What started out as a university-led project more than a decade ago has become a community-wide effort to help provide northern Kentucky’s underserved population with access to healthcare.

NACU Photo by Timothy D. Sofranko

“I want them to be aware of where that patient in that bed came from and where we’re sending them home—because there might not be one…”

By Jayna Barker
NKU Marketing + Communications

Northern Kentucky University’s Nurse Advocacy Center for the Underserved (NACU) started with one student. Marian Cummins was a registered nurse working at St. Luke Hospital in 2003 when she began pursuing her master’s degree at Northern Kentucky University. By the time Cummins was ready to begin her capstone project, her interests had broadened to issues faced by underserved populations in the community—specifically those of women who were living in local homeless shelters. But when Cummins started searching for existing research on these populations, she didn’t find any. It didn’t exist.

With the help of her faculty advisors, Cummins came up with a model of care—at the time called “Health from the Heart”—that would place registered nurses in shelters to aid homeless women and hopefully improve their healthcare behaviors.

The initiative started with a one-year pilot study at the Women Residential Addictions Program (WRAP) in Covington. Cummins and her colleagues quickly discovered a singular issue faced by many of the women they served. Before the Affordable Care Act, most, if not all, of these women didn’t have health insurance—or even a family doctor—and were using the emergency room for their primary medical care.

Cindy Foster, current NACU director and professor of nursing at NKU, says that after just one year of stationing nurses in the Covington shelter, ER visits from the group dropped 70 percent. The program was able to secure grant funding and placed nurses in two more shelters—the Welcome House, and the Women’s Crisis Center (WCC), both located in Covington. After six months, ER visits dropped another 60 percent.

For three years while the grant funding lasted, the initiative was highly successful. Of course, when the grant money was gone, the needs in the community remained. The nursing faculty decided to convert the program into a volunteer model, at which point the program officially became known as NACU.

Currently, NACU operates five clinics locally. Volunteer nurses and students work at the clinics one day a week, screening patients for medical conditions like the flu, pertussis, HPV, and collaborating with the Health Department and state of Kentucky to provide vaccinations. In addition to patient triage, nurses assist patients by helping them get medical cards, making doctor appointments, and answering other medical-related questions. In 2012, NACU was honored with the Award of Excellence in Public Health by the Northern Kentucky Independent District Health Department.

“A lot of our patients need a boost in confidence,” Foster says. “It’s really empowering them to feel like they can take care of themselves.”

While the nurses aren’t there to replace traditional healthcare, they serve as a bridge between the women who live in the shelters and the healthcare they need. But more than healthcare, students found that women—especially at the WCC—needed to feel a connection to the community. NKU students recently started activity therapy with residents by giving them materials to make bracelets. Some nurses also bring in community representatives who offer finance, health, and cooking programs.

Foster wants students to understand that there are many cultural, psychosocial, and physical factors that place women at risk for poor health—especially homelessness.

“When I came to NKU, I got attached to these patients,” Foster says. “You can’t let go of it because it becomes your mission. I don’t want students to be obsessive, but I want them to be aware of where that patient in that bed came from and where we’re sending them home—because there might not be one.”

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