50 Years of Excellence in Care and Community Engagement
Faculty, Students Creating Legacy: Advancing Health Care for All
The School of Nursing promotes health as an act of social justice and brings this mission to life through community engagement, community partnership and community-based health care delivery.
Since 1978, the nursing school has been actively engaging communities in an effort to improve the health and well-being of San Antonio and South Texas. Educating nursing students in community-based health care settings has been a long-standing practice at the School of Nursing.
Engaging with more than 50 community organizations, the school delivers health care services to people in shelters, senior homes, low-income housing, schools and community-based clinics. Under the supervision of faculty, student nurses learn about the social determinants of health by engaging patients where they live, work and play.
FIRST NURSE-RUN CLINIC
In the late 1970s, the Bexar County Hospital District’s obstetrical clinics were a community concern with too many patients and too few physicians. The hospital district, now known as University Health System, collaborated with the School of Nursing and the Long School of Medicine’s Department of Obstetrics and Gynecology to create a nurse-run prenatal clinic, which began operations in February 1978. All involved recognized that normal prenatal care could be provided by clinical nurse specialists.
The nurse-run clinic offered services to low-risk pregnant women from conception through six weeks postpartum. The Nurses’ Prenatal Clinic demonstrated an expanded role for nurses in the area of primary care, provided clinical education for undergraduate and graduate nurses, and offered a unique opportunity to acquire research data. More than 4,500 patient care visits were recorded annually at the facility now known as the Robert B. Green Campus near downtown San Antonio. It closed in 1993 after 15 years of service.
From 1990 through 1992, the School of Nursing responded to critical needs of people diagnosed with HIV and AIDS and their family and friends. Established by Willie Hayek and Margaret Brackley, the practice offered counseling, teaching and technically skilled care. Once the importance of this service was demonstrated, other resources were developed by public and non-profit organizations and the HIV Nursing Services clinic was discontinued.
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“The evolution of this school is noteworthy not only to those who have acquired (or will acquire) their credentials therein, but also the public these nurses serve. The chronicling of the school’s development provides opportunity for appreciating its momentous contributions to Texas.”
—Ruth Stewart, M.S., RN, FAAN Founding Faculty Member |
CLINICAL ENTERPRISE
The School of Nursing had been working to develop its robust clinical enterprise when it undertook management of the Student Health and Wellness Center in 2007 and the Employee Health & Wellness Center in 2010. The UT Nursing Clinical Enterprise is a nurse-managed system with six clinical practice sites including a mobile health care unit. A team of advanced practice registered nurses, RNs, a registered dietician, psychiatric mental health nurse practitioners and support staff provide care to students, faculty, employees and their families at a newly combined Health and Wellness Center.
UT Health San Antonio is the only Tier 1 research institution in South Texas and demands outstanding occupational and student health in order to ensure the safety of students, researchers and faculty. The school manages a complex occupational health program through the nurse-managed wellness centers.
Children of faculty, staff and students are served by the pediatric health center, a new clinical initiative developed to meet campus needs and the needs of underserved children in San Antonio and surrounding Bexar County. The pediatric health center offers vaccines free of charge to children who are under-insured and uninsured.
A HISTORY OF CARE
The school has had long-standing relationships with the Healy-Murphy Center and the AVANCE-San Antonio child care centers where the nurse-led provider team provides health care services in underserved communities. Healy-Murphy serves a population of adolescents who have not succeeded in other high school settings. Nearly 25 percent of the students are pregnant or parenting; many experience homelessness, abuse, neglect and food insecurity. Jane Smith, one of the school’s full-time RNs, worked with the young people daily ensuring that they have food and a place to live. Smith teaches the high school students, who are in the process of completing their high school studies, how to care for themselves and their children. Her outcomes have been remarkable with nearly 100 percent of the mothers breast feeding and 95 percent reaching term delivery. More than 90 percent of Healy-Murphy’s students graduate with a high school diploma or GED. Healy-Murphy provides student nurses the opportunity to work in a community-based setting where nursing students see firsthand, the social determinants of health and the critical role nurses play in overcoming barriers to good health.
AVANCE’s Head Start and Early Head Start programs are supported by the school’s Clinical Enterprise which provides health care services at AVANCE centers in Bexar and Uvalde counties. Again, the School of Nursing provides services to children who have limited access to care due to the social determinants of health and geography. The trips to Uvalde have been so successful that the frequency is increasing to once a month and services will be provided in the recently acquired Mobile Medical Unit (MMU).
RELIEF RESPONSE
A gift from singers and songwriters, Edie Brickell and Paul Simon, resulted in the purchase of the MMU so that nursing faculty and students could deliver health care services to Hurricane Harvey survivors in Rockport, Texas, and surrounding Aransas County. With Harvey’s wind speeds reaching nearly 140 miles per hour, Rockport was one of the hardest hit coastal communities in the state.
Brickell and Simon granted the nursing school more than $250,000 to deliver health care services to Harvey survivors in Aransas County. Three times each week for six months teams of student nurses and faculty would make the 167-mile trek to Rockport providing first aid, health education, vaccinations, primary health care and emotional support to Harvey’s hardest hit. Quickly gaining recognition for its work, the School of Nursing received a sponsorship from Superior Health Plans to support the school’s outreach efforts and provide services to populations that are often hard to reach.
IN THE COMMUNITY
Closer to home, the school has been providing care since 2009 to the refugee population in San Antonio. Working with community members, partners and other health professionals, faculty member Roseann Vivanco, M.S.N., RN, established a Population Health Nursing Clinic at Wurzbach Manor. With funding from the Nursing Advisory Council, the clinic allowed students to do health screenings, take health histories, administer a depression inventory, and assess nutritional status. The need for additional clinic services and resources soon became obvious.
St. Francis Episcopal Church offered a larger space that could be used as a clinic at no charge. Other organizations and churches became involved. This interprofessional practice led by the School of Nursing—in collaboration with the School of Allied Health Professions, the School of Dentistry and the Long School of Medicine—operates the San Antonio Refugee Health Clinic where teams of students and faculty from more than four health professions deliver primary health care services to the more than 5,000 immigrant refugees living in northwest San Antonio.
| “The School of Nursing continues to provide future nurse leaders for South Texas through the exemplary education of entry level and advanced practice nurses, and nurse researchers. In the response to Hurricane Harvey and participation in the Pride Community Clinic, the school exemplifies its mission to make lives better by promoting health as an act of social justice.”
— Janet D. Allan, Ph.D., RN, FAAN Former Dean, School of Nursing,1997–2002 Dean Emeritus, The University of Maryland, School of Nursing |
OPIOID CRISIS
Associate Professor Lisa Cleveland, Ph.D., RN, FAAN, has been awarded multiple grants totaling more than $27 million to address the opioid crisis in Bexar County and across the state of Texas. With community-based efforts educating firefighters, police, emergency medical technicians, nurses, doctors and average citizens about the crisis and methods for overdose reversal, the school is becoming nationally recognized as a frontrunner in combatting overdose deaths.
The School of Nursing also is contributing to improving the lives of women suffering from opioid use disorder. Casa Mia is a recovery residence where women in treatment can live with their newborns and other children. The program is a partnership between the school and Crosspoint, a community organization with extensive experience caring for people in recovery. Casa Mia has become a haven for women who might be incarcerated or otherwise separated from their children due to addiction recovery. All of Casa Mia’s mothers are in treatment and monitored by the Crosspoint staff in addition to the nursing school’s team of APRNs, nurses and a dietician. In an effort to address food insecurity and healthy eating, our dietician planted a spring garden to celebrate the season and the reunification of mothers and babies.
A REGIONAL REACH
Community outreach is extended through a number of other school initiatives. The South Texas Area Health Education Center (ST-AHEC) Program was established in 1990 from a Health Resources and Services Administration (HRSA) grant with the mandate to improve health care by addressing the unique workforce challenges and economic and health disparities across South Texas. Fulfilling the university’s mission to serve South Texas, the ST-AHEC program now uses a multi-pronged, multi-partner approach to increase diversity and distribution of the health care workforce in both rural and other medically underserved areas of South Texas.
Through the current HRSA-funded program, health professional students from a broad range of the region are now developing knowledge and training in interprofessional team collaborative care within rural and other medically underserved areas. Since January 2018, the School of Nursing has overseen the ST-AHEC program which is directed by Janna Lesser, Ph.D., RN, a tenured professor and director of the Center for Community-Based Health Promotion with Women and Children.
