Time To Care

Working at a Community Health Center (CHC) site has provided me with the opportunity to provide care to a variety of people from all walks of life. Financially, many of the patients are uninsured and utilize a special program that provides care on a “sliding scale type” basis for patients without health insurance. I care for patients that pay for services out of pocket with no insurance and no other coverage. I care for patients with Medicaid and Medicare that could clearly go to any provider of their choice, however in many cases due to transportation limitations will often times choose to come to our facility. Occasionally, I care for patients that have private health insurance but again, chose our site because it is more convenient.

The unique feature of working in such environment is the ability to also learn about my patients varying levels of health education. It is interesting to see groups of individuals as they come together to learn about their health issues and concerns. It is also interesting to see how some people seem to either truly understand their chronic and acute health issues and others simply lack that understanding. This gives the providers an avenue for more support, encouragement and education. It is really rewarding to provide this support and see the patient grow and become a successful advocate for themselves and truly understand what they must do to maintain achievement of their health goals.

Something about having the time for this education is one key difference of working at a CHC. Many times in private health care settings providers are reimbursed on the number of patients seen on a daily basis, however the more patients you see the less time you are able to spend with each patient. I enjoy CHC work environments because I actually get to take the time educating and empowering my patients. I am able to arm them with knowledge to make better health care decisions, now matter where they seek care.

Attractions Coming Your Way

There are many attractions to working at Virginia Community Healthcare (CHC) Sites:

TIME:
Often, you have an opportunity to spend much more valuable time with a patient than you would in traditional private practice sites. Broadly speaking at a CHC you may have 15 to 30 minutes for patient office visits—on average in private practice you may only have 6-7 minutes. This increase of time in our proactive medical care model can make a huge difference.

PATIENT EDUCATION AND ADVOCACY:
Granted, in our practice settings there are in many cases much, much more things you have to do in a single visit, as that may be the only encounter you have with the patient who may not come back to see you for several months to years after initial office visit. You can spend more time in educating the patient of disease processes and actually explaining the pharmacology and pathophysiology of what is going on with the acute or chronic health condition. It really provides an opportunity to make a major impact on the life of the patient that you may not have otherwise.

SUPPORTIVE TRAINING ENVIRONMENT:
Oftentimes you will work with providers who were once in the same shoes you may find yourself in as a novice and appreciate and understand what it means to be new to the profession. As a new provider there is much to learn and CHC sites tend to foster a supportive and encouraging environment for doing so.
To better accommodate new practitioners, CHC’S have a supportive “slower pace for learning”—this is VERY important for a new graduate as they begin to grasp putting together textbook with reality. In many cases, you are seeing things for the first time and actually able to tie all the links together to get a broad, bigger picture of what you have learned in school.

LOAN REPAYMENT OPTIONS:
In being the novice provider and creating your foundation, at a Community Health Center there is the added benefit of the HRSA student loan repayment program. This is a special federally funded program that actually helps to fund repayment for professional student loans for a timed commitment to work in certain “HRSA” approved sites. You have the option of doing so half time or full time, based on your personal choice and needs. If you select full time, you could possibly earn up to 60K towards your student loan debt--in addition to your annual salary. I was very fortunate in that my educational institution actually encouraged this for us and my nursing class was very well informed of this incentive that exists.

Posted for Author Narita Snead

Dreams and Realities

It has been very exciting to finally live my dream career, but nevertheless the process has challenges. I honestly feel privileged to open my arms and welcome a population of individuals that may not always be welcome in private practice.  It is wonderful to be able to provide care to individuals who may not have received any traditional medical care for many years. It is also wonderful to be able to educate patients about their health, answer their questions and give them the tools they need to become better advocates for themselves in an environment where they may have once have felt “like I don’t fit in.”

The realities of providing access to care for our patients are oftentimes inhibited by lack of medical insurance, transportation and finances to pay for services (diagnostics and co-pays). At our particular CHC--we provide services regardless of patient ability to pay and most of our satellite sites are located near public transportation services. In some cases, the realization of access barriers lies within our patient population learning what organized health care is and how to utilize the services that are provided.

Posted for Author Narita Snead

Welcome to Our May Ambassador - Nurse Practitioner Narita Snead

Narita Snead has wanted to work in a Community Health Center since she was treated at one as a patient – ironically at the same CHC, Capital Area Health Network, where she now works (although at a different site). “It was a terrific experience. I never felt stereotyped as a CHC patient.” From that encounter, she decided she wanted to give back to ensure others had the same positive experience.

From an early age, Narita aspired to be a physician. She always admired her pediatrician and his love for the medical profession. She had a terrific high school biology teacher, and discovered a knack for science. But a life experience left her disheartened with the patient/physician relationship. Watching a family member die of breast cancer, she became keenly aware of the different objectives of nursing and medicine. The nurses were more involved and compassionate – treating the patient holistically rather than focusing simply on “cure.” Narita realized she wanted to concentrate on preventative care, patient education and encouragement, and the overall patient/provider collaborative relationship. She set out to be an Adult Nurse Practitioner (ANP).

After completing her undergrad at Howard University, Narita went on to get her MPH from Eastern Virginia Medical School. Post graduation, she worked for two years as the HIV/AIDS Special Project Coordinator for the Virginia Department of Health, funded by a grant from the CDC. She then went back to school and completed her Nursing and Nurse Practitioner degrees simultaneously, via the VCU School of Nursing A2D program – all while working 12 hour weekend shifts and mothering a young family.

Once her young son was ready for kindergarten, she wanted to work traditional hours to be home with him more, and sought an environment where flexibility to meet her family’s needs was possible. That’s when the CHC calling kicked back in – she contacted the Virginia Community Healthcare Association. She was looking for a good work/personal life balance, which Capital Area Health Network has provided beyond her expectations. And she works only minutes from home.

Narita serves a very diverse patient population. She sees every type of adult – insured and uninsured, men and women, from all walks of life, with a wide spectrum of both acute and chronic health issues. Narita feels she’s getting a “great education and becoming a better provider because of” her work in a CHC. And it’s incredibly rewarding. “The patients are so appreciative. It’s very heartwarming.”

When asked what she would recommend to someone considering an opportunity to work in a CHC, Narita has a word of caution. “Don’t assume anything or take anyone’s word for it if they have not experienced a CHC firsthand.” She recommends talking with a provider, and ideally shadowing them to see what it’s like. “Live a day there, and experience the satisfaction and self-fulfillment.”

Regarding the pros and cons of work in a CHC, Narita observes she’s blessed to be able to make an impact on her patient’s lives, works with a great team of people, has great flexibility and balance in her life, all with the opportunity to pay off her student loans though the National Health Service Corps. “What’s not to like?” she quips. When asked to sum up her CHC experience, she had four words: “enlightening, invigorating, refreshing and humbling.”