Sara
has been a pioneer in establishing nursing centers in several southern
states. These centers not only provide patient care but also give faculty
an opportunity to practiceto keep their skills current and maintain
job satisfaction.
Annette Frauman,
associate professor of nursing at Emory
Sara
was very intelligent, very
hard-working,and never hesitated to speak her mind. She knew where she
wanted to go. She was a challenge but an exciting one, even when you locked
horns.
Mary Hall 49N, 62MN, 83PhD,
Emory professor emerita of nursing
Everyone
in the town is thrilled to have us there, including the mayor and the
city council. The nurse practitioner who runs the clinic grew up there.
That makes an incredible difference to people in the community because
they know and trust her.
Sara Barger, 73MN,
who oversees the Capstone Rural
Health Center in Parrish, Alabama
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Ever since high school,
Emory Medal winner Sara Barger has shunned tradition to do what she loves
bestproviding health care for people in rural areas.
by
Pam Auchmutey
June 4, 2001, was
a day of renewed hope and celebration in Parrish, Alabama. After more
than a year without a primary care facility, residents of the small Walker
County town had a local health clinic once again. As those associated
with running the clinic will quickly tell you, business has been steady
ever since.
Were seeing between 15 and 20 patients a day, reports
Jeri Dunkin, program director for the Capstone Rural Health Center and
a professor of nursing at the University of Alabama (UA) in Tuscaloosa
some 55 miles away.
In a short time, the health center has become a trusted resource for folks
in Parrish and beyond. Like much of the state, Walker County is made up
of rambling farms and tiny communities, miles away from the nearest physician
or hospital. When residents there get sick, they often depend on Medicaid
or Medicare, while many others are uninsured. For those reasons, people
put off going to the Capstone Rural Health Center until they are quite
ill.
Caring for those patients requires a lot of quick thinking and resourcefulness,
according to Kathleen Williams-Thomas, the family nurse practitioner who
operates the center. To handle the caseload, she relies on a licensed
practical nurse, an office manager, and eager students from the Capstone
College of Nursing at UAs Tuscaloosa campus. Seeing patients in
a rural setting like Parrish can be quite an eye-opener for student nurses
as they jump in to assess patients, draw blood, and help with whatever
else needs to
be done.
Its a worthwhile experience, but it can really be hard for
students, says Williams-Thomas. Our patients have no routine
health care. When they come in, theyre falling apart. The challenge
is to educate them and find creative ways to care for them when they dont
have the money to pay for medications or risk losing their jobs if they
take time off to come and see us. We dont have a social worker,
so we have to use every resource in the community. It helps students to
see these patients and what theyre going through.
Thats exactly what Sara E. Barger, 73MN, had in mind for students
when she became dean of Capstone College of Nursing in 1995. A public
health nurse at heart, Barger has a distinguished track record in setting
up health care clinics run by nurses and developing models of faculty
practice in schools of nursing. And she continues to serve Emory as an
adviser to nursing faculty and students involved in statewide public health
efforts and local community service projects.
She is one of the most valued leaders in nursing today, says
Annette Frauman, associate professor of nursing at Emory, who has worked
with Barger over the years. Sara has been a pioneer in establishing
nursing centers in several southern states. These centers not only provide
patient care but also give faculty an opportunity to practiceto
keep their skills current and maintain job satisfaction.
Last fall, Emory recognized Bargers contributions to her profession
and alma mater with an Emory Medal, the highest award given to university
alumni. She is the seventh alumna from the School of Nursing to receive
the honora distinction that Barger ponders to this day.
Ive always done what excited me, but Im still not sure
thats the best way to build a career, explains Barger good-naturedly.
I never intended to end up in nursing education. My mother and sister
wont let me forget that!
Breaking the mold early
Barger is referring to her childhood on a farm in southern Maryland, where
the women in her family traditionally became teachers. She broke that
mold in high school by joining the Future Nurses Club and working summers
as a nurses aid at the local hospital, where her supervisor was
a graduate of Emorys nursing school.
I was so impressed by her, says Barger, who to this day cannot
recall the nurses name. She knew so much, yet she was very
caring with patients. And she was very kind to me. She had the most unusual
cap, and she looked great in her uniform. Those things really impress
you when youre 15 years old.
Another chance encounter through the Future Nurses Club fueled Bargers
admiration for nurses and her determination. After I went out with
a public health nurse for the day, I was totally sold on becoming a public
health nurse. The opportunity to see what she did made a real impression
on me, says Barger. Those of us who practice nursing tend
to forget how important that can be.
With her goal clearly in mind, Barger enrolled in nursing school at the
University of Maryland and tried hard to follow the traditional route
of becoming a medical-surgical nurse after graduation. She chose instead
to begin her career as a public health nurse in Prince Georges County,
Maryland. Barger was assigned to a large rural tract where she practiced
home health care, provided mental health care services to the community,
rotated among five different schools, and counseled families about their
health and well-being through well-baby clinics and the like.
I loved the diversity, she recalls. I would never make
a good assembly-line person.
Barger served five years as a public health nurse and nursing supervisor
in Maryland and Virginia before moving with her husband to Atlanta. She
enrolled in the masters program at Emorys School of Nursing
and soon made herself known.
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Governor
George Busbee presented Sara Barger with her certificate in public
management in 1978. At the time, she was based in Athens, Georgia,
with the states Department of Human Resources. |
Sara was very
intelligent, very hard-working, and never hesitated to speak her mind,
says Mary Hall 49N, 62MN, 83PhD, now professor emerita of nursing. She
knew where she wanted to go.She was a challenge but an exciting one, even
when you locked horns.
During one of her graduate classes, Barger heard a visiting nurse practitioner
describe setting up and running a primary care clinic in northeast Georgia.
There was no physician or community clinic in the areashe
was it, says Barger. I was excited about what she did because
it was so important.
Ironically, after completing her masters degree, Barger joined the
Georgia Department of Human Resources and began to establish primary care
clinics in the very same health district. She secured the federal funding,
found space for the clinics, had them spruced up, hired the nurse practitioner
to run them, set up the record-keeping system, and reported back to the
federal government on their progress.
Intent on strengthening her administrative skills, Barger became a certified
public manager with the state and eventually completed a doctorate in
public administration at the University of Georgia as she continued to
operate nurse-managed clinics outside of Athens, Georgia.
Coming in through the back door
She never imagined doing anything else, even when a colleague called from
South Carolina to ask Barger if she would consider a teaching post in
the nursing college at Clemson. Of course Barger said no. But then the
caller talked up another position that involved running a clinic. That
caught my interest, says Barger. Thats how I got into
nursing educationthrough the back door.
She arrived at Clemson College of Nursing in the early 1980s as coordinator
of its Nursing Center and a spanky brand new assistant professor. She
subsequently rose through the ranks to become the department head for
professional services and a full-fledged nursing professor. The move to
Clemson afforded her the luxury of implementing projects and programs
free of mandates set by state or federal law. Suddenly, I could
do anything I wanted, Barger says. It was up to me to figure
out what to do and how to pay for it.
Understandably, she bumped into some brick walls along the way, which
ultimately deepened her appreciation for mentors like the late Mary Lohr,
then dean of nursing at Clemson.
Before I moved to South Carolina, I had worked in public health
for 17 years and knew how to set up clinics, but I had no experience in
nursing education, says Lohrs protégée. She
took it upon herself to position me. She made sure that I got on the right
committees and met the right people on campus and around the country.
Eight years later, Lohrs patient mentoring, coupled with her own
drive, led Barger to take on a new role as professor and chair of the
nursing school at Northern Illinois University. Once there, she received
a federal grant to set up a rural health clinic at a local community college
to serve students, their families, and nearby residents, including Latino
migrant workers. Yet, with all the leadership and organizational skills
she had to offer, Barger realized that running a clinic and running a
nursing school were two different animals. She often sought the counsel
of Billie Brown, the retired nursing dean of the University of Texas at
Austin who had recruited her to Northern Illinois.
Brown offered some sage advice. Choose your battles carefully and decide
what hill you want to die on. Consider whether your decision will make
or break the quality of your program. Find a way to make a decision youre
comfortable with that will propel the school forward.
Those were valuable lessons for me to learn, says Barger.
One of the things Im proudest of is having spent half of my
career in practice. That has made me broader as a dean than if I had spent
my entire career in education. I love partnering with people. I love interdisciplinary
projects. The result is much better than what any of us can pull off by
ourselves. The seeds of that are in public health nursing. The nurse heads
the team that brings different resources to the table to help a patient
who has a particular set of needs.
By the time Barger arrived at Northern Illinois, she had lived in the
warm Deep South for nearly 20 yearsa fact made more apparent after
Barger and her husband experienced the harshness of Midwestern winters.
An opportunity to return south arose four years later, when the dean of
UAs Capstone College of Nursing retired. There was an added attraction.
During Bargers interview at Capstone, she met Dr. Sandral Hewlett,
the director of a large primary care clinic system, and saw the possibilities
unfold. I began to think of all the partnerships we could form to
expand health care services in the area, Barger says.
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Kathleen
Williams-Thomas (left) and Jeri Dunkin help provide much-needed primary
care services and valuable learning experiences for nursing students
at the Capstone Rural Health Center in Parrish, Alabama. |
The Capstone Rural
Health Clinic in Walker County is the result. When plans to partner with
the primary care clinic system fell through last spring, Barger encouraged
Dunkin and Williams-Thomas to look for an alternate site, which they found
in Parrish. The three-room house, just shy of 1,000 square feet, had stood
vacant since the previous clinic
closed 17 months earlier.Townspeople pitched in to repair the storm-damaged
roof, while prisoners from the county jail painted the 1950s structure.
When the toilet backs up or something else goes awry, health center staff
call on the towns mayor, who doubles as the clinics janitor.
The health center also has a community advisory board comprised of laypersons
and professionals.
Everyone in the town is thrilled to have us there, including the
mayor and the city council, says Barger. The nurse practitioner
who runs the clinic grew up there. That makes an incredible difference
to people in the community because they know and trust her.
Williams-Thomas has quite a loyal following, with some patients driving
60 miles to see her. She travels a good many miles on her ownoften
with nursing and other students in towto visit homebound patients,
schools, and group homes for mentally ill and mentally retarded citizens.
Things at Capstone Rural Health Center are about to change. A second nurse
practitioner is being hired to help run the clinic and expand its services
to cover five counties served by the Northwest Alabama Mental Health Authority.
That means more site visits for Williams-Thomas and more hands-on experience
for Capstone students, UA medical scholars, and Auburn pharmacy students.
Back on campus in Tuscaloosa, Capstone students follow a new curriculum
focusing on the primary, secondary, and tertiary levels of prevention
instead of a traditional one emphasizing courses such as medical-surgical
and psychiatric nursing. At first, Capstone based its new curriculum on
a purist model of prevention across the lifespan. But that proved too
difficult for nursing undergraduates.
Some pieces just didnt work, says Barger. Students
at the undergraduate level cant think as broadly at that point in
their nursing education. Were still using the primary, secondary,
and tertiary prevention model, but weve broken it down for certain
population age groups instead of looking across the lifespan.
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Mary
Hall, professor emerita of nursing, was there for her former student
when Sara Barger received the Emory Medal during Alumni Weekend 01. |
Further changes are
in store for Capstone. After attending the Emory Medal award ceremony
last fall, Barger toured Emorys new School of Nursing building to
glean ideas for a new college of nursing building at UA. This university
(UA) is 155 years old, and there has never been a building on campus designed
to educate nursing students, says Barger. Nursing students
have special needs, and the facility for educating them needs to reflect
that.
A new building, a prevention-based curriculum, and a diverse clinic experience
in Parrish will go a long way toward attracting the type of nursing students
that Barger wants to reach. Capstone has also introduced a graduate program
on case management for rural populations, the only offering of its kind
in the state.
Our niche is ruraltheres no question about that,
Barger emphasizes. Weve had four hospitals in the surrounding
area close in the past two years, and theyre not going to reopen
again. So there is a real need for someone to work in those areas with
client groups who may have a particular condition, such as diabetes, or
special population groups, such as pregnant women, to determine what services
they need and where they can find them.
We want to recruit nurses from those areas into our program,
she adds. Our data tell us they are going to stay in those areas
because thats where their families are.
Bargers efforts to advance nursing education and practice have not
gone unnoticed, even before she received the Emory Medal. She has been
honored by the Alabama State Nurses Association for outstanding
nursing administration. In 1988, the South Carolina legislature passed
a resolution recognizing her achievements in nursing, and the American
Nurses Association awarded her the Honorary Nursing Practice Award. She
also received awards for nursing excellence from the Illinois Nurses Association
and the Alabama League for Nursing. Currently, she holds a prestigious
Robert Wood Johnson Executive Nurse Fellowship.
I want to learn more about how to get things done through people,
says Barger of her latest opportunity. Im not always good
at that. I can be much too driven at times than is good for me or the
people Im trying to lead.
That drive has been propelling her forward since the day a willful young
farm girl decided to break with family tradition and become a public health
nurse.
I tell nursing students to follow their passion, says Barger.
The wonderful thing about our profession is there are different
avenues to take. You have many experiences as a nursing student, some
of them more appealing than others. Set aside what youre supposed
to do and follow what you love doing. Youll never regret it.
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