Nurses to the rescue
Archived article from Oct 30, 1998
By Laurel Van Leer
Health care for people in the Elizabethport sec tion of Elizabeth used to mean finding a ride out of town -- there's no public transportation -- and waiting a half day at a hospital emergency room, said Robert Howard, a longtime resident. Now Howard, his family, his friends and his neighbors have another choice -- a primary health-care clinic right in E-port, managed and operated by the Rutgers College of Nursing.
The E-port Community Health Center opened in February 1996 and is funded by a five-year, million-dollar grant from the U.S. Department of Health and Human Services. It is a partnership among Rutgers-Newark, the City of Elizabeth and the nonprofit Visiting Nurse and Health Services.
Howard credits the E-port nurses with saving his life. The first time he went in, they discovered he suffered from high blood pressure. Eileen Scarinci, a family nurse practitioner, helped him get his hypertension under control with an improved diet, exercise and medication. Then, on a routine follow-up visit, Scarinci discovered Howard's heart rate was about 40 beats per minute, drastically below the normal rate of 80 to 100. Howard said he was feeling just fine, but Scarinci and colleagues convinced him to see a cardiac doctor.
"My doctor said, 'Thank God for those ladies,' " recalled Howard, who now has a pacemaker. "Whoever thought of that place down there, God bless them. It's really needed, and it's making an impact on that little area."
Howard's blessings also go to Congress, which mandated that health care be increased in federally designated "health professional shortage areas" such as Elizabeth, and to Rutgers, which had the vision to see that nurses could and should provide that care, said Patricia Hurley, professor at the College of Nursing and project director for two similar clinics that recently opened in Newark.
Scarinci manages the E-port clinic with Cassandra Barnett, a pediatric nurse practitioner, under the administrative guidance of Project Director Mary Ann Scoloveno, an associate professor at the College of Nursing, and Nina Chianese, community coordinator for the Visiting Nurse and Health Service. The two nurse practitioners have joint appointments with Rutgers and the visiting nurse association.
In addition to treating patients, clinic staff supervise College of Nursing students who come in to practice their skills and get experience with patients. Students run education programs for patients, take health histories, and do simple procedures such as giving shots or removing sutures. More advanced undergraduates and graduate students may design and implement a research program. Approximately 50 percent of Rutgers' nursing students gain some of their clinical experience at E-port.
The E-port clinic was the first nurse-managed clinic in New Jersey. It operates under laws that allow specially trained, educated and licensed nurses to go beyond traditional nursing work. Nurse practitioners can examine, diagnose, counsel and prescribe medication for common illnesses.
This allows them to treat many of the problems found at E-port: colds and flu, ear infections, skin rashes, diabetes, hypertension, asthma, depression, and drug and alcohol abuse. For more serious illnesses, each nurse partners with an off-site primary-care doctor who can be reached by phone or beeper. The clinic also pro-vides childhood immunizations, health-care screening, employment and school-sports physicals, educational programs and referrals. Since opening, the E-port nurses have treated some 1,800 patients who made more than 3,000 clinic visits.
Nurse practitioners do not operate as "mini-physicians," said Scoloveno. Nursing care is different from so-called acute care because nurses are trained to look at the big picture, she said. They will look at diet and exercise when treating an illness. They will also consider the patient's family situation, with an eye toward stress, depression or substance abuse that should be addressed.
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