Half nurse, half teacher - College health centers require a special kind of nursing

By Jody Rathgeb

"Wellness must be a prerequisite to all else. Students cannot be intellectually proficient if they are physically or psychologically unwell."

The comment from Ernest Boyer, an American educator of the early 1900s, is April Scruggs' favorite quote . and one that explains what she does as a nurse.

Scruggs, a family nurse practitioner (FNP) and clinical director of the Student Health Center at Lynchburg College, is among those nurses whose work takes them daily into college and university settings, dealing with teens and young adults who are getting their first tastes of independent living and taking charge of their own wellness.

This is work that is half nursing, half teaching, as RNs and FNPs use their skills to not only keep students healthy, but also guide them toward better lifestyle choices. It is nursing with a strong education component.

"In my opinion, nurses are all educators," comments Margo Potts, NP, who has worked for four years at Longwood University's Student Health and Wellness Center in Farmville. "The difference between practicing nursing and practicing medicine is that education piece, and I get to use it quite a lot here. I feel like I'm using my nursing skills to the fullest."

Health and education
Nursing in a college setting can vary widely, depending upon the school, its location and the "model" for its clinic. Schools that are connected with or close to medical schools can and do provide a different form of care - such as more referrals - than those in isolated and rural areas, which function more like the family doctor's office.

But the nurses in these student health centers share a dual commitment to health care and education.

Nurses come into this work in various ways.
Betsy Gentry, program assistant at the University Health Center at James Madison University, Harrisonburg, has degrees in both health education and nursing, so when she left home health and moved to JMU to handle its allergy clinic, the career move fused her strengths. "It really allows me to use my education background with my nursing," she says.

Moved into the college health care
Others found educational nursing through working to fulfill their own needs. Scruggs, who previously worked in oncology, was searching for a way to combine nursing with starting a family; she liked the regular hours.

Heidi Simpson, FNP and associate director of student health at the University of Mary Washington, Fredericksburg, says she always wanted to work in the college setting and finally landed her job after working in various family practice jobs.

Timmye Ross, also a nurse practitioner at UMW, formerly worked with the state health department and moved to the school after participating in a joint program in which department clinicians provided services at UMW (then a college).

Wellness models
The nurses share a delight in being able to put their clinical skills toward promoting wellness in the next generation.

"The model here is a self-care wellness model," explains Potts. "Many of our patients are working with dealing with conditions to which their lifestyles contribute. And the impact is greater when you're younger."

"Yes, they're invincible," says Ross wryly about her charges, but she adds that she loves working with the teens and young adults. "Wellness education is the biggest part of my job."

"I like working with this age group," agrees Gentry. "They are sponges soaking up knowledge and it is great to watch them mature and grow."

Most of the nurses say they spend about half their time in clinical work and hands-on education, with the other half devoted to administration. And while there are challenges, ranging from referral limitations to the fact that today's students have more psychiatric needs, job satisfaction is high.

As Scruggs put it simply, "I love it, love it, love it."

In your opinion

We asked the same question of nurses and nurse practitioners who work in college or university settings.

The question: In your opinion, what are the most important campus health issues?

Heidi Simpson, nurse practitioner and associate director of the Student Health Center, University of Mary Washington, Fredericksburg: “Newly found personal freedoms and time management are the most pressing issues in campus health. Somewhat surprisingly, sleep issues are at the top of the list … as well as sexual health issues and issues surrounding alcohol consumption.”

Betsy Gentry, program assistant for the University Health Center at James Madison University, Harrisonburg: “Alcohol and the behaviors associated with those social situations.”

Margo Potts, nurse practitioner in the Student Health and Wellness Center, Longwood University, Farmville: “The number one issue to students is stress, which manifests itself in many different ways. The number one public health concern is flu.”

Timmye Ross, nurse practitioner in the Student Health Center, University of Mary Washington, Fredericksburg: “What you expect: sex, drugs, alcohol and tobacco. It’s no different here than on any other campus, or for anybody else in this age group.”

April Scruggs, nurse practitioner and clinical director of the Student Health Center, Lynchburg College, Lynchburg: “I’m seeing more dual diagnoses of substance dependency and mental illness, and those need to be addressed through wellness education.”
--J.R.