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Holistic Care, Healthier Community
A patient arrives for an appointment at the LSU Health New Orleans School of Nursing’s nurse-managed Dental and Medical Primary Care Clinic (DMPCC) complaining of a dry mouth and bleeding gums. A dentist – aided by hygienists and shadowed by dental and nursing students – examines him, noting red, swollen and receding gums. The students ask the patient about his overall health, and he says he’s frequently tired and thirsty and has experienced headaches with blurred vision. A er a brief discussion, the dentist and students refer him to the nurse practitioner for a blood glucose test. His reading is over 200 mg/dL. He is given a preliminary diagnosis of type 2 diabetes, and is referred to the clinic’s nurse practitioner for further tests and follow-up care.
This type of interdisciplinary health care is provided to patients in an underserved area of New Orleans each day through the DMPCC, an integrated primary and dental care clinic launched in 2016 as a collaboration between the LSU Health New Orleans Schools of Nursing and Dentistry.
“You can tell a lot about someone’s health by looking into the mouth, and the clinic shows both nursing and dental students that systemic health
connection and o ers patients a more holistic health care experience,” says Deborah Garbee, PhD, APRN, ACNS- BC, Associate Dean for Professional Practice, Community Service and Advanced Nursing Practice. “When patients come to the clinic, they’re triaged based on whether their chief complaint is medical or dental. The nurse practitioner and dentist perform a brief joint exam, huddle along with students to discuss what issues need to be addressed, and then decide with the patient what services he or she prefers to have that day.”
This patient-centered approach allows patients to be active participants in their care. It also o ers a “one-stop shop” where a person can be examined by and discuss health issues with dental and medical professionals, undergo lab tests, access preventive care and wellness resources, and get referrals to specialists, as needed.
Practice-based, Collaborative Learning Benefits Students and Patients
Nursing and dental students ask patients questions at intake, administer screening questionnaires, sit in on many examinations and are involved in patient education based on the nurse practitioner’s or dentist’s advice.
“Because they’re also meeting with students, patients feel like they get more attention and interaction, someone to listen to their concerns and give them options to address those concerns. They don’t feel hurried or like they’re not being heard, which is
a common problem in busy medical settings,” says Dr. Garbee. “And, our students are getting these important interprofessional experiences that show them how important collaboration will be in their practice.” Nursing and dental students learn to work on a team, communicate with other care providers and ensure that the care they provide is collaboratively focused on the patient’s best possible outcome.
“They gain confidence, knowing that they can speak up and be respected and valued contributors to the care team,” Dr. Garbee explains. “They get hands-on experience working beside experienced nurse practitioners and dentists. And they learn to interact e ectively with patients.”
Patients, practitioners and students have expressed a high level of satisfaction with this fully integrated model of care. Down the road, Dr. Garbee says it would be wonderful to add a behavioral health component to the clinic, addressing another community need.
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