Cathy Grote, director of health services at Oglethorpe University in Atlanta, travels the campus to make house calls. She carries a backpack, which holds her medical kit, chicken soup and ginger ale.
Lest you think that nursing on a college campus is as tranquil as images of tree-lined walks and ivy-covered halls, remember the patients. Eighteen- to 24-year-olds are anything but tranquil.
"I love this age. They're fun and they're smart, but they don't always know how to take care of themselves," said Cathy Grote, RN, director of health services at Oglethorpe University in Atlanta. "You have to be a nurse, a mom, a confidant and a good friend, because some of them need a little nurturing."
Grote came to Oglethorpe with more than 15 years of experience as a hospital operating room nurse and educator. "This job brings all my past nursing experience together, and I love it," she said.
Describing herself as "a one-armed paper-hanger," Grote enjoys the autonomy of running the university's health clinic and planning health education programs for the 1,000-plus students and faculty members. A physician holds office hours one day a week and leaves standing orders that allow Grote to dispense medications and administer some clinical tests. A nurse practitioner from an Atlanta OB/GYN practice comes twice a month to deal with women's health issues.
When students are too sick to come to her, Grote makes house (or dorm room) calls. She carries a backpack filled with medication, assesses students' conditions and gets them to a doctor, if needed. She also has delivered ice chips, crackers, chicken soup and ginger ale, and she has arranged for resident assistants to pick up food for sick students.
"Any emergency, I go. I drove one student to the ER last year for a virus that kept her out of school [for] six weeks," Grote said. "I'm not shy. I ask patients to be honest with me, and I'm honest with them.
"I try to be a friend, give good medical advice and help them make good lifestyle choices. I treat them as if they were part of my own family and feel blessed that they come to me."
A campus nurse must be prepared to deal with everything, including colds, flu, allergic reactions, seizures, bacterial meningitis, rape, eating disorders and problems with drugs or alcohol, sexually transmitted diseases and suicide attempts.
'A safe haven'
"A big part of the job is to provide a safe haven, where students feel like they can tell you anything and it won't get back to anyone," said Rebecca Tew, BSN, MSEd., nurse director of student health services at Columbus State University. "Confidentiality is of the utmost importance, because we want students to come to us."
Tew explains to parents that she can't divulge medical information about patients 18 or older. "I tell them that it's against the law and I don't look good in stripes, but I invite them to talk with their child and come to an office visit if their child grants permission," she said.
On the other hand, Tew will lend her cellphone to students she thinks might want to call their mothers.
"Sometimes the stomach problem is really homesickness or trouble with a roommate. Part of what we do is getting to the source of the problem," she said.
A former hospital supervisor in the critical care unit and emergency room, Tew said that caring for the university's 7,600 students is the best job she's ever had — one that keeps her on her toes.
"Many students are 25 to 30 years old. They've quit work to go back to school and don't have health insurance, so they use us for their primary health care," she said.
Tew's challenge is to provide as many services as possible within a limited budget. The student health fee is $30 per semester. Using a formulary (a list of approved or available drugs) and prepackaged medications, she can fill most student prescriptions for $5.50.
The clinic provides women's health services on a sliding scale by partnering with the local public health department.
"We know all the community resources and do our best to get our students the help they need," she said.
With doctors scheduled for only one or two hours a day at the clinic, Tew and her two-member staff perform plenty of triage. She has learned to listen closely, watch body language and take good notes on students' medical histories.
"Students may present with one complaint, which is not the real issue at all. You have to learn to read between the lines and look for the inclination that they want to tell you something but don't know how to start," she said. "If your antennae aren't up, you could miss the chance to help."
If she finds a teachable moment, Tew takes advantage of it and saves the paperwork for afterward.
"A lot of students don't even know how their body works. They don't know what a Pap smear is. We do a lot of one-on-one teaching."
Promoting a healthy lifestyle
Fran Beall, APRN-BC, a nurse practitioner in the medical clinic of University Health Services at the University of Georgia in Athens, said that a large part of her job is "teaching students how to be good health consumers.
"I'm passionate about prevention, and I love working with college students. They're all so knowledgeable but at risk for so many behaviors: alcohol and drug use, eating disorders or smoking. People practice unhealthy behaviors, and then, 20 to 30 years later, they pay for it. If we can reach them young and teach them healthier ways, we can make an impact."
Formerly a critical care nurse in New York, Beall moved to Athens when her husband enrolled in law school there. UGA offered to pay her tuition for the school's nurse practitioner program if she'd work for four years in the health center.
That was 33 years ago. She's seen all the campus fads — streaking, body piercing or taking cellphone calls in her exam room — and watched the campus grow from 12,000 to 32,000 students.
"People ask me if I get bored working with the same population, but I've always found something new to do, and I work with a team that values excellence. This is considered one of the top university health centers in the country," Beall said.
The center houses clinics for acute care, medical care, women's health and sports medicine, as well as a laboratory and a counseling and psychology center.
The facility also is accredited by the Joint Commission for the Accreditation of Healthcare Organizations.
The clinics see about 350 patients a day, including students with serious injuries, asthma and diabetes and those who are taking chemotherapy for cancer.
The doctors, nurses and psychologists form interdisciplinary teams for health promotion and education on subjects such as asthma management, safe sex, the new HPV vaccine, drinking problems and smoking cessation.
With the help of a private grant, the University of Georgia recently opened the John Fontaine Jr. Center for Alcohol Awareness and Education. Nationally, about two in five students drink in a high-risk manner, resulting in assaults, accidents and deaths.
"We ask all students if they smoke — it's a fifth vital sign around here — and we ask them about drinking," Beall said. "It's not always easy to confront a patient about behaviors. It's uncomfortable, but we do it."
When Beall gets a letter from a student who says that the smoking cessation program changed his or her life, she knows she's doing good work.
Because of the variety of patients and ailments, campus nursing calls for clinical skills and a broad knowledge base. Beall keeps current by taking in-service and continuing education courses and serving as a delegate to the American Nurses Association.
Campus nursing also takes caring. Student complaints about headaches or upset stomachs can be signs of stress or depression — warning signs of suicide.
"One student kept coming in homesick, so I helped her find activities. Planning someone's social calendar is not in the job description, but sometimes it's part of the job," Beall said. "You can't separate yourself from the caring part. You embrace it."