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Monday, Aug. 13, 2018

MLK HEALTH CENTER: 20 YEARS IN REVIEW

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Nurse practitioner Terry Kevil shares accomplishments and milestones of the center

Terry Kevil has volunteered her time at Martin Luther King Health Center for 20 years.

Kevil said she moved back to Shreveport in 1997 after living in Lincoln, Neb., to take a faculty position in the graduate program at Northwestern State University.

“Since nurse practitioners must maintain practice hours for board recertification, I was looking for a site to do faculty practice,” she said. “I had heard about the MLK Health Center and called to see if I could do some hours on Saturdays.”

Kevil said she was not actually evaluating and treating patients initially, but instead doing patient intake, which did not meet her practice requirements.

“I stopped coming, but all that changed once Janet Mentasane became the executive director,” she said. “At the time I was coordinating the Family Nurse Practitioner program, and Janet wanted us to think about bringing FNP students to the clinic.”

Dr. Norann Planchock, dean of the College of Nursing at the time, and Kevil, along with Dr. Art Fort, then-chair of the Department of Family Medicine, began the process of becoming credentialed through the Department of Family Medicine at Louisiana State University Health Sciences Center to be able to treat and manage patients, Kevil said.

“We completed the process; however, NPs at LSU were at that time not allowed to prescribe,” she said. “Dr. Planchock and I both had prescriptive authority from the State of Louisiana and agreed that we would need to be able to prescribe medications for those patients who needed them. We then approached Dr. Robert Jackson, the medical director of MLK and the physician that started MLK Health Center, if he would be willing to be our collaborating physician. He responded that he would ‘be honored.’ That’s when NSU’s affiliation with MLK began.”

Kevil said many things set MLK apart from any other health-care clinic. She said services are provided to all patients free of charge, that no payment is accepted nor is any insurance filed.

“All patients are welcomed to enroll in the clinic if they meet enrollment criteria, some homeless, some undocumented, some the working poor, some unable to find employment,” she said. “Patients typically come every three months with the same group of patients. This allows them the opportunity to form relationships with each other for support. These patients are the most vulnerable in the community with many serious medical comorbidities to manage.”

MLK does so much outreach – an example of when they were located on Sprague Street is that the clinic passed out free condoms to the prostitutes and the “johns” to keep safe, Kevil said.

“I’ve also been involved in a couple of free flu vaccine clinics, such as to community members at the VOA,” she said. “Our community garden, where the produce is grown, is all given to patients. Healthy cooking demos are done during many of our clinics where patients can sample the recipe, take a copy with them and sometimes are given the vegetables to reproduce it at home.”

Kevil said several local drug stores donate over-the-counter medications, hygiene products, nutritional supplements, eyeglasses, greeting cards, books, etc., which are offered free of charge to patients in need.

“We are blessed to have several area physicians, both primary care and specialists, who volunteer their services monthly,” she said. “MLK staff try to keep us on the front lines of health care, such as their diabetes self-management program and the diabetes prevention project, which elicits input from interdisciplinary board leaders; and I promise I could keep thinking of things, but hopefully you are getting the picture that this clinic is definitely a diamond in the rough.”

Many services are offered at MLK, Kevil said. There are three FNP faculties, one adult-gero NP faculty and one women’s healthy NP faculty who volunteer on a routine basis monthly. The Northwestern NP faculty and student clinics regularly include three diabetes clinics, one respiratory clinic, one gerontology clinic, two women’s health clinics and one sexually transmitted disease clinic.

“The wonderful thing about these clinics is that we have students who come from all over the state for this experience – my last gero clinic, I had one student who had driven from Lake Charles and one from Lafayette – and students love it,” she said. “MLK provides a setting where the students are not rushed as they might be in a private primary care clinic, where patient turnover must be quick and efficient. The students, under the preceptorship of the faculty, are able to take their time, consult their resource materials, dialogue with other students and the faculty regarding their patient, suggest lab that the patient needs, etc.”

Kevil said MLK is definitely a learning environment.

“Students aren’t made to feel like a wrong answer reflects negatively on them,” she said. “In the FNP and gerontology programs, students follow an identified family during the curriculum. We have frequently approached MLK patients for their willingness to participate. These patients are supported in their home, where an environmental assessment is done, sometimes followed to their private M.D. appointments, and followed when they are scheduled at MLK.

Students have been extremely positive about their experience and the unique opportunity they have to see the patient in their everyday environment.

“On more than one occasion, I have had students who, upon reflection of their experience explained that their prior perception was that all patients existed in the world of health and illness as the student had experienced it,” she said. “They come to gain an understanding of the most medically vulnerable patients who have no ready access to health-care services. It also offers the student the opportunity to interact with patients in a culturally sensitive way. Our clinics include Hispanic, Chinese and Taiwanese patients.”

Kevil said she gets so much much pleasure from working with the selfless staff and volunteers who staff the clinic, as well as from the patients.

“Patients are so grateful for the services they receive, and I get to know that what I’m doing truly makes a difference in someone’s life,” Kevil said. “When we are able to identify and intervene in a potentially life-threatening patient situation, the satisfaction is immeasurable.”

Years ago, MLK had an obese diabetic patient who was seen in a local clinic by different providers, Kevil said.

“They gave her instruction on a diabetic weight-loss diet and monitored her weight at each visit,” she said. “The patient explained to me, in tears, that they kept telling her that she wasn’t being truthful about her diet since her weight remained unchanged. This lady was an amazing person as she had accepted two special needs children to foster, one a teenager and one an infant. She also regularly kept her own grandchildren on occasion and was doing the very best she could. I assured her that we would never imply that she was lying in our clinic and that we would assist her in trying to get her diseases under control.”

Another example, Kevil said, is when the RN volunteering to do lab draws intuitively felt as though she should pull an A1c (a diabetes indicator) in a 32-year-old Hispanic woman whose only medical diagnosis was high blood pressure.

“When I got the results, I found that she was diabetic and lab indication that she already had some kidney damage,” she said. “I was able to get her started on medication, the equipment to check her blood sugars at home and had our nutritionist talk to her about a diabetic diet. We will see her back in 30 days to follow her progress and reinforce our teaching.”

Kevil said her most significant accomplishment volunteering at MLK is that she knows she is always helping someone in need.

“It would definitely be the knowledge that each time I am here, I am truly helping a person in need,” she said.

Kevil said she realized that volunteering at MLK was her passion when she saw that they were providing condoms to protect people who were not even their patients.

“This was evidence for me that MLK’s care extended beyond our four walls,” she said. “Also, the constant reinforcement that MLK’s approach to patient care is service to all individuals in a nonjudgmental manner, regardless of their life circumstances.”

Volunteering is crucial when so many people have so much need, Kevil said.

“There is no one out there who doesn’t have some type of service they could perform,” she said. “I agree with Dr. Robert Jackson (our medical director and the clinic’s originator), who I have heard repeatedly say that he has ‘always gotten so much more from the patients than he has ever given.’” Kevil said if she had only one piece of advice to give to others, it would be not to let life’s tribulations bring you down.

“I would say that it’s easy to allow life’s tribulations to weigh you down day-today,” she said. “However, volunteering allows you to escape them and put your own difficulties in perspective briefly. There is no greater feeling than knowing you helped someone and made a difference.”

Kevil said she is humbled because she has been recognized for her service.

“I’m very humbled to be acknowledged; however, there are so many MLK volunteers who could have been chosen for this recognition,” she said.

Other than volunteering at MLK Health, Kevil said she is blessed to be part of a large, loving family, and she loves spending time with all of them.

“I am retiring at the end of January, and I love to read suspense novels so that will become a priority of mine. I have told Janet and anyone who asks that I will always be a part of MLK Health Center in any capacity I am needed. In fact, Janet has asked me to take over a monthly weekday clinic for a physician who will be retiring as well. It will be my honor to do so.”

Kevil said she would like to say that she thinks Sister Margaret, who started the clinic with Dr. Jackson, is proudly looking down from heaven to see the impact that the clinic has on the neediest citizens in North Louisiana.

“I truly think the two most remarkable people in this clinic are Dr. Robert Jackson, who started this clinic with a desk and a chair on Saturdays at Christian Services 31 years ago when he was an internal medicine resident,” she said. “He went from seeing a few patients a day to MLK currently serving 1,700 patients. Dr. Jackson still staffs the clinic, even in retirement. The other person is our executive director, Janet Mentasane. MLK operates on grants, awards, sponsorships and donations. She is always promoting MLK.”

For every $1 invested, the clinic provided between $23-25 in services. Under Mentasane’s leadership with a budget of $800,000, MLK delivers approximately $16 million in services, Kevil explained.

“I know when we were down on Sprague Street, we had about 350 patients,” Kevil said. “Under Janet’s leadership, we now serve 1,700 patients.”

– April S. Kelley

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