The St. Vincent de Paul Society sponsors the Vocie of the Poor (VOP) which advocates for the underserved and vulnerable populations nation-wide including the homeless, poverty-stricken, and disabled. The following is a video produced by the national office of the VOP.
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Friday, August 17, 2012
Wednesday, August 1, 2012
“Never
worry about the numbers. Help one person at a time, and always start with the
person nearest you.” Mother Teresa
Description of
learning experiences in my clinical practice environment:
I completed 16 hours 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.
What was the best/worst/most challenging thing that happened this
semester?
The most
challenging experience in the FMVPDC happen during my first 4-hour shift in
which I triaged and cared for Mr. X, a 38 year-old Native American man who was
complaining of a fever, night sweats, weight loss, poor appetite, and a persistent
productive cough. He admitted to smoking 1 pack/day x 20 years, drinking 1 pint
of alcohol/day for 8 years, and being an IV drug user. He had been seen
previously in the clinic for ETOH abuse, tuberculosis (TB) treatment, and
dental care. His clinical presentation included being gaunt, having tremors, febrile,
hypotensive, hypoxic, tachycardic, and tachypneic. He was immediately referred to
the staff physician for evaluation. He was also placed in a negative pressure
isolation room and masked. I inserted an IV and gave him a fluid bolus. In reviewing
at his previous work-up, he was referred to the county health department for
Multi-Drug Resistant TB (MDRTB) and being HIV positive. This patient also
received an antipyretic, an anxiolytic, and oxygen therapy. After he was stabilized
he was transported to the emergency department of a nearby hospital for further
evaluation and treatment.
On my third
4-hour shift in the clinic (1 month later), I encountered Mr. X in triage complaining
of pain in his right antecubital area which revealed a hard mass over the right
antecubital vein which was thrombosed and reddened. Once again, he was
evaluated and sent by ambulance for further evaluation at a nearby emergency
department.
Through dialogue
with the social worker and Indian Health Service, we found out the patient was
eligible for healthcare at the HIS hospital and eligible to receive public
assistance and additional health care coverage for TB and HIV with the state
and county agencies. The patient received long-term treatment with the Maricopa
County Health Department and Phoenix Indian Medical Center. Additionally, the
Centers for Disease Control (CDC) interviewed this patient because his strain
of TB was unique. Furthermore, we were able to get Mr. X the treatment he
needed and protect the other vulnerable populations from the spread of MDRTB.
Examination
of my experiences:
What
did I accomplish?
I provided quality and effective care to an
underserved population (indigent) which stabilized and improved the care at
least one person received. I made the difference in people’s life, one person
at a time. I was able to positively intervene in healthcare situations to
affect outcomes. I provided a health care safety net to those without one. I
enhanced my community by using the expertise of nursing.
How did
this experience affect my interactions with others?
I was able to be part of a community of
caring individuals with similar goals who want to help the underserved and
vulnerable populations in our society. Working with the social workers, clinic
providers and nurses, and the others allowed me interact positively with
community partners such the United Way, Salvation Army, Catholic Charities, and
the Maricopa County Health Department.
What have I done
differently as an individual and as a professional to support and advocate for
some of the issues I encountered during your service learning experience?
Becoming a member of the Voice of the Poor (VOP) chapter in
Phoenix has given me a platform for advocacy concerning human dignity and
caring. The VOP works with state and federal agencies to provide a communal
network to keep the “safety net” intact through policy and legislation at the
municipal (local) level while being a base for issues related to poverty,
immigration, and social justice.
Articulate
learning of my experiences:
What
did I learn?
Human caring is central to nursing
interactions and is essential to optimizing health care delivery. In this
environment, one must 1.) clear the mind; 2.) desire to understand; 3.) affirm
the presence of the receiver; 4.) establish confidentiality; 5.) prepare to hear
anything; 6.) actively engage in and encourage dialogue; 7.) avoid assumptions;
8.) follow intuition; and 9.) never give up (Schwerin, 2004). These attributes
created an environment that was conducive to the clinic staff and the patients
that received care.
How
did I learn it?
I learned this through experience, the
clinic staff members, and the clinical manager. Additionally, Schwerin (2004)
states these tenets are the necessary building blocks of creating a caring
connection.
Why
does it matter?
Social justice— preserving of human
dignity, protecting the poor, promoting solidarity and human equality—requires us
to be kinder than necessary through the use of empathy, compassion, and
resilience through adversity. Employing the techniques of human caring
increases the interaction and responsiveness of the community to help each other
and preserve human dignity.
What
will I do in light of this?
Continue to serve my community and use my
expertise to ensure access to healthcare for the underserved and vulnerable
populations.
265
– 270.
Saturday, July 7, 2012
“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/.
Sunday, April 15, 2012
NR725A_WongPa_wk16_SL Blog Entry#2
The under/uninsured, working poor, and indigent population I
served at the St Vincent de Paul Free Clinic, have their basic and some
preventative healthcare needs met. The services provided by the clinic
addressed urgent needs such as wound care (suturing and monitoring for
complications), cold and flu treatment, hypertension management, diabetes
management, and well child care. Unfortunately, the healthcare needs of these
populations require more than the clinic has to offer. For example,
hypertensive or diabetic crises require more in-depth resources in an
in-patient setting for treatment and management which in turn require hospital
admission. Without health insurance, many of the patients served by the clinic
will put off admissions due to lack of money and insurance until they are
physically overcome by the disease or illness progression. In fact, one of my
most challenging things happened when I encountered a 23-year old male patient
who was experiencing left-sided abdominal pain for two weeks without relief
from over-the-counter medications. Subsequently, a CT-scan revealed intestinal
cancer but the patient initially refused more diagnostic testing and treatment
because he could not afford the cost of treatment. Although I counseled him
about the gravity of non-treatment, he still refused. I involved the social
worker and the clinic physician in a discussion about this case and fortunately
the social worker was able to enroll this patient in an emergency temporarily
funded state health insurance program for just these types of patients. After
several attempts to contact the patient, we were able to secure a referral to
oncologist who managed the patient as an outpatient through his initial phase
of treatment. At this writing, I have lost contact with this patient for
follow-up.
Services such as the St Vincent de Paul Free Clinic (SVDPFC)
is a necessary fixture for this community as well as communities across the
nation. This facility acts as a safety net for those who cannot afford
insurance and those who are deemed ineligible for insurance. Additionally,
services like the SVDPFC extend their human caring to undocumented immigrants
who are suspicious and cautious about seeking health care (especially
preventative care). In these uncertain times and decreasing financial support
for charities, the SVDPFC needs more facilities like themselves to accommodate
an increasing number of people requiring their services. In fact, Maricopa
Health System (a county-run agency) has decreased the number of clinics
county-wide and has started to require residency documentation in order to use
their services. The means to provide more services such as the SVDPFC and
diminishing rapidly without an alternative solution therefore I fear the Free
Clinic will be overwhelmed if the Affordable Healthcare Act of 2010 (AHA) is
repealed by the Supreme Court. With this in mind, I am obligated as a member of
my community, as a professional nurse, and as a Christian to continue my
services with SVDPFC in order to promote the common good, care of the less
fortunate, and the infirmed.
Throughout my service learning at the SVDPFC, I have learned
that I have deep inspiration for political and social advocacy. I have attended
several community action boards with State legislators concerning cuts in
Medicare funding and have worked diligently to provide quality nursing care to
the underserved and vulnerable populations within my community. Additionally, I have gained insight to
fragmentation of community resources for the under/uninsured, the working poor,
and the indigent populations within society. Furthermore, I have gained compassion,
sympathy, and empathy for those who are less fortunate and fear for their
safety.
Last Words for the Semester: "When a poor person dies of hunger, it has not happened because God did not take
care of him or her. It has happened because neither you nor I wanted to give
that person what he or she needed." --Mother Teresa
Saturday, March 17, 2012
NR725A_WongPa_W8_SL_ReflectionsBlog1
“Never doubt the power of a small group of committed individuals
to change the world; indeed, it is the only thing that ever has.”
Margaret Mead
As part of the Society of St. Vincent de Paul (SVDP), The Free Medical and Virginia G. Piper Dental Clinics offer medical and dental care for the working poor, the uninsured, and the homeless population in the surrounding Phoenix metropolitan area. The funding for this service is derived from a perpetual grant from the Virgina Piper Foundation and the Society of St. Vincent de Paul. I believe that SVDP has internalized the building blocks of Catholic social teaching : preservation of human dignity, respect for human life, association, participation, protection of the poor, solidarity, stewardship, subsidiary, human equality, and “the common good” (Byron, 1998, p. 2 - 6). My service learning experience is working as a RN in the evening health clinic providing nursing care to pediatric and adult populations requiring medical treatments and nursing interventions. The rationale for choosing this site and this environment for my service learning experience is three-fold: St. Vincent de Paul mirrors my values and beliefs; I can use my professional skills and experience to make a difference in people’s lives; and I can ease the suffering of the citizens within my community.
My role at the Free Clinic is as a staff registered nurse (RN) working with a compassionate group of healthcare providers which includes nurse practitioners (NPs), physicians, social workers, physician assistants (PAs), and registered dietitians. In the clinic, I administer medications, apply splints and casts, obtain vital signs, create referrals, and document the encounters. I have worked 2-3 hours per week on the evening shift (the busiest part of the day) providing nursing assessments and interventions—that’s a total of 12 hours as of this posting. For example, a middle aged indigent man with diabetes and a gangrenous left foot came in for evaluation. While cleansing the foot and the associated ulcer, I was able to assess the foot for the absence of pedal pulses and capillary refill. Additionally, I was able to solicit a detailed medical and psychosocial history which included moderate bipolar behaviors and schizophrenia. Furthermore I will able to ascertain that he was a Vietnam-era veteran. Through the use of the social worker and the Veterans Administration, we were also able to get this patient a referral for behavioral health, a hospital to perform the amputation, and a prosthetic device, as well as a post-operative rehabilitation plan. This was just one encounter of many in which the opportunities to make a difference in people’s lives are limitless yet realistic. In fact, I have been asked to help with the community diabetes outreach program and the pediatric dental caries prevention program. Just recently, one afternoon, we went the local mall for a few hours and provide fluoride teeth painting to children 3 – 5. My long term plans include assisting the manager of the Free Clinic in performance improvement projects such as patient wait time reduction, referrals processing, and cost containment issues. Additionally, I would like to do more community projects such as diabetes teaching and exercise.
I would like to leave you with an inspirational quote that sums up my passion and service learning experience:
“Far and away, the best prize that life has to offer is the chance to work hard at something worth doing”—Theodore Roosevelt
Byron, W. J. (1998). Ten building blocks of Catholic social teaching. America
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