It’s 9:33 a.m. on a frigid October Monday, and a line of vehicles is winding through the parking lot, waiting for Pittsboro’s CORA Food Pantry to open at 10 a.m.
Nearby, four UNC School of Nursing students and Associate Professor Jean Davison set up a tent and unpack supplies for a mobile health clinic. The parking lot is one of three school mobile clinics where students ask people if they will fill out an anonymous health assessment form that could indicate a health problem such as depression or diabetes.
The other clinics are held at UNC Farm on Penny Lane in Chatham County and in Wake County at Dorcas Ministries. Fourteen students rotate through the Chatham County clinics. Sixteen more students are rotating at the Wake County Clinic.
“We invite people after they grab a meal to come to our booth under the canopy for free blood pressure and glucose checks and other health screenings,” says Davison. “Students will check anyone in the car line who wants to fill out a form. If the person’s information indicates anything unusual, we will ask them if they would like to be examined in a more private area on board Miss Penny.
“Miss Penny” sits at the end of the parking lot. She’s a 35-foot recreational vehicle wearing a colorful vinyl wrap on both sides emblazoned with “Wellness on Wheels” and photos of six young people of various genders and races, along with fun art of vegetables, chickens and two dogs. It would look right at home at any state fair.
During a typical three-hour clinic, seven to ten people will agree to be examined on Miss Penny’s board.
We are getting ready to start
The students finish setting up a tent after receiving a tip about a stuck pole from a farmer in dusty denim who has just unloaded produce from his pickup truck for the food pantry.
Davison huddles with the four — Moriah Fender, Peyton Gulley, Emma Krueger, Tara Horojo — and goes over forms in English and Spanish. Just before 10 a.m., students attach a banner to the tent that reads, “UNC School of Nursing Mobile Health Clinic.” They laugh as Gully, on tiptoe, manages to hook the left side.
As the cars begin to roll in, the students move through the line with Chick-fil-A glee and efficiency. “Hello,” says Krueger, greeting a driver. “How are you? We offer free blood pressure and blood sugar screenings. Would you be interested?”
Soon, a driver agrees to let the students take vital signs and body measurements. Another’s form shows he needs a more thorough examination of Miss Penny, which Davison is dealing with.
When a Spanish-speaking driver needs language assistance, sophomore Delfino Benitez steps in to translate. Benitez, who is involved in African, African American and Diaspora Studies, is also Miss Penny’s chauffeur.
What do students learn?
Students come to the clinic as part of school courses such as Public Health in Community Settings or Experiential Learning in Nursing.
“We learned a lot about what it means to be a community nurse, not just a hospital nurse,” says Fender, a senior from Asheville. “It’s really great for them not to have to come to us at the hospital when they need care, but instead we’re helping people in the community be proactive with their health needs.”
Davison says students learn to conduct a public health community assessment, which includes looking at how social determinants of health such as housing insecurity, transportation issues and lack of health insurance affect a person’s health and well-being. “For example, we partner with food pantries where food insecure people seek help and they may have health issues that need attention, so we check for those social determinants,” she says.
Clinics provide access to health care that some people would not be able to get otherwise. Students tell people about the Chronic Illness Self-Management Support Classes in the Look Up program. Students help teach classes on nutrition, exercise, and weight, stress, and medication management. “By focusing not only on community members’ blood pressure and blood sugar, but also including improved access to healthy foods and meeting other social needs, we help remove some of the barriers they have to health equity,” says Davison.
Davison secured a grant from Blue Cross Blue Shield to support the clinics’ work to address food insecurity and conduct risk assessments of community members. They also performed retinal screening to prevent blindness.
Clinics, Davison says, are paying attention to the need for equity in health care, as described in a 2021 National Academies of Sciences, Engineering, and Medicine report on the future of nursing:
“A nation cannot fully flourish until everyone – no matter who they are, where they live or how much money they make – can live their healthiest lives possible, and helping people live their healthiest lives is and always has been the primary role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, a supportive work environment, and autonomy.”