New digs, old roles for health facility

By Laura Raines

Pulse editor

MUST Ministries has been providing free health care services for the homeless, underserved and uninsured in Cobb County for more than 15 years.

Thanks to the dedication and imagination of Kennesaw State University’s nursing faculty, the clinic does much more than that. It serves as a clinical site for teaching future nurses, nurse practitioners, social workers and other health care students.

“The clinic began as a partnership between WellStar Health System, MUST Ministries, the public health system and the KSU nursing school,” said Richard Sowell, dean of KSU’s College of Health and Human Services. “MUST Ministries provided the location near its emergency night shelter. WellStar gave most of the funding and our nursing school supplied the nurse practitioners, who gave the care with back-up from the public health system.

“The plan was to see patients and place them into the regular health care system, but that plan didn’t work. Patients had no money for doctor visits, and they liked and trusted the care they received from our nurse practitioners. They kept coming back, and soon we were doing primary care.”

Operating three nights a week with the help of nursing volunteers, the free clinic was averaging 2,500 to 3,000 patient contacts a year. When the community partnership dissolved, the nursing school picked up the funding through its WellStar endowment in 2003.

“The exam room was in an old trailer and the waiting room was the parking lot,” Sowell said. “Our nurses were doing Third-World triage type of care, seeing a significant number of patients and saving lives. After listening to the heart of an older patient, the nurse sent him to the emergency room, where he received open-heart surgery the next day.”

The clinic was serving an obvious need, but it was operating mostly on imagination, Sowell said. In 2007, he asked KSU assistant professor and nurse practitioner Donna Chambers and fellow faculty member Kathie Aduddell to reorganize it.

“What emerged — the KSU Community Clinic at MUST Ministries — is an academic model that is very much in keeping with how our health care system is going,” Sowell said.

A subsidiary of the Kennesaw Research and Service Foundation, the clinic, which is open three days a week, is managed by nurses and has a part-time, paid medical director.

“A nurse-managed clinic operating out of a school of nursing and funded by a university is a model that I haven’t seen anywhere else in the country, and as dean, I couldn’t be prouder of this clinic,” Sowell said.

On Aug. 20, the clinic opened a new 30,000 square-foot, state-of-the-art facility within the new MUST Ministries headquarters on Cobb Parkway in Marietta. In place of the old trailer, the clinic has five exam rooms, a waiting room and new equipment.

MUST Ministries raised the money for the new building. The university rents the clinic space and has assisted with grants and other fundraising efforts.

“I started here as a volunteer in 2005, and by 2007 it was my main job. I can’t think of anything else I’d rather do,” said Chambers, RN, MS, FNP-C. “One thing I’ve learned is how to take care of patients on limited resources. We help people manage their diabetes, asthma, hypertension and high cholesterol, as well as take care of ear and respiratory infections and other illnesses.

“Working as a nurse practitioner here, I get a chance to do everything and to see what people are really dealing with out there. We have to take time to figure out what the patient really needs. Just because they don’t have money, doesn’t mean they shouldn’t get services.”

As more people lose their jobs and health insurance, the clinic has added more open slots for walk-in patients. It’s open on Mondays, Wednesdays and Thursdays and treats roughly 24 patients a day.

“Providing quality care to vulnerable populations and helping patients manage their chronic conditions keeps people out of overloaded emergency rooms, where the cost of care is much higher,” Sowell said.

Clinic nurses help patients gain access to community resources for medicines and other health services. That happens at many free clinics. But the KSU Community Clinic is also a place for students to learn and for faculty to practice and teach.

“The teaching focus makes us different,” Chambers said. “We serve as a clinical and research site for nurse practitioner students. They do triage, develop teaching materials and coordinate health care screenings here.”

As part of their community health rotations, preceptors bring undergraduate nursing students to the clinic, where they learn to take patient histories, check vital signs and test blood-sugar levels.

“Our mental health clinical nurse specialist now has an office to see patients and a place to teach mental health students how to set up group therapies,” Chambers said.

Students in Kennesaw State’s new master’s in social work program can now observe medical social work in action, and learn how to collaborate with other nurses.

Chambers said the goal is to operate the clinic five days a week and offer more services.

“We’ll bring in pediatric nurse practitioners on Fridays starting in January, and we want to have a women’s health care provider who can do gynecological exams,” she said.

Clinic officials would like to offer group classes in disease education, prevention and management on Tuesdays.

Managing a dual-purpose clinic is challenging, but Chambers has found her niche.

“Our students love coming here and our patients are so appreciative. They often say thank you with hugs,” she said. “We serve as a safety net for people who have fallen through other safety nets.”

For information about the KSU Community Health Clinic at MUST Ministries, call 770-427-9862 or go to www.mustministries.org.