In honor of National Nurses Week (May 6-12, 2018), our Nurses of the Week are Ana Verzone and Jackie Baer, two nurse practitioners who have dedicated their careers to caring for the neglected and underserved populations in America’s rural regions.

According to The National Rural Health Association (NRHA), the US is facing a major rural health care crisis, with nearly one third of the country’s rural hospitals having closed or at serious risk of closure. This leaves rural populations at risk, often putting the lives of the poor, elderly, and chronically ill in jeopardy.

Both Verzone and Baer credit Jonas Philanthropies – an organization devoted to improving our nation’s healthcare through advancing the nursing profession – for the work they do today. As graduates of the Jonas Scholar program, they were awarded scholarships to achieve their Doctor of Nursing Practice (DNP) degrees. Over 1,000 nurses across all 50 states have received funding support from the Jonas Scholar program to further their doctoral education.

To shed light on the current rural health care crisis, we interviewed Verzone and Baer on their thoughts on the issue, and how they are both personally working to provide care to those most in need.

Q+A with Ana Verzone, FNP, CNM, and Jonas Scholar

Ana Verzone is a nursing educator and practitioner who has brought care to the most remote communities across the globe, from Alaskan villages to Nepal, where she conducted her doctoral research on improving communication between rural clinics and emergency rooms. Verzone now teaches future generations of nurses at Frontier Nursing University and the University of Alaska, helping to address the nationwide shortage of nursing faculty and rural primary care providers.

  1. Tell us about your background in nursing.

I love to travel, and before I became a nurse, I was a professional mountaineering guide in Nepal, amongst other places. While passing through a rural village I met two nurse practitioners conducting research on the impact of high altitude on health – they were incredibly inspiring. Knowing I wanted to serve others, I decided to follow their paths and become a nurse. I earned a Master’s in Nursing from the University of California, San Francisco and then worked at San Francisco General Hospital in the emergency department.

I knew continuing my education would empower me to help underserved communities, as well as eventually teach. Thanks to Jonas Philanthropies, an organization that supports doctoral nursing students through its Jonas Scholar program, I was able to pursue my doctorate as a way to give back to the profession I became so passionate about, and to address the shortage of nursing faculty in America. With support from this scholarship, I was able to improve care in remote regions of Nepal, continue my work in remote Alaskan villages, and teach the next generation of future nurses.

Today I work as adjunct faculty at Frontier Nursing University, where I received my Doctor of Nursing Practice (DNP) degree. I have also taught in the University of Alaska’s nursing program.

  1. How did you develop a passion for rural health care?

My mother was a first-generation immigrant, and my father was second-generation. I grew up in a poor environment that exposed me to the great need in underserved communities and inspired me to find ways that I could help improve nursing care in these areas with a sustainable impact. I have worked in private settings, but my heart was always in providing primary care to the less fortunate, because otherwise these communities would have no other options. Rural areas remain the most at risk; they continue to be neglected and there’s still much work to be done.

  1. How are you personally working to combat the rural health care crisis?

I am currently a member of the National Quality Forum’s (NQF) Measure Applications Partnership (MAP) Rural Healthcare Workgroup. This is a multi-stakeholder group that aims to identify appropriate quality measures and measurement gaps relevant to vulnerable individuals in rural areas, and provide recommendations regarding the alignment and coordination efforts of measurement in the rural population. This Workgroup will ensure the perspectives of rural residents and providers—those who are most affected and most knowledgeable about rural measurement challenges and solutions—have adequate representation on MAP.This group will provide recommendations to the federal government for Medicare/CMS’s measurement standards.

Of note: NQF is the only consensus-based healthcare organization in the nation as defined by the Office of Management and Budget. This status allows the federal government to rely on NQF-defined measures or healthcare practices as the best, evidence-based approaches to improving care. The federal government, states, and private sector organizations use NQF’s endorsed measures, which must meet rigorous criteria, to evaluate performance and share information with patients and their families.

My doctoral project focused on improving emergency transports from rural outreach clinics to large referral hospitals in Nepal and was very successful. The protocols I initiated during my project are continuing even though my project itself is complete. I remain committed to rural Alaskans, and continue to serve this population. I also make sure to volunteer in rural areas internationally, so I can keep my finger on the pulse of these issues on a global level. I travel with my family when I do this, since it’s important to me that my daughter also grows up exposed to these issues. My husband is a physician assistant, so he can also actively participate in these trips on the healthcare side as well.

I also hope to improve the quality of healthcare delivered in rural areas by committing to train the next generation of advanced-practice nurses to excel in rural settings. This is important to me especially as a Jonas Scholar, as Jonas Philanthropies empowers nurses to take leadership and faculty roles, to ultimately advance the nursing profession and improve care for our nation’s most vulnerable citizens. Frontier Nursing University, where I currently work, is committed to training advanced-practice nurses that want to serve rural populations, and my work at the University of Alaska supported training students in the specific needs of rural Alaskan regions. Rural areas often require a practitioner to have a wider breadth of skills (primary care practitioners in particular) and have fewer resources available. There are challenges such as geographic isolation or small practice size, limited time, staff, and infrastructure for internal quality improvement efforts. Advanced-practice nurses are a critical part of the solution for these issues.

Q+A with Jackie Baer, APRN, DNP, FNP-BC, and Jonas Scholar

Jackie Baer is a nurse practitioner who runs a free clinic in rural South Carolina, serving 3,000 uninsured patients per year. After witnessing the similarities in healthcare conditions for the poor in rural South Carolina compared to mission camps she served in Venezuela, Baer decided to leave her work in the privatized healthcare sector to serve the rural communities who need it most.

  1. Tell us about your background in nursing.

I began my nursing career in 1993, and after earning my Nurse Practitioner degree in 1998, I was still called to continue my higher education in nursing. With help from Jonas Philanthropies’ Jonas Scholar program, an organization that seeks to advance the nursing profession through the higher education of leaders in the field, I earned my Doctorate in Nursing Practice (DNP) degree at the University of South Carolina. The Jonas Scholar program took a big financial burden off my doctorate education, allowing me to grow as a nurse and connect with a network of nurse leaders that I wouldn’t have had otherwise.

Throughout my career, I’ve worked in many different arenas: ER, research nurse, home-health, rehab, and even a city jail. The different settings have helped me develop a passion for primary care and preventative medicine. In 2003 I started the first rural health clinic in Johns Island, South Carolina—a very destitute and underserved community. My clinic provides primary care to many in my community, keeping open late into the evening and providing weekend hours to accommodate the working poor.

  1. How did you develop a passion for rural health care?

In early 2000 I was a single mother and still relatively early in my nursing career. I took a mission trip to Venezuela and was so inspired by the patients who could maintain health and happiness even with a few resources. When I returned to the US, I stumbled upon Johns Island by accident; I got lost while traveling the Sea Islands of South Carolina and came upon the island and its federally qualified healthcare clinic serving the poor. I stopped by to ask for directions, but as fate would have it, I was inspired by the clinic’s work with the local community and began working there shortly after.When I moved to Johns Island and eventually opened the first rural health clinic in the county, I immediately recognized there were similarities to Venezuelan migrant camps and rural communities in South Carolina. Having spent part of my career working in private care, it was heartbreaking to see a great disconnect between how private patients and patients in poor, rural communities are treated. I believe each patient should be given the same care, which is what drives me to continue my work at my clinic today.

Being a nurse in rural healthcare is so much more than providing care—it’s about being an advocate for my patients. I’m helping people who are in great need, and recognizing not everyone has a roof over their heads. That’s why I chose to be a nurse, not a doctor. It’s not just about writing a prescription or providing an operation, it’s more about listening and providing care. Nurses are taught to care for the heart, mind, and the soul. I try to write few prescriptions and instead focus on life skills versus pills. Looking back, I feel that I have not only impacted my patients but improved the health care of families with early diagnosis and intervention. My doctorate thesis was on weight loss in obese African American women and it continues to be a great success for the community I serve.

  1. How are you personally working to combat the rural health care crisis?

At my clinic, we see around 3,000 patients a year who would otherwise not have primary care options. I feel a very strong connection to my community and am happy to provide a service to the poor. I am blessed to have a 73-year-old supervising physician at the clinic. But if she leaves or heaven forbid something happens to her, my clinic closes! In fact, one physician wanted to charge me $1,000 per month to supervise me in giving medically assisted treatment to patients. The red-tape and financial burden of these agreements continue to overwhelm me.

Health policy change is critical. In South Carolina, I continue to struggle with “agreements” due to outdated laws. Winston Churchill said, “History has a lot to teach and we are doomed if we fail to learn from it.” The National Council of the State Board of Nursing conducted a study in 2018 and found that states with “full practice” authority—the ability for advanced practice registered nurses (APRNs) to work to the full extent of their education—have better outcomes, save taxpayers money, and provide increased care access to rural communities. As doctors continue to leave our rural communities, the opportunity for APRNs is great, but the obstacles in the scope of practice limit success. As a nurse practitioner in rural South Carolina, I work day-by-day under these “agreements,” but could literally be gone tomorrow. Sadly, the injustice in healthcare continues for those that are poor and underserved.

As a highly trusted profession, nursing needs a mammoth legal presence in the state legislature to make sure laws are simple and clear. With fifty years of conclusive data, nursing will win but only if we have a team of lawyers advocating on our behalf. I believe that if “full practice” has improved outcomes for our Veterans, why not for rural America?

More Nursing News

Listen to the Nursecasts Podcast on your Amazon Alexa or Echo

Launch the latest episode of Nursecasts on your smart speaker today or click below to listen online.

LISTEN ONLINE

You have Successfully Subscribed!

Share This