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The Helena Arkansas Daily World - Helena, AR
  • Practitioner makes perfect sense for nursing home

  • More common in other parts of the country, including the East and West coasts, having nurse practitioners on staff still is relatively rare in the Midwest and unheard of in Springfield until Scales came along.

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  • It turns out pioneers wear stethoscopes, at least in Jennifer Scales’ case.
    Last fall, 39-year-old Scales became the first nurse practitioner in a nursing home setting in Springfield, Ill.
    More common in other parts of the country, including the East and West coasts, having nurse practitioners on staff still is relatively rare in the Midwest and unheard of in Springfield until Scales came along.
    Generally, nurse practitioners can make diagnoses, prescribe drugs, perform non-surgical procedures and write orders.
    Scales spends one day per week at Washington Christian Village, a supportive living complex and rehabilitation center, in Washington, Ill., which gives her a chance to know the patients and their ailments better.
    “I round patients daily, if not more frequently. If something acute comes up, the nurses can notify me,” said Scales, who formerly worked as a staff nurse at Memorial Medical Center and Prairie Cardiovascular in Springfield and at veterans’ clinics in Springfield and Decatur, Ill.
    “I’m able to assess the situations and come to a decision of what we need to do.”
    Fewer trips to the hospital
    Scales said her presence at the 155-bed facility can help cut down on residents’ trips to doctor’s offices or hospitals by treating some conditions in-house.
    “This keeps residents healthier because their illnesses don’t get out of hand,” adds Dr. Mark Canty, medical director at Lewis Memorial. “We can nip problems in the bud.”
    One resident, Scales said, was getting frequent urinary tract infections, requiring frequent trips to the hospital.
    “I knew when she was getting sick, and I knew what to do,” she said. 
    Residents are arriving at nursing homes sicker than ever, said Scales, because they are put out of hospitals more quickly, requiring that personnel monitor them more closely. That makes having a nurse practitioner, Scales said, even more vital.
    Scales has a master’s degree in nursing with designs on earning a doctorate degree in the same field, and she comes from an acute care nursing background. Having worked at veterans clinics in Springfield and Decatur also gave her an opportunity to work with an older population.
    “I use every (skill set) I used at the hospital,” said Scales. “The only difference is that here I’m treating patients.”
    Push for change
    Scales admits that there is a learning curve among different parties — communication between the nurses and her, and physicians not fully realizing what a nurse practitioner’s role is, for example — but she thinks the situation might be one more facilities will consider.
    “I get asked all the time why I came here,” she said. “I knew I wanted to be a pioneer and push for this. I think it’s so new, but in the long run, it will catch on.
    Page 2 of 2 - “The relationships I’ve established with the patients, the fact that we’re preventing patients from going back (frequently) to hospitals, I do feel like I’ve mattered.
    “I hope people say that I’m professional, that I’ve taken the time to listen. I try to stay on top of everything. I hope they’re saying I’m doing a good job.”
    Steven Spearie can be reached at spearie@hotmail.com.
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