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UNC School of Nursing Mobile Health Clinic:

A Time Line

 

2014: A Seed Is Planted

A faith-group in Cary, North Carolina meets to discuss issues of social justice, poverty, and other local concerns. During one of the meetings, the group realizes that two well-established local crisis ministries in the area offer a variety of services to individuals and families undergoing financial hardship, but do not offer healthcare services. Marianne Cockroft, PhD, RN, an associate professor at the UNC School of Nursing (SON) and a member of the faith-group, proposes the establishment of a hub to provide health care and resource information at the two crisis ministries. In addition, she proposes for the hub to serve as a clinical practice site for nursing students and as a place for nursing faculty to volunteer their knowledge and expertise. The group is on board with the suggestion and moves forward with the idea.

2015: Ideas to Action

The meetings generate a new academic-community partnership with the goal of creating a nurse-managed health clinic to provide free health services to clients of Dorcas Ministries in Cary and Western Wake Crisis Ministry in Apex. Additional support for the clinic is gained through meetings with key stakeholders, including crisis ministry leaders, UNC SON administrators, and a local federally qualified health clinic. Dr. Cockroft conducts a needs assessment through a survey of program participants at both crisis ministries. Nursing faculty representing advanced practice, public health, administration, and research participate as the preliminary planning group.Following UNC SON approval for the clinic, initial funding is provided through a grant from Christ the King Lutheran Church with supplemental funding from First United Methodist Church, both in Cary. The UNC SON absorbs the costs associated with the grant administration time of Dr. Cockroft, the clinical director.

2016: A Vision Realized

The UNC School of Nursing Mobile Health Clinic opens its doors on January 19, 2016. This first year, the clinic opens three hours per week on Tuesdays using a 16 ft. cargo van rented from the UNC School of Medicine. The initial services include blood pressure screening, diabetes assessments, education on chronic disease self-care management, nutrition information, connecting to local resources, and smoking cessation resources. Except for the clinical director who earns a small salary to manage the grant, the clinic functions strictly with the help of volunteer SON faculty, nurses, and professional students.

2017: Moving Forward

In July, Dr. Sara Hubbell joins the clinic as its first paid nurse practitioner. She provides in-depth consults with clinic visitors who many need a prescription for medication, medical devices or other medical services. Because the clinic is open only once a week and is not equipped to be a primary care home, the clinical team chooses not to dispense prescriptions for chronic conditions. The hours of operation are increased to four hours per week to serve more patients and grant nursing students additional practice time.  Wellness on Wheels, a 36-foot RV is rented from the Center for Excellence in Community Mental Health and becomes the new clinic space. With a nurse practitioner on board and a private examination room, the clinic adds a few additional services including sick care visits, cholesterol assessments, and mental health screenings.

2018: Flourishing Collaborations

The UNC SON Mobile Health Clinic initiates more community partnerships. Beginning in April, a representative from the Wake County Department of Health and Human Services (DHHS) HIV/STD Community Program offers our clients education, outreach, counseling, testing and other services free of charge once a month. Sunnybrook Smiles, another DHHS service, provides free dental evaluations to children 0-20 years old who have no health insurance. Arrangements are made for a dental hygienist to visit the Clinic once every month beginning in January 2019. Another community partnership forms with Prevent Blindness North Carolina. The organization offers to provide vision-chart training to the staff at the Mobile Health Clinic and places the clinic on its 2019 retinal screening schedule.

2019: Further Additions

On January 22, the clinic offers the first of its quarterly retinal screenings conducted by Prevent Blindness at the Clinic’s Dorcas location. The free scans offer visitors the opportunity to get screened for eye diseases including glaucoma, age-related macular degeneration, diabetic retinopathy, retinal detachment, and cancer. Leigh Mullen becomes the clinic’s new nurse practitioner when Dr. Hubbell accepts a new position with UNC Wilmington. In August, the clinic begins to offer bi-monthly Saturday hours. This is possible with a grant from the National Association of Free Clinics and funds provided by FIGS of Wake County, an organization dedicated to improving access to prescription medication. The hours allow the clinic to reach out to individuals who are not available during weekdays. Data shows that the number of males attending the clinic increased by five percent that year.

2020: COVID-19 Challenges

The first cases of COVID-19 community spread are detected in North Carolina in early March. The state and federal government posts a series of guidelines regarding gatherings, shelter-in-place, and stay-at-home orders. Along with other academic institutions around the nation, the University of North Carolina announces plans to begin remote teaching and learning starting the third week in March. Due to lack of proper personal protective equipment, and the inability to secure the equipment due to its global scarcity, the clinical staff decides to temporarily close the clinic and offer virtual consults instead. The consults are advertised via flyers and in collaboration with our community partners. The UNC School of Nursing cancels on-site clinical practice education for its students for the remainder of the spring semester. Students assigned to the Mobile Health Clinic must complete their hours through virtual consults, and other special public health related assignments. The staff launches a Facebook page to facilitate the dissemination of health information. Leigh Mullen is accepted to the doctor of nursing practice (DNP) program at Duke University and Dr. Jean Davison becomes the clinic’s third nurse practitioner beginning in August.