Nuns on the Bus

This summer I became a “groupie.” I literally chased down a bus full of people that I wanted to meet.

I am not even sure how I became aware of the Nuns on the Bus – probably on Facebook (as much as that scares me). I became obsessed. I was so inspired by these amazing women – doing God’s work in the world, and also being advocates. It is a balance that I have not been able to find in my own life. I love the work that I do, and I know that we touch people’s lives in very real ways, but… I want to change the world. And, for that reason, these women inspired me.

In case you don’t know them, this is from their website:

“Every hour of each day, Catholic Sisters stand in solidarity with all who live in poverty, and we confront injustice and systems that cause suffering.

We cannot stand by silently when the U.S. Congress considers further enriching the wealthiest Americans at the expense of struggling, impoverished families.

As part of our campaign for budget fairness we are taking a bus trip. Our bus will travel to places in many states where Sisters actively serve people in need. For they are our best witnesses to the suffering our federal government must not ignore.

We ask all who visit this website to join us in prayer and to support our work to defeat government actions that would add to the suffering of already struggling families.

This bus trip has been organized and is sponsored by NETWORK, A National Catholic Social Justice Lobby, and the NETWORK Education Program. http://nunsonthebus.com/about/”

The bus was coming through a city just half an hour away and I had to go. I had no idea where they were stopping; I just knew they would be there at 9 a.m. on a Saturday morning in June. So I drove up there, couldn’t find the park so I decided that if I parked near the interstate highway, I would see the bus come by. That is what I did – once I saw the bus, I followed it to the downtown area. I was there when the nuns got off the bus.

It was such a thrill to meet them, to hear them speak and have a chance to talk – very briefly – with them about the work we do here at the clinic. The point wasn’t really meeting them – the point was to be inspired by them – to have my faith in “religious” people restored. I am not a Catholic – but one of my real life heroes is a Catholic nun, so I have a lot of respect.

This group of women changed my life. Their example gave me hope and a renewed passion for the work I do, as well as a hope that maybe, in some small way, I can change the world!

You can watch their story on Bill Moyers at:

 http://billmoyers.com/episode/full-show-nuns-faith-and-politics/

The Clinic Team

Let me introduce you to my staff. I am blessed, through grant money from Blue Cross Blue Shield of Michigan to have the funding for two part-time staff. For better or worse, I am the face of the clinic, but they are the heart and soul of the clinic.

Connie first volunteered at the clinic as an intern for her degree program. She was a young mother, finishing up her education. She was, and continues to be, an inspiration to me. As an intern, she helped me write the job description for the Patient Care Coordinator. We both wanted her in the job, but then it didn’t look like she would be able to apply for it. I went through the process hoping that the right person would apply. And, finally – she did. Connie knew it was the work she was meant to do, and worked out the issues so that she could apply. She may regret that decision at times, but I never have!

As the Patient Care Coordinator, she works closely with the patients and the community resources – whether it is the specialists in the community who see our patients, or the many service organizations that work with the same population that we do. She understands our patients and their lives. She teaches me every day how to serve this population.

Connie serves as the liaison to the community from the clinic as a member of the Multi-Agency Collaborative for Emergency Services (MACES).

A big part of her job is accessing medications at no cost for patients from the pharmaceutical companies. Many of the large pharmaceutical companies have programs called Patient Assistance Programs, and they make brand name medications available to low-income, uninsured individuals. Each company has their own paperwork, set of rules, and process for obtaining these medications. Connie does the paperwork for the patients, coordinates the ordering and re-ordering of these medications, and processes the medications when they arrive at the clinic. It is a huge job – there are currently about 200 patients on the Prescription Assistance Programs, and many of them have multiple medications they receive through these programs. She makes it look easy. But it isn’t!

 The Volunteer Coordinator is Linda. She too started at the clinic as a volunteer – in a job she hated. But fortunately, we saw what her gifts were, and put her to work using them. She is the nicest person you could hope to meet – and makes everyone feel appreciated. I can’t even begin to describe the monthly treats the volunteers find, the cards she sends, the events she plans. Everything is done in order to say “thank you” to those who give so freely of their time here at the clinic.

Linda’s job includes recruiting, training and appreciating the volunteers. We are so lucky that finding the people to work here is pretty easy, but if you have never worked with volunteers – well, there can be some frustrations. Trying to juggle the schedule – to make sure we have the right number of volunteers, in the right jobs… it can be like trying to herd cats. We love our volunteers, but they are  volunteers – which means the clinic is sometimes a secondary concern.

I think the three of us make an incredible team – we each bring strengths that complement one another. I can’t imagine doing this job without them.

 

Uninsured Caregiver

Lauren was one of my favorite patients. She was a beautiful woman – full of life and with a smile that would melt anyone’s heart.

She was 55 years old, had no health insurance, and had not received healthcare for quite some time. She came into the clinic the very first night we were open. She was thrilled to be able to receive the medications she needed for her asthma. 

Lauren was taking care of her disabled husband. And the stress from that was slowly killing her. We saw her regularly at the clinic for the first couple of years; then she didn’t show up for a while.

When she returned, I didn’t recognize her – she had aged 20 years in the months we hadn’t seen her. She had developed a severe dental infection (the uninsured have even less access to dental care than they do to healthcare). As a result, she had lost all of her teeth and could not afford dentures. She had gone from a lovely, vibrant woman to an old, old lady in just a few short months.

And now, her depression was full blown. She was one of the lucky ones as I had a counselor I could refer her to. Often, mental health services are also seriously lacking for the uninsured. She was under so much stress from taking care of her husband alone, and was having suicidal ideation (she had a plan for suicide).

I don’t know the end of Lauren’s story. We were able to get her on the County Health Plan, which isn’t insurance, but it does provide some limited access to healthcare services. Like many of our patients, they come through our system and then move on. We are only here for an instant in the life of many uninsured individuals.

Karen's Story

Karen is a 51-year-old female with a diagnosis of high cholesterol, high blood pressure, and depression. She is a well-educated woman, with a degree in Human Resource Management and nearly finished with her marketing degree. Her son’s suicide at age 20 began a downward spiral in her life. She became severely depressed, lost her job, divorced, and lived with various family members before relocating to this area. Since moving here she has been homeless – living in her car.  She has a friend who lets her shower at her house.

How do you live in a car??? I can’t even picture it – in the heat, in the cold… where do you pee? How do you fix a meal? How do you take care of yourself?

We live in a community that has blinders on about homelessness. There is no shelter, no place to take a shower, no safe place to sleep. We pretend that homelessness is a problem of “big cities,” not a problem here. And, we do nothing.           

Success stories?

I would like to tell you that we have all sorts of success stories here at our clinic. We are blessed to have healthcare providers that care and are committed to providing care to the uninsured. So many times people without insurance put off coming to the clinic. Sometimes they don’t know that we exist, sometimes they are too embarrassed to come here for help. That is something we often forget – for us Tuesday night is a great time. We get to see the volunteers who have become our second family. We get to have a meal together at the end of the evening….so, it is easy for us to forget how incredibly hard it is for someone to walk through our doors.

About the clinic

Let me tell you a little about our clinic. We are located in the basement of the local Episcopal Church. The clinic was the vision of our priest at that time, the Rev. Debbie Semon-Scott. None of the rest of us had any idea of the need, or even what a free clinic was. The vestry (the governing body of an Episcopal Church) invited me to be part of the exploration process. My only qualification was that I was a nurse. We spent nearly a year visiting other free clinics, talking to people, attending a meeting of the Free Clinics of Michigan. In April of 2002, Debbie and I attended a conference put on by the Free Clinics of the Great Lakes Region in Iowa, and decided we could do it – we could open a free clinic. We picked a date: September 10, 2002.

I remember that evening so well – so anxious in both the good way of being anxious and the bad way of being anxious. We had no idea how many, if any, people would walk through our door that night. We were prepared for a dozen, hoping that maybe five or six would show up.

We had nineteen people that night, and have never looked back.

The clinic is open one evening a week - on Tuesday. We open the door at 5 p.m. to start registration. We lock the door at 6 p.m., and close registration at that time. We see however many come through the door during that hour. We never know what to expect.  Since the first of this year, we have seen as few as 41 and as many as 73. Our average is 59.

There are many different things going on during the clinic hours. New patients are all screened for eligibility. It is less about our desire to take care of people and more about our realization that this is not the best option for healthcare – so if someone has other options, we want to make sure they utilize those options. During the screening process consents are signed, other needs may be addressed, and the patient is given information about the clinic. Once this process is finished, the patient is put in line to be seen by one of our healthcare providers.

Returning patients may be in to be seen by a healthcare provider or to get refills on their medications. We provide most of the medications to our patients here. I will talk about medications at another time.

On a typical Tuesday night, the clinic is staffed with two healthcare providers – usually one physician and one mid-level provider – either a Nurse Practitioner or a Physician Assistant. There are anywhere from 3 to 6 nurses working. Our dispensary is staffed minimally by a Registered Pharmacist and a Pharmacy Tech; there are lay people involved in screening, registration, pulling charts and doing data entry. Most Tuesday nights we have 25-30 volunteers present as well as the three paid staff members.

It looks and feels like chaos most of the time, but by the end of Tuesday night, the patients have been seen, the medications dispensed, orders written for lab tests, X-rays and referrals, and the volunteers have been fed.

We lock the doors, turn off the lights, and call it a night.

The Phone

One of the most important parts of my job is answering the telephone. It seems like a routine task that could be assigned to anyone. But the telephone is the most important part of my ministry. The person on the other end of the line is calling with a need. Sometimes it is a need that can be addressed by our clinic. Often, it is not. We don’t have funds to help pay for past medical expenses, we don’t have funds for healthcare provided elsewhere, nor do we have funds for the multitude of needs that people have in today’s society. So, I listen, I problem-solve, and when possible help individuals figure out where to go for the help they need. Some days that is easy, others times not so much.

This was a typical phone call: “I am calling for my fiancé. He has been throwing up – can’t keep anything down, but he won’t go to the emergency room. We just can’t afford to pay for that.” I ask how long this has been going on, and the answer: “For months.”

Introduction

Let me introduce myself. My name is Jill; I would like to tell you that I am a middle aged female, but since I have no intention of living to be 112 years old, I am past that middle aged thing. I am a white Anglo-Saxon protestant female, who finds herself rather unexpectedly working with the low-income uninsured residents in our community. I say unexpectedly, because I never envisioned myself in this place – doing this work, and yet, it seems that my whole life has prepared me for this. As I travel on this journey we call life, I am amazed at how the pieces of the puzzle begin to fall into place. For me, it is proof that God exists. For others, it might just be fate, or circumstance. But I see God in all that I do and in all that I am.

This blog is my attempt to share the stories of my own journey, but more importantly the stories of the staff, volunteers and patients in a free clinic, located in the basement of an Episcopal Church in a rural Midwestern town. It is a specific place, but the stories could be anyone – anywhere. And that is the point of my blog – to share stories that are about people – the people struggling in this economy to keep their families fed; the people for whom healthcare is a luxury they just can’t afford; and the people who give of their time and talent to make some form of healthcare available.