For high school students in San Antonio, an area with one of the highest levels of adult and childhood poverty, health care can be viewed as a luxury.
Many of these students have single parents who would need to sacrifice a day’s work to take their child to the doctor. Some are homeless and unsure of where to even start.
That’s where Kathryn A. Parke, D.N.P., APRN, CPNP, assistant professor/clinical in the School of Nursing, and a team of health-care professionals come in. At the Healy-Murphy clinic, located at a high school in the east side of San Antonio, Dr. Parke works with fellow colleagues to provide each student with individualized care. Students can go in for a pesky cough or congestion but can also be seen for anxiety and depression. “I can refer them to the licensed professional counselor on campus and she will in turn refer them to the psychiatric nurse practitioner,” says Dr. Parke.
A great example of this comprehensive care is a boy who was seen by Dr. Parke for bandages on his knuckles who was simultaneously being seen by “Mr. Joe,” a counselor. During his check-ups, Dr. Parke noticed drastic changes in his demeanor. “Any time he came in to see me in the clinic, he always talked to me with his head down, and after a couple of sessions, I go, ‘I think you’re feeling better.’ And he goes, ‘why do you say that?’ (and I responded with) ‘Because you are looking at me in my eyes.’”
This story follows what many of these students and their health providers are witnessing: all inclusive care is what these students need.
Because of these screenings that are in place to look at deeper issues, Dr. Parke thinks they have been able to identify a lot more students with depression. “Students have been surprised that it is not unusual or not just them, that other kids have those issues and there is a name for it; there are things that can be done to help it.”
This comprehensive care provides a holistic approach to health and includes a registered dietician who helps students by providing nutrition classes, nutrition activities, and even a community garden to engage the students with the food they eat.
Screening done at the clinic also looks at food insecurity, housing, interpersonal violence, risky sexual behavior, drug use, etc. “We know that this population is very vulnerable, so we try to work on things that really affect their lives and give them help with those issues.”
Dr. Parke’s hope for the future includes implementing her “Ask me 3” tool in school-based communities as a model of what others can do. She instituted the “Ask me 3” tool after most students identified themselves as health illiterate. After she is done with an appointment, she will ask the student, ‘so I am checking to see if I’ve done a good job – can you tell me what I said was wrong with you? What did I tell you to do? Why would that be important?’ “If they can answer those three questions, it is very likely that they understood what is going on in the visit.”
School is where kids spend most of their day, and this clinic is there to meet them on their time. Dr. Parke knows that this type of care is setting them up for a healthier, brighter future. “Social and behavioral determinants of health, being healthy as an adult, is so dependent on what happens in childhood. If you can provide some interventions that are not necessarily prescription or treatment based, getting people linked with services or recognizing there is a need – that is the best way to improve people’s health outcomes over time.”
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