September 10, 2004

VUSN’s nurse-managed clinics branch out to meet industry needs

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William Stead, M.D.

VUSN’s nurse-managed clinics branch out to meet industry needs

Working long hours and round-the-clock shifts can make it difficult to find time for things like a trip to the doctor’s office, but thanks to the Vanderbilt University School of Nursing, the nurse is in — and right in the workplace for employees at the Sanford Corporation plant in Lewisburg, Tenn.

The School of Nursing signed a contract with the Sanford Corporation, a division of Newell/Rubbermaid, known for their popular Sharpie® markers, pencils, and ballpoint pens, to design and staff a full-service, nurse-managed clinic for the 400-plus company employees working in their Lewisburg plant. “It’s a nice thing for them to have in-house. If they get hurt on the job they can come see me and they can come right down to the clinic, so it works out well, said Caroline Portis Jenkins, M.S.N., the family nurse practitioner who runs the clinic at Sanford.

Portis Jenkins is the sole provider at the clinic. “I am the receptionist, the triage nurse, the provider, the referral nurse, the venipuncturist, the follow-up contact.” She has a master’s degree in both health systems management and the family nurse practitioner specialty and said she enjoys the fact that the job allows her to use both of her degrees. “Sixty percent of what I do is primary care and disease management, about 25 percent to 30 percent is preventive care, and the other 10 percent to 20 percent is worker’s compensation related care,” said Portis Jenkins.

Her door is open to more than just company employees. “Dependents and spouses of employees come on an average of about one to two times a day.” Some employees have decided to make Portis Jenkins and the VUSN nurse-managed clinic at Sanford the primary care provider for their entire family. “They have appointments, I do walk in visits occasionally, and we have flexible hours for various shift workers,” said Portis Jenkins. “They don’t have to miss work and don’t have to worry about a co-pay,” she added.

Brian Keith, Human Resources manager at Sanford’s Lewisburg plant said those conveniences were just part of his motivation for bringing a nurse practitioner into the plant full time. “My goal was to encourage early visits for illnesses, generic drug use, and wellness and lifestyle changes like tobacco cessation, weight loss, and exercise. These are all things people want to do, but they rarely have time to go to a doctor to discuss wellness issues. The onsite medical facility allows them to do it all at their convenience while they are at work,” said Keith.

Bonnie Pilon, who has a doctorate of science in nursing degree and is senior associate dean for Practice, said the partnership is proof the concept works. “In the past, we’ve had nurse practitioners in school sites and we knew what we could accomplish there, but we didn’t know what we could do in industry and now we do. For Sanford, for its parent company, Newell-Rubbermaid, for the School of Nursing and for nurse practitioners, it’s proof of concept,” Pilon said.

This is the School of Nursing’s first venture into providing clinics in the workplace. VUSN’s faculty practice operates nearly 20 nurse-managed clinics across Davidson County and Middle Tennessee, including a clinic at a domestic violence shelter, three Metro-Nashville school-based health clinics, the West End Women’s Health Center, a clinic for residents at McKendree Village in Hermitage, the Vine Hill Community Clinic, and more. Pilon said the school is committed to meeting the needs of the underserved population by providing these services. “It works well in these remote sites, where their health care choices are limited. It makes the nurse practitioner model more desirable,” she said.

Pilon said plans are already in the works for opening a clinic in Sanford’s Maryville plant, near Knoxville, and she is already starting to search for a nurse practitioner to staff that clinic and meet the needs of approximately 600 employees in that facility. Both Pilon and Keith agree that the novel program could catch on nationally as word gets out about the success Sanford has seen. “Having a nurse practitioner on site has provided over $100,000 in annual savings in the areas of office visits, productivity losses, and worker’s compensation costs. Caroline has also provided early diagnoses of diabetes, hypertension, and other diseases,” said Keith. “This concept will continue to catch on as medical costs continue to skyrocket. Companies have traditionally curbed costs through increased employee contributions, increased co-pays, or plan restructuring. We have proved that there is another way to cut costs — pay a fixed cost for this program, and encourage utilization of the program,” he added. Pilon said there is no telling what the future holds for more programs in the world of industry. “I don’t know where this is leading. The experience seems to be working, there is talk of expanding, but I don’t know where the future is, we’re taking this one plant at a time.”