By Maryanne Lieb, MSN, RN
Who would have ever thought that making a mediocre casserole would have resulted in a fulfilling lifelong commitment that combines a dedication to service and a love for nursing? That is exactly what happened to me more than 22 years ago when I offered to provide a meal once a month to support the Day Room, a basic needs day center at St. Agnes Catholic Church. The church is in the borough of West Chester, Pa., near two homeless shelters and a large Hispanic immigrant population. The Day Room provides visitors an opportunity for companionship, a warm meal and socialization.
Because I was a nurse, I was asked if I would explore the healthcare needs of the Day Room guests. This was new to me. I was out of my comfort zone and I wasn’t sure what to do. I was far from the sterile and familiar environment of the classroom or hospital setting. So, I began by listening.
The Day Room guests were very willing to talk to a nurse. We discussed their health and health concerns, but I also found in them an eagerness to share their life stories. The most prominent theme carried throughout the stories was their lack of self-worth that stemmed from previous life events, some it was in their control and some of it wasn’t. To this day I remember the stories, I remember many of the people and without a doubt remember the impact the stories had on me. As a result of listening, I finally “got it” and knew I was in the right place.
The lack of available healthcare services was immediately apparent. There were no clinics or healthcare providers willing to care for uninsured individuals, and the expense from being cared for in the ED was overwhelming. Therefore, diabetics were without medications, injuries were left untreated and the diagnosis and treatment of acute and chronic conditions were delayed. Something had to be done.
As a result — and after doing some legwork and paperwork — the St. Agnes Nurses Center was established in 1999 and remains the only parish-run primary care clinic in the Archdiocese of Philadelphia.
The St. Agnes Nurses Center is a nurse-managed clinic staffed by dedicated volunteer RNs, nurse practitioners, physicians, nutritionists and medical interpreters (among other volunteers), who care very deeply for their patients and work tirelessly to address their social and emotional challenges, as well as their physical needs. Located on St. Agnes Parish property, the clinic is open two days per week for a total of six hours.
Worth the wait
When the clinic first opened, we sat for two months waiting for the first patient to arrive. We knew the need for the clinic existed but also knew that word of mouth would be the best advertisement. Patience with our clients helped us earn their trust.
I remember the day a young woman with two toddlers in tow came to the clinic having been referred by a domestic violence shelter. The mother had recently escaped an abusive situation but had left her hypertensive medications behind. In addition, both children had ear infections. I am glad we were able to be there for her and her children.
It took about six years for patients to start consistently keeping appointments and partnering with us in their health. But it was worth the wait! To date, we’ve had more than 7,000 patient visits.
For many patients, this center represents their first point of entry into the general healthcare system. Services include illness and wellness care, health screenings, education and referrals. Laboratory testing and medications are prescribed as needed. Patients are seen by appointment, but those who walk in also are accommodated.
Patients are primarily Hispanic men, women and children and require treatment for a variety of health issues, the most prevalent being diabetes, hyperlipidemia, hypertension and obesity. Education remains a very important and ongoing part of the treatment regimen.
The St. Agnes Nurses Center continues to be supported by donations used to purchase equipment, medications and supplies and pay for laboratory tests. We participate in programs that offer low-cost medications and lab testings; otherwise, these costs can be prohibitive. Assisting patients to obtain medications remains a challenge.
For many years, the St. Agnes Nurses Center has provided a rich learning environment for nursing students from local colleges and universities where students observe firsthand the difficulty that certain individuals in our society have in maintaining health and accessing healthcare and the important role the nurse plays affecting change in this arena. For example, at Villanova University College of Nursing senior nursing students collaborate with the RNs and NPs on education programs that are culturally sensitive and based on population needs. A student once said, “Society on the whole sees the homeless and poor as faceless shadows on the corners and streets. But this clinical experience has opened my eyes to the fact that we are dealing with persons just like ourselves, people who have dreams and aspirations just like anyone. Each of the guests has a story to tell, and after listening to them you realize at the end of the day, this faceless shadow you may have walked past several times on the street without a backward glance could have been me, you or your sibling, parent or child.”
I remember an elderly woman with complications from diabetes who was living in her car as she was not able to afford a room, her car and her medications. Her car was her independence. The nursing students helped her obtain the benefits to which she was entitled resulting in her ability to afford all three. This woman demonstrated her appreciation by volunteering as a receptionist at the Nurses Center for more than 10 years.
I also remember a young man diagnosed with lung cancer who had been estranged from his family for many years. With our nurses’ help he reconnected with his family who cared for him until he died a couple of months later. After his death, a note with a check enclosed arrived at the center. It was from his sisters. The note thanked the nurses for caring so lovingly for their brother and communicated how grateful their brother was for coming to the Nurses Center. The check was a donation from the family made in his memory to help us continue to help others as we had helped them.
Have we made a difference? I think we have. We rarely take the time to reflect on certain aspects of our lives, and I am grateful for this opportunity. I am inspired by the countless volunteers who I have had the privilege of working alongside and who have made volunteering at St. Agnes a part of their lives. I am inspired by our new graduates who, during their time in nursing school have “gotten it,” have heard the stories and have actively listened and now see their roles as nurses in the community. These nurses are the heroes and change agents for the future. We are in very good hands.
Maryanne Lieb, MSN, RN, is a clinical assistant professor and coordinator of the accelerated BSN program for college graduates at Villanova University College of Nursing in Villanova, Pa. She is the founder and inaugural coordinator of the nurse-managed St. Agnes Nurses Center in West Chester, Pa., where she sees patients as a volunteer RN.
Donations to the St. Agnes Nurses Center can be sent to: Saint Agnes Day Room and Nurses Center, 233 West Gay Street, West Chester, Pa., 19380.