboration; advocacy; designing preventative services such as screening, counseling,
and public policy intervention. I believe I am already providing many of the tasks
involved in the DNP role (as previously stated); however, at present time, the
clinic is focusing on immediate treatment and has little time to prepare for
prevention strategies except in the dental clinic where we provide fluoride teeth-painting
to 3-5 year olds in the community to prevent tooth decay. So, solid servant
leadership would help health promotion strategies.
References
National Coalition for the
Homeless. (2012). People need health
care. National
Coalition for
the Homeless. Retrieved from http://www.nationalhomeless.org/facts/health.htm
St. Vincent de Paul Society of Phoenix St. Vincent de
Paul Society of Phoenix. Retrieved from
http://www.stvincentdepaul.net/.
