Many family nurse practitioners work in hospitals or in private practice settings, but some APRNs have discovered that in-store workplaces — such as CVS MinuteClinic — are a good fit for their skills.

CVS MinuteClinic was launched in 2005 and now operates clinics in 30 metro Atlanta CVS stores. There are plans to expand into Georgia's rural areas, where access to health care often is a more limited.

Barry Williams/Special (ENLARGE)

Holly Kouts (left) and Cory McPherson are family nurse practitioners with CVS MinuteClinic.

Barry Williams/Special (ENLARGE)

Family nurse practitioner Rhonda White checks Sheri Bachstein's throat at a CVS MinuteClinic on Powers Ferry Road in Atlanta.

The mission of the clinics is to provide fast, quality care for common maladies.

"It's another point of contact for patients to receive care. We're there if someone can't get in to see his regular physician, or doesn't have one," said Holly Kouts, APRN, FNP, manager of operations for MinuteClinic in Georgia.

A visit can save patients a trip to the emergency room or keep them from going without care. The clinics accept most insurance plans.

"The health care system is broken and we're being a part of the solution," Kouts said. "By removing unnecessary volume from the ERs, they have more resources to give care to those who need it."

Patients can walk into CVS MinuteClinics without an appointment and are seen by family nurse practitioners, who can diagnose and treat conditions after following protocols that are updated regularly. Ear infections, strep throat, conjunctivitis, flu, sinusitis, bronchitis and minor skin infections are among the common ailments they treat.

The nurses also give routine vaccinations, remove staples and sutures, and educate patients about health issues and the need for regular screenings.

"There is a collaborating physician for every four clinics available by phone, as well as alternate physicians [as backup], so someone is always available," Kouts said. "Our physicians check close to 100 percent of the charts."

Some doctors have expressed concern about the safety of patients when nurses deliver care without direct supervision. Kouts argues that APRNs have advanced degrees and are trained to diagnose and treat patients. She also said that national research has shown that APRNs deliver safe and high-quality care.

"We are very aware of our scope of practice," she said. "When patients present with something outside of that scope, we refer them to their own physician or to a list of nearby physicians that we keep in every clinic.

"If it's an emergency situation, such as crushing chest pain or the patient can't breathe, we call 911."

Recently, a CVS MinuteClinic nurse found a tonsillar abscess in a 12-year-old patient. "She couldn't see it, but she felt a hard area and sent her to the emergency room. They operated within 20 minutes and probably saved her life," Kouts said.

Cory McPherson, APRN, FNP, has worked for CVS MinuteClinic since February 2007. She said that she earned an advanced degree so she could give more complete care to patients.

She likes diagnosing and treating patients, in addition to educating and advocating for them.

"My background was in emergency medicine and primary care settings, where I did rounds and covered a gamut of illnesses, but I found myself very interested in the concept of convenient health care," McPherson said.

She began to look into clinic work and was impressed with MinuteClinic's operation.

"The company is rock-solid and they give us the support we need to do care right," she said. "I feel like we're blazing a trail as we go."

She appreciates that the company supports continuing education and gives nurses time off to take courses.

"I'm also part of a company training program and get to pass on my knowledge to new nurses," McPherson said. "I also like the flexibility of the schedules."

The clinics are open 8 a.m. to 8 p.m. on weekdays and 10 a.m. to 4 p.m. on weekends. Nurses work three 12-hour shifts per week. If they work on weekends, the shifts are split into six-hour blocks on each day.

To help store personnel and customers get to know them, most nurses work at a primary store, but they may also cover several locations as needed.

"We ask each and every one of them [customers] how they heard about us, and the answer is usually from another customer," Kouts said. "Our business is increasing through word-of-mouth and I think that speaks volumes about the care we're giving."

Kouts and McPherson said that they learned something new every day in their jobs.

"Some of it is medical, and some is better ways to educate our patients so that they understand something and take ownership of their health," Kouts said. "We also see subtleties within diagnoses."

"It's a wonderful thing to be accessible to patients who otherwise would be sitting in an emergency room waiting room for four hours," McPherson said. "One of the greatest rewards is the constant thanks we get from patients who tell us they're glad we're here."