Nurse prac­ti­tioner pro­gram pro­vides con­ve­nient ac­cess for high schools

With fund­ing ce­mented, ini­tia­tive eyes ex­pan­sion

The Hamilton Spectator - - FRONT PAGE - JOANNA FRKETICH

HUN­DREDS OF HAMIL­TON’S most vul­ner­a­ble teens have vis­ited a nurse prac­ti­tioner right in their high school.

The pro­gram at Sir John A. Mac­don­ald Se­condary School and Cathe­dral High School has been quiet about its suc­cess for the last four years be­cause it was al­ways in dan­ger of shut­ting down.

It could not get ded­i­cated fund­ing de­spite a wide va­ri­ety of health and com­mu­nity or­ga­ni­za­tions agree­ing a nurse prac­ti­tioner was des­per­ately needed in the high schools of the city’s poor­est neigh­bour­hoods with high new­comer and abo­rig­i­nal pop­u­la­tions.

The Hamil­ton Com­mu­nity Foun­da­tion gave what cash it could to the pro­gram. It also had sup­port from McMaster Univer­sity’s school of nurs­ing and Refuge: Hamil­ton Cen­tre for New­comer Health.

But many times, Good Shep­herd Cen­tre had to find ways to keep it run­ning with no fund­ing at all.

“We’ve been func­tion­ing on a cri­sis ba­sis,” said Peter Ki­bor, di­rec­tor of Good Shep­herd Cen­tre Shel­ter Health Net­work Med­i­cal Clin­ics. “Are we go­ing to get by to the next se­mes­ter? We’ve not been able to reach out and tell our story be­cause we’ve been try­ing to sur­vive.”

The hours the nurse prac­ti­tioner could spend at each school bounced from four to

eight a week de­pend­ing on what money the pro­gram could cob­ble to­gether.

“If I was sched­uled for four hours, I’d of­ten spend six to eight,” said nurse prac­ti­tioner Hal­lie Stre­ith. “I didn’t want kids not to be seen.”

All the while, the num­ber of vis­its to the nurse climbed to 416 in 2015 from 328 in 2013.

Over three years, there have been more than 1,000 vis­its.

There is no way to mea­sure how many more stopped by to find the clinic was closed.

“There are al­ways stu­dents there,” said Ju­dith Bishop, chair of the Hamil­ton School Based Health Net­work. “We don’t know how big the need is.”

For the first time since open­ing their doors in the fall of 2012, the school clin­ics can fi­nally stop wor­ry­ing about where the next dol­lar is com­ing from and fo­cus in­stead on ma­jor ex­pan­sion.

The Hamil­ton Niagara Haldimand Brant Lo­cal Health In­te­gra­tion Net­work has agreed to spend $130,000 a year on the pro­gram. It will al­low the nurse prac­ti­tioner to spend three full days a week at Sir John A Mac­don­ald and two days at Cathe­dral.

It is ex­pected to make a big dif­fer­ence for stu­dents and their fam­i­lies.

“You can get the in­di­vid­ual at a stage when in­ter­ven­tion can be pro­vided,” said Ki­bor. “You can change the tra­jec­tory of their life.”

One in five stu­dents who came to the nurse prac­ti­tioner in 2015 had men­tal health is­sues, al­though that was of­ten not the main rea­son for the visit.

One in seven had a gyne­co­log­i­cal prob­lem. One in 10 came for der­ma­tol­ogy help or mus­cu­loskele­tal in­juries. Oth­ers sought help with asthma, headaches, sleep prob­lems, weight-loss ad­vice, den­tal is­sues, smok­ing ces­sa­tion and a wide va­ri­ety of other health con­cerns.

With­out the nurse prac­ti­tioner, many would have ended up vis­it­ing a hos­pi­tal. North Hamil­ton youth aged 10 to 24 make up more than one-third of the city’s emer­gency depart­ment and ur­gent care vis­its for this age group.

At least one-third of the stu­dents have no fam­ily doc­tor.

“We can’t turn a blind eye and pre­tend it’s life as usual,” said Ki­bor. “There is poverty and other chal­lenges. We’re deal­ing with a high-needs neigh­bour­hood.”

It was the Spec­ta­tor’s Code Red se­ries that con­vinced the pub­lic and Catholic schools boards that a nurse prac­ti­tioner was needed at the two high schools. The se­ries showed the pow­er­ful im­pact of the so­cial de­ter­mi­nants of health and ex­posed dis­par­i­ties at the neigh­bour­hood level.

Sir John A. Mac­don­ald Se­condary School is at 130 York Blvd., at Bay Street North. Cathe­dral is at 30 Went­worth St. N., near Wilson Street.

“For so­cial de­ter­mi­nants of health and their im­pact on qual­ity of life, this is where it is at,” said David Hoy, man­ager of so­cial work ser­vices at the Hamil­ton Went­worth District School Board. “We don’t want this to look like a stand­alone ser­vice. It’s a gate­way to other ser­vices.”

A nurse prac­ti­tioner is per­fect for the job be­cause, like a doc­tor, there is the abil­ity to or­der tests and re­fer to other health-care ser­vices. But nurses are less in­tim­i­dat­ing than physi­cians to many high school stu­dents.

“Ev­ery­one sees nurses as tremen­dously pos­i­tive,” said Bishop. “You can es­tab­lish a re­la­tion­ship. Our hope is not only can we get ap­pro­pri­ate care to young peo­ple who need it, but teach them so they know how to use the ser­vices ap­pro­pri­ately and get the help they need.”

The schools al­low other fam­ily mem­bers to come see the nurse prac­ti­tioner, as well. Young peo­ple who are not cur­rently in school can also visit the clinic as a way to bridge their way back to class.

“It re­duces the bar­ri­ers,” said Hoy. “It’s timely ac­cess.”

The pro­gram will now turn its at­ten­tion to find­ing a donor to fund nurse prac­ti­tioner vis­its at al­ter­na­tive school Wilma’s Place at 770 Main St. E.

BARRY GRAY, THE HAMIL­TON SPEC­TA­TOR

Kaeli Cochrane is a nurse prac­ti­tioner who works at two down­town high schools, Sir John A. Mac­don­ald on York Boule­vard and Cathe­dral on Went­worth Street North.

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