Helping those from away right here at home

Contact: Christine Phelan Kueter: 434-982-3312

(5-1-2012) ER nurse Catherine Herrington (CNL ’11) spends a lot of time sweating the small stuff.

That’s because the small stuff is often what comes between a patient – especially those who don’t speak English, or come from cultures a world away – and the right treatment.

“You take it for granted when you, say, hand a patient a prescription, that they understand how to use it,” says Herrington, who lives in Charlottesville and works at UVA Medical Center (pictured above, right, with outreach coordinator Michael Sanchez). “They look at the piece of paper and ask themselves, ‘How is this supposed to make me feel better?’”

The “they” in this case are migrant workers most often from Mexico, Central and South America who come to pick and process Virginia’s range of seasonal crops. If they speak English, many do so haltingly. They’ve often left families behind, and live in camps that provide basic, sometimes meager facilities. Between the long work day, its physical toll, tight finances and problems with transportation, language and education, finding health care for routine and acute issues is often not even on their radar.

And that’s where Herrington and the team from the Blue Ridge Medical Center’s Rural Health Outreach Program (also known as RHOP) fit in.

Initially armed with a degree from U.Va. in cultural anthropology, Herrington – who received her master’s degree in nursing in 2011 through U.Va. School of Nursing’s Clinical Nurse Leader program, a two-year track for those with at least an undergraduate degree in another field – turned to nursing to serve the underserved. She’d seen the dramatic work nurses could do during an outreach trip to Guatemala, and wanted to do more, but closer to home.

Enter Herrington’s partnership with Blue Ridge Medical Center, which she does part time, in addition to her work at UVA Medical Center. In Charlottesville and Albemarle and Nelson counties, RHOP – a single arm of the BRMC, which provides more than 9,000 patients with primary care – tends to the health needs of hundreds of migrant workers during the state’s long growing season and, as weather trends warm, sometimes even year-round.

Many migrants, says Herrington, suffer from heart, weight, alcohol and blood sugar problems that can morph into more devastating chronic diseases, like diabetes and high blood pressure. As part of a bilingual team – a community health promoter, program coordinator, and nurse practitioner– Herrington dispenses A to Z health care from the inside of a specially outfitted, if close-quartered van. Inside, hips and elbows bumping, the team does everything from prostate checks to blood tests, offering detailed advice to address what ails them: keeping carbs, blood sugar and dietary salt in check, using flip flops in the showers to keep foot fungus at bay, wound care, some alcohol and drug counseling, and how to fill prescriptions start to finish.

And, almost always, in Spanish.

“I’ve really gotten a sense of how culture impacts our perception of health and wellness,” says Herrington. “It’s why you ask, ‘Have you ever filled a prescription before in the U.S.? Do you know how to find a pharmacy? Do you know that Wal-Mart has a pharmacy, way at the back of the store?’

Their work, which Herrington says keeps many patients out of the ER, is done on site, after hours (often between 6 and 11 p.m.), in the dark, the heat, the cold, the rain.

She wouldn’t have it any other way. It is, she says, what nursing’s all about.

“It’s a sexy thing, to go hop on a plane and go and do work far away,” says Herrington. “But what I know is that my neighbors, two doors down, a half mile away, are just as detached from the health care system, and have just as many barriers as people a half a world away.

“I don’t have to go across the world to find a different culture,” she adds. “I can do it right here.”

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Photo: RHOP's Latino Outreach Team, in the mobile clinic van; Community Health Promoter Michael Sanchez, left; Catherine Herrington, right. (Not pictured: Program Coordinator Vanessa Hale; Family Nurse Practitioner Reagan Thompson)