In a bustling trailer at the El Sol Science & Arts Academy in downtown Santa Ana, UC Irvine's Program in Nursing Science offers a window to healthcare's future. Children and their parents fill a sparse waiting area, but the people in white coats who move from room to room seeing the young patients aren't physicians. They're nurse practitioners and UCI nursing students.
The Program in Nursing Science, in collaboration with the existing SOS-El Sol Wellness Center, established Orange County's first nurse-managed practice in January. Along with providing healthcare to the charter school's students and parents and to people living in the neighborhood, the trailer-housed clinic is showing how nurses can step up to address the growing shortage of primary-care physicians in the U.S.
The Association of American Medical Colleges estimates that there will be 90,000 fewer doctors than needed a decade from now, with half in the area of primary care. Helping to fill the gap, says clinic director Susanne Phillips, a UCI associate clinical professor of nursing science, will be nurse practitioners such as those at the El Sol academy.
Nurse practitioners are registered nurses with advanced education and clinical training in primary care. They're licensed in California to prescribe medications, manage chronic diseases, promote health literacy and, when necessary, confer with physician specialists.
At the SOS-El Sol Wellness Center, under the guidance of UCI nursing science faculty, students pursuing either a bachelor's or a nurse practitioner master's degree will gain hands-on experience in community-based healthcare.
"With nurse practitioners playing a greater role in primary care today, practices like this one are vitally important for delivering much-needed healthcare to underserved communities and for educating tomorrow's nursing workforce," Phillips says.
To expand the wellness center's health assessment services, UCI's nursing science program received a $1.5 million federal grant to partner with El Sol and Share Our Selves, a nonprofit, Costa Mesa-based poverty relief agency that oversees existing medical, dental and behavioral services. The center is staffed by UCI nurse practitioner faculty members — including Phillips, Camille Fitzpatrick and Susan Tiso — and Alina Matutes from Share Our Selves. Phillips talked to ZotZine about the endeavor.
Q: How did the idea for the clinic come about?
A: The nurse practitioner faculty had a vision to develop and manage a practice. Camille Fitzpatrick was coordinating the medical-provider volunteers at El Sol, and when Share Our Selves — which has a medical license — became involved, we proposed the idea. Since Camille was already seeing patients there and taking students, I approached El Sol with a proposal that our faculty see patients and have a site for our students' training. They thought it was a great idea, and subsequently, we were funded to achieve this goal.
Q: Nurse practitioners offer many of the services that primary-care doctors do, but what are some of the characteristic differences?
A: Nurse practitioners are nationally board-certified and provide healthcare in primary, acute and long-term settings in family practice, gerontology, pediatrics, mental health and women's health. They take a distinctive approach that stresses care and cure, focusing on health promotion, disease prevention, health education and counseling.
Q: With a severe shortage of primary-care physicians on the horizon, how can nurse practitioners help fill that need?
A: There are currently 250 nurse-managed health centers across the country that record more than 2.5 million patient visits annually. They have the capacity to serve millions more. Nurse-managed health centers are staffed by nurse practitioners and are located primarily in medically underserved areas. They incorporate wellness promotion, disease prevention and management of chronic conditions, as well as provide dental, behavioral and mental healthcare. Nurse practitioners have the potential to significantly improve the health of American children and their families.
Q: How did UCI's nurse practitioner master's program originate?
A: UCI began educating nurse practitioners in 1996 in the Department of Family Medicine as a post-master's degree certificate program. In 2004, the university started collaborating with Cal State Fullerton to provide family nurse practitioner coursework for their master's students while continuing the post-master's program. In 2009, UCI admitted its first master's-level nurse practitioner students.
Q: How will these students participate in clinic activities?
A: They'll have an opportunity to complete clinical hours with faculty supervision. In addition to the El Sol clinic, they will rotate through Share Our Selves' Comprehensive Care Center in Costa Mesa. Undergraduate nursing students can complete their clinical education at El Sol through pediatrics, OB/GYN, leadership and community health rotations. Our goal is to prepare expert public health nurses with an emphasis on ambulatory nursing care in underserved areas.
Q: How important is it for UCI's nursing program to participate in the community?
A: One of our missions is to provide care and service to our community at large, specifically its underserved areas. Nurse practitioners are in high demand in both urban and rural areas, and it's vital to be well prepared to render services outside the infrastructure of a large healthcare institution. By partnering with local community healthcare agencies and identifying and responding to their needs, UCI can equip a nursing workforce to provide expert care.
—Tom Vasich, University Communications