Eight Days a Week Not Enough: Nursing Students Volunteer at Free Clinic, Gain First-Hand Experience of Health Care Crisis

As the debate over health care access continues to rage on the national front, Dr.Patricia Hinchberger’s students in the master’s entry-level professional nursing program (MEPN) at California State University, Dominguez Hills decided to act locally. As volunteers for the nonprofit Remote Area Medical (RAM) they had the opportunity to admit and screen patients, maintain supplies and equipment, and assist dentists and doctors during RAM’s eight-day free clinic that took place Aug. 11-18 at the Los Angeles Forum.

Hinchberger, assistant professor of nursing and director of the MEPN program, connected students in her Health Promotion and Disease Prevention class to RAM. She says that the organization’s alignment with the goals of the U.S. Department of Health and Human Services’s Healthy People 2010 were in sync with her objectives for the course.

“Participation at this event visually emphasized the differences in health care provided to those without insurance,” Hinchberg said. “It also demonstrated to the students that small things, like taking care of cavities, can improve an individual’s quality of life.”

Based in Knoxville, Tenn., RAM focuses its attention on providing free health care to rural and impoverished communities throughout the world. Over eight days at the Forum, nearly $2.8 million in donated services and supplies was provided for approximately 6,344 patients. The free procedures included everything from dental and vision care to chest X-rays and blood work and were provided by volunteer doctors, nurses and other trained health professionals licensed in the state of California.

Aspiring nurse Deandrea Washington says that RAM’s services were “very much needed in this neighborhood.”

Fellow student Abby Lockhart points out that although access to medical treatment is not a rare commodity in Los Angeles, the ability to afford treatment is. She says that events like the RAM clinic would lessen the community’s need if they occurred more often.

“This was their first time doing RAM here in L.A.,” she says. “We had people who put [medical treatment] off for years. [They] just can’t afford it, it’s very costly. If we did this yearly, we’d have people coming in with fewer problems and fewer complications. We’re not meeting enough of the need currently, so we’ll be faced with bigger problems as they occur.”

The students were charged with tasks ranging from admitting patients - many of whom had spent the night in the Forum’s parking lots in order to assure their place in the daily queue; assisting with dental exams; maintaining inventories of medications; and preparing and cleaning supplies and equipment. Students who served their volunteer shift in the early days of the event noticed that many patients received more than one service or procedure. Those who volunteered in the last days of the event say that by that time, patients were only provided one service due to the depletion of supplies and medications.

The wide range of patients from diverse socioeconomic levels was an eye-opener for students.

“It was a very wide array of economic representation as far as the people who were there,” says Orlandes Fletcher. “I saw people who looked middle-class, but [might have] just lost their health insurance due to unemployment, to folks who appeared as if they were homeless.”

The ramifications of the health care issue for those who actually have health insurance, but are experiencing its inadequacies, was observed by Liz Cho, who worked in the admissions area on the clinic’s last day.

“When I was screening the patients, one of the questions was, ‘Do you have medical insurance or access to care?’” she says. “About 95 percent said yes, they did. However, their insurance didn’t cover enough vision or dental or they had a high deductible. So they came because [care] was provided for free. One gentleman actually told me that he had an unfinished root canal and was denied for a dental procedure that day. He found out that RAM was going to Utah next, so he was actually willing to drive there to get his root canal done.”

Along with confronting the desperation of those with limited or no access to health care, the students found that their experience with RAM enhanced their learning outside the classroom with an opportunity to think on their feet. Cynthia Castillo, who worked in registration with Cho, says that she had to help patients decide what one service they were going to request on the last day of the clinic. She also assisted Cho as an interpreter for Spanish-speaking patients.

“Medical Spanish is a little different when you’re reviewing medical histories, like the way to say certain organs or diseases,” she says. “So I want to go back and look over some terms because it’s really important to know.”

Melissa Rivera, who assisted a dentist with cleanings and exams, said that the experience gave her a whole new respect for dental assistants. However, she recognized that the need for a good chair-side manner with dental patients crossed over to the skills needed for her future as a clinical nurse.

“A patient is a patient,” she says. “It was a good learning experience, with that interaction. In the MEPN program, we’re taught to think critically. That was one of the strengths and weaknesses of RAM: it was makeshift, but we had a ‘Let’s do it’ attitude. Let’s say there’s a natural disaster. We’re going to be more prepared to help out.”

Shelli Hicks says that the RAM experience cemented her desire to enter the nursing profession.

“The best thing it did for me was to open my eyes to the need and how one day I can be a part of this and can actually help,” she says. “I was talking with a couple of my classmates who did it with me. It inspired us to want to help in the future. We talked about having a reunion five years down the road, where we would go [overseas] and participate in a RAM mission.”

For more information on the master’s entry-level professional nursing program (MEPN) at California State University, Dominguez Hills, click here.

- Joanie Harmon

Photos above: CSU Dominguez Hills' nursing students volunteered for an eight-day free clinic in Los Angeles administered by Remote Area Medical (L-R) Jaclyn Gallegos, Melissa Rivera, Sheli Hicks, Sarah Pintauro, Abby Lockhart, and Kristen Franzese (In front) Clara Brisbin. Photo by Courtney Pucci-Babcock

Nursing students welcome patients to a TB test. L-R: Carol Massey, Rosanna Moreno, Dwight Summerfield and Kimbra Hill. Courtesy of Dwight Summerfield

The Forum served approximately 6,344 patients over eight days. Photo by Dwight Summerfield

Dr. Patricia Hinchberger with Stan Brock, founder, Remote Area Medical. Courtesy of Patricia Hinchberger