All across the country, there is a growing movement of committed nursing professionals who are bringing excellent health care to vulnerable communities. We treat sickness, but we promote health. We work with our patients to understand the issues and situations concurrent with their health problems. We offer nutrition counseling. We develop programs to address violence in the community and the family. We offer counseling and other supportive services. And we offer pre- and post-natal care that assures that healthy mothers will deliver healthy babies who will grow into healthy children. This is our movement and while it is still young, it has already proven to be a remarkably effective means of providing people with accessible, affordable, high quality health care.
Nurse-managed health centers, often referred to as nurse-managed health clinics or NMHCs, are run by nurses. Many have advanced practice degrees and are nurse practitioners, clinical nurse specialists, nurse midwives, and public health nurses. We have the expertise to diagnose illness and prescribe medication, to make referrals to specialists, to provide pre-and post-natal care, and to offer a wide variety of other primary health care services.
Our centers are focused on the needs of communities. We develop programs that meet the needs of our communities. We work with other health professionals to make sure that our patients get all the services they need. We bring people together to solve problems. We are located in public housing, and on blighted urban streets; on Native American reservations, and in rural communities; in senior citizen centers and in elementary schools; in storefronts and in churches. Wherever there is a need, we make health care work!
While today's nurse-managed health center traces its immediate roots to changes in national health care laws begun in the mid-1960s, the nursing model of holistic health care that integrates health promotion with primary care and focuses on serving vulnerable populations dates back to the late nineteenth century. As far back as the 1890s, visionaries, such as Lillian Wald who founded the Henry Street Settlement for the sick and poor of New York City and later Margaret Sanger, who opened the nation's first birth control clinic, were instrumental in establishing the public health movement in the United States. These nurses, and others like them, drew their inspiration from the needs of their communities.
Since those early days, nurses have always approached health care as a compassionate profession that focuses on the special needs of society's most vulnerable people: the poor, the aged, those suffering from social injustice, and those living in areas without access to adequate health facilities.
Their quiet courage and dedication have taken nurses to the frontlines of every war, just as today, it takes them to the inner city, to rural communities, to homeless shelters and Native American reservations, and anywhere fighting disease is tied to the battles against poverty, racism, and injustice. It is this focus on healing and on meeting the unmet needs of society that has kept nursing at the forefront of the public health care movement in the United States.
We combine the latest in health care and health promotion science with the traditions of community leadership, social vision and personal courage as exemplified by the nursing profession throughout this century.
While nursing has come a long way in the past century, today's nurse-managed health center is grounded in the same principles, is dedicated to the same mission, and is imbued with the same vision of community service as its nineteenth century counterpart. It is a mission and a vision that is becoming increasingly important as American society struggles with burgeoning health care costs, fewer private employers providing full benefits, new health care demands of an aging population, and increasing numbers of individuals and families in vulnerable situations who lack health insurance.
Health care in America is designed for the healthy person. Private medical insurance profits by insuring the generally healthy person with an occasional illness or condition requiring medical attention. Treatment usually requires a nominal co- payment by the client, thus making routine office visits easily affordable. But for vulnerable populations, often poor, elderly, without insurance, or facing cultural, linguistic or other barriers to receiving services, routine and minor health needs are often neglected until serious problems develop that cannot be ignored. These problems often require emergency and expensive care, and they can cause long term or permanent damage before they are addressed. When such a medical problem occurs in a child, the consequences can be catastrophic, causing lifelong impediments and disabilities.
In the Philadelphia region, nurses see their patients almost twice as often as other providers; their patients are hospitalized 30% less and use the emergency room 15% less often than those of other health care providers. These are the statistics, but behind these numbers are mothers who are at home with their children or able to work rather than spending many hours in an emergency room; men who are working and providing for their families rather than living on disability income; and elders who have the vigor to spend their free time volunteering in the community rather than at home in loneliness and seclusion.
We are dedicated to sound pre-natal care and healthy children. Several Philadelphia area centers have all of the pregnant women in their care giving birth to normal birth-weight babies, a critical measure of proper prenatal care, and an incredible success rate among women in vulnerable populations. The caring doesn't stop when a child is born. We have outreach and tracking programs to ensure that our children receive all of their immunizations on time, and get the proper care to grow up to be healthy individuals.
Community comes first, we work with community groups to identify health issues and services they would like the centers to provide. We establish community boards to provide on-going community input and feedback on our services. We identify other resources and service providers in the community and build bridges to them so community residents can better access them.
Our centers work hard to develop and maintain the trust of our patients. We listen to our patients so we can meet their needs. We listen to the broader community concerns and work to meet those needs as well, and where it is advantageous, we enlist other providers to help. We respect our clients and make sure that services are available when they need them, such as after hours and on weekends and holidays.