A Domestic Missions Opportunity

When I first started working in the hospital setting, I had a weird existential dilemma somewhere in the first year. The first several months, I was just trying to survive, but once I finally got to a place where I could see what my hands were doing and think clearly, I had one particularly clear thought; some of these patients shouldn’t be here. I don’t mean that they were being over treated or came in for no reason. I mean, there are so many preventable health conditions, and it struck me hard that a few different choices over the course of their lives could have prevented them from being as sick as they were. 

(Ok, so, before I go any further, what I’m not trying to say is that unhealthiness means people are getting sick on purpose or it’s all their fault. There are a lot of circumstances that come together that lead to unhealthy dietary, activity, and lifestyle choices, and even if a person can control some of them, some things are influenced by genetics, community, history, and social pressures. I’m not playing a blame game.)

I had this sense that so many of these patients could have avoided a hospital visit and have had a better quality of life if they just had the support and education needed to prevent them from getting say type 2 diabetes or high blood pressure or high cholesterol, all of which contribute to increased complications when an emergency comes up. 

Now, I’ve been working oncology for several years now, and I’ve lost a little bit of that connection with doing primary care and working with medical conditions like diabetes and high blood pressure. Because we’re an integrative clinic, most of my patients are honestly healthier than I am. Their diets and activity level are pretty up there. Generally speaking, they are in a demographic that allows for certain health resources to be available to them that might not be realistic for the everyday person. So, I’ve been looking for opportunities to grow in my understanding of community health. 

Another thing that has come up in my research and in my dabbling into health ministry is that many of these kinds of ministries reach out to the impoverished and disenfranchised. This shouldn’t be a surprise, since God cared deeply for the poor, the widow, and the orphan. Throughout all of scripture, God called his people to take care of the “have-nots.” It’s an integral part of scripture. A natural extension of health ministry will be caring for those who are not able to find or afford the care themselves. 

But when I first started this foray into health ministry, it actually didn’t really latch onto my brain that I might need to get involved in this demographic. My main goal was to work in the church and with the people I interact with on a more day-to-day basis. And if I’m being honest, my experiences in churches have been with mostly middle to upper-middle-class people. I myself am super blessed to work at a place that provides me with really good insurance. My husband and I don’t consider ourselves wealthy, but we’re also very aware that we live in a place of a certain level of privilege, and we don’t have any desperate needs regarding our health or ability to provide for ourselves. 

A few months ago, one of my friends texted me about a possible domestic “missions” opportunity. Bolingbrook Christian Health Clinic would be running a special clinic day, and they would like some volunteers available to provide care for the patients who were coming, patients who do not have insurance (I don’t know much about the Affordable Care Act, to my shame, but even the insurance plans here are still too expensive for some families, to the point that paying for these plans might mean not being able to pay for rent or food for the month). Would I be interested in giving it a shot? 

Of course I said yes. I had one day of “training”, where a wonderful staff member by the name of Eimi showed me the charting system. I would absolutely not remember how to do it until the day of the clinic, since it was more than a month away. But I was excited to see how they did things. Between then and the day of the clinic, there would also be some renovations going on, so I was eager to see what those changes might look like as well. And not only did they have building renovations, their website also had major updates by the time the clinic happened. 

A few things that I found surprising was that the whole operation had much more available than I thought they would. They had many of their medications donated/provided by a few different large charitable organizations. They also had a small fitness area, an area for a physical therapist to do some work with their patients, and once all the renovations were done, they had four patient visit rooms, a “pharmacy” with some basic medications, a lab station, front desk area, and staff office space. There may have been more areas set up for this organization, but it’s also part of a church building, and the church building used to be a school (hope you’re not confused at this point.) My thought had been we would mostly be doing screenings, and treatments and prescriptions would be provided via referrals, but I was glad to see that at least a few of these services could be provided here.

In order to prepare for the day of the clinic, there actually wasn’t a lot of prep to do. I’m used to missions trips from when I was younger, where we had boot camps, summer training, and Bible studies. Of course, this event was not my idea of a traditional short-term mission. It was a single day clinic. And since most of the volunteers are working professionals or in a medically-based educational program, it would obviously require high levels of coordination for all of us to gather even a few times prior to the event. So, with fingers crossed and a few lifted prayers, I went the day-of, having spent some time reviewing an email with information sent to us from a staff member on how to use the charting system and what to expect, much of which we ended up not needing. 

Here’s how the day went;

We started at 8:30 am with a word of prayer, a quick but concise review of the charting system, and a few encouraging words. There were two clinicians who would be assessing and prescribing care to patients, a Nurse Practitioner (NP), who was a regular volunteer, and a Physician Assistant (PA), who was a first timer but with a hefty amount of experience in the ER (one insight I gained was that as an ER PA, she also had a general understanding of which medications would be low cost to prescribe to patients, as ERs treat all manner of patients and knowing which ones are affordable is a regular part of the experience. I’ve never worked ER so it was eye-opening for me). There was also a scribe, who would be working with the PA, 2 medical students, 1 retired nurse (midwife), her daughter, who works the administrative side of medicine, and myself. There was also the director, also an NP but not seeing patients, her husband, who worked front desk, two translators who spoke Spanish and regularly volunteered, and another PA who regularly volunteered but was there mostly as our photographer that day.  Of course, due to Covid, we took additional precautions, such as staying gowned, gloved, and masked throughout each of these visits.

My role would be intake. Although the retired nurse and her daughter were assigned to doing vitals, I did a few of my own, after which I would do intake questioning. It took me until the third patient to realize I was probably asking too many questions (like I probably didn’t need to do the Ebola questionnaire), and I wasn’t always sure which ones were necessary. However, more was better than less so I erred on the side of more. Intake questions were basic things, like medical history, medication lists, demographic information confirmation, etc. For a few of those patients, it also involved doing a blood sugar test, as some of them were in for issues with elevated blood sugars and type 2 diabetes. It took a couple tries, but Eimi helped me figure that out too. 

Once intake was done, the next step was to inform the clinician that her patient was ready, or at least let someone know to let her know, if she was in with another patient. There was a break in the middle for lunch, where they provided magnificent tacos and juice, and we continued on with the day. The clinicians would see the patients for their respective medical issues and complaints and prescribe medications or referrals per their needs. They would also be told when they should come back for a followup. 

At the end of the day was breakdown. Each of the rooms was cleaned and wiped down between patients, and after the last patients, we also took out the trash. We ended up taking a group picture after a 30 minute or so debrief. We talked about significant moments, stories, and how we felt throughout the clinic. And then… we went home. 

It was only a single day experience, but I learned so much, some of which surprised me:

1. The first thing I learned is… I actually know what I’m doing!

Ok, so there were definitely hiccups along the way, and I also learned I definitely DON’T know a LOT. But I gained a lot of confidence in my own skills as a nurse and just as a human being who is looking to serve people and help them figure out how to help themselves. I realized my 9 years of nursing experience are actually good for something! I learned a long time ago that my job isn’t to know everything, and it’s ok to admit to patients that if there’s something I’m not sure about, there are people we can ask, and we can both learn something. I found that I can walk into a room, into an unknown situation, fake some confidence, and be flexible enough to learn along the way, while also helping someone feel less ill-at-ease. It’s a good thing to know, since I’ve never thought of myself as a confident or authoritative person. But I realized it’s not because I feel confident or authoritative that I can walk into a room and start joking with patients and helping them feel welcomed. It’s years of practice and experience in doing that same thing over and over again.

This realization hit a little harder as I spoke to a few medical students who volunteered for the clinic as well. I could feel their palpable nervousness, and I think at some point, I just said, “Fake it til you make it!” I know, it’s a little cheesy and I hope it didn’t come off as disingenuous, but honestly, I’ve done that a lot, and for some reason, it works. 

1. I need to catch up on common community health issues. 

High blood pressure. Type 2 diabetes. High cholesterol. Nutrition. Exercise. All of these things are really the basics of community health, not to mention some of the basics of mental health. If my goal is to become a church nurse or health minister, (although I’m sure a lot of my chemo experience will be useful) I need to expand my understanding of some of the more common, day-to-day issues. I take it for granted that my patients actually don’t struggle with things like diabetes or high blood pressure unless they are part of their chemo side effects. 

One of the amazing things about this clinic is that they can provide medications to manage high blood sugars AND they do a 12 week class for newly diagnosed diabetics on how to manage their diabetes. I remember doing very very basic diabetes teaching in the hospital, but I can’t even tell you the number of times I had to rely on the formulaic orders given to us by their primary care providers and endocrinologists to help guide their insulin dosing and diets. Which isn’t a bad thing, I just had very little true understanding of why certain insulins worked the way they did, and it’s been so long, I’ve forgotten all of it anyway. So one of my goals after this is to keep finding ways to better understand the community at large, not just the demographic I work with currently. 

1. Learning to incorporate the spiritual with the medical. 

Even though my eventual goal is to end up in health ministry, I realize more and more that I am woefully unlearned in the ways of skillfully weaving together faith with practice. My interactions with the patients who came were conversational and good, but I was so absorbed in my task at hand that looking to feed the spiritual aspect of our interactions hardly crossed my mind. I even found myself impatient when the director of the event slowed us down in the morning to address the need to speak to our patients and be open to talking to them about faith, as I wanted to get on with it and just figure out the system! Granted, being a first timer probably had something to do with that, since I was just getting used to everything and I didn’t know what to expect all that well. However, for the next time something like this comes along, I want to experiment and learn to get comfortable with pulling some of that from our patients. I want to learn to dig in, get a little awkward, and find out how to do this well. 

Overall, this clinic was eye-opening. As I spoke with these patients, it became more and more clear to me that there is so much need. And many of these issues would take time. They would require making relationships with people who have experience and expertise, and for many people, this means paying for services they might not be able to afford. 

I was also reminded that I am only one person, and I can only do what I can do. But I can hope and pray that God will use that effort and do more with it than I ever could. 

So overall, 10/10, would recommend! I continue to be excited to see where God leads me in these forays into different areas of faith and health. And I also continue to be humbled by these experiences, my lack of knowledge, and the fact that I can only do so much. My eventual vision is that the church would be a model, a place for people to go where they can see how God has called them to live, with stewardship of the body being a part of its DNA.