ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, April 28, 1996 TAG: 9604300034
SECTION: NURSE PAGE: 6 EDITION: METRO
SOURCE: SARAH COX
Karin Musselman, a nurse practitioner who runs the Teen Health Center at Patrick Henry High School and works at the Hurt Park Center in Roanoke, enjoys telling a recent success story.
A young lady who had become sexually active in the last several weeks came into the center for an examination and went through counseling. After receiving all the information, she decided, said Musselman, to practice abstinence.
While many parents automatically think that the teen health centers (in Roanoke at Hurt Park and Patrick Henry and William Fleming high schools) are mostly for dispensing birth control devices, that is anything but the case, said Musselman. The health centers are site-based near schools because transportation is often a problem, and removing that barrier is one less excuse for teens not to use the facility.
The centers offer comprehensive health services, with parental consent, which can range from health screenings, immunizations, diagnosis and treatment of minor injuries and illnesses, to routine lab testing, health education, drug and alcohol counseling and birth control counseling. There have been smoking-cessation clinics and men-only counseling sessions.
There have been success stories and there have been frustrating moments in her job, said Musselman. But perhaps the best indication of all is the increased number of patients seen at the clinic on a daily basis.
``I've been most joyful at the response. Students keep coming back - they've learned to trust us and they bring their friends," she said.
Musselman, as a nurse practitioner with a masters degree from the University of Virginia, specializes in family practice. She is trained to do examinations and she has prescriptive authority.
On Monday mornings, a family practice resident from Roanoke Memorial also has office hours at the Patrick Henry High School-based clinic; the resident goes to the Hurt Park clinic on Wednesday afternoons. In addition, there is a full-time counselor at the clinic.
Musselman said she decided to take on the job of managing the clinic because she saw a need.
``I always believe that if you can take on good health behavior at a young age, that will carry over," she said.
The clinic is a service of the Roanoke Adolescent Health Partnership, which is the combined effort of Carilion Health System, Roanoke City Health Department, Roanoke City Schools and the Roanoke City Housing Authority. In addition, it receives funding from the Virginia Health Care Foundation and the Teen Pregnancy Prevention Fund.
Musselman said teen health has not improved in the last 10 years. What's even more frightening, she said, is that their health, as an age group, is worse than that of their parents. In 1993, Roanoke City reported more than double the state average in teen-age pregnancies.
If they're coming into the clinic, they're getting information, said Musselman, and they're finding people who they can talk to. She said the very nature of her calling as a nurse practitioner fits into this job description perfectly. Nurses are nurturing - they are trained to be patient-oriented, and they are trained to be educators. Nurse practitioners approach patients holistically, also, she said, and want to serve all the needs of the patients.
``If we see a student suffering from bad grades, we try to figure out why," she explained.
There are, she admitted, some who might wonder about the nature of their services.
``The last thing we want to do is undermine a parent's role. Everything is confidential, but if there is a life-threatening circumstance, we would notify the parents. We encourage the students to talk to their parents about problems," she said, adding that they offer counseling sessions where both student and parent are present.
One of the most frustrating things for Musselman is to encounter a female student who is disappointed that her pregnancy test is negative.
``As much as we would like these young people to have other goals, they are present-oriented. They don't have hope that anything more can come of their lives," she said. "If they see a friend pregnant, they think that's what they want to do, too."
But, she said, getting them into the clinic and sitting them down for a full dose of information often has good results. They get honest answers with regard to their health, particularly in the area of sexual activity. A bonus is that many have learned how to take better care of themselves, Musselman said.
Peggy Balla, director of the Roanoke Adolescent Health Partnership, said nurse practitioners bring a dimension of caring to any position. From a medical perspective, the approach is more comprehensive.
``When you think about the period of adolescence, it's second to infancy in terms of growth and development. Our adolescents are learning how to take care of themselves, and this teen health center can be their first contact to a health center," she said. "You need someone who has the time and expertise to spend on these teens. Nurse practitioners are in a good position to be friendly, caring, safe and to facilitate adolescent growth and development."
LENGTH: Medium: 95 lines ILLUSTRATION: PHOTO: TIM TREVILIAn. Karin Musselman, nurse practitioner inby CNBRoanoke, is friend, counselor and health-care advocate to her young
clients.