Thomas McCafferty and J Glenn Smith Health Clinic

     At the start of my Capstone experience, my partner and I both had no idea what it meant to work with the "Cleveland Health Department." We were not informed about what activities we would be doing and what type of facility we would be placed at. We both were very excited to discover that our experience meant that we would be at STD and reproductive health clinics (both of which are sister clinics to the Free Clinic on Euclid Avenue). This meant that we would be acting as nurses in the clinic: administering medications (oral and IM), providing patient education, and addressing diagnoses with patients. I was honestly not looking forward to the Capstone because, from my prior knowledge, most of the "Capstone experiences" were not the type of public health I enjoy. Luckily, this one was!

     There are two clinics that my partner and I switched between: Thomas McCafferty Health Clinic at W. 41st and Lorain on the West side of Cleveland and John Glenn Smith Health Clinic at E. 111th and St. Clair on the East side of Cleveland. Both clinics are set up almost identically. The clinics are walk-in based, but also take appointments. The patients come in to a waiting room, are checked in by the secretary and wait for triage, where a medical assistant discusses why they have come to the clinic and takes their vital signs. The patient then has to have blood work done, if they have come for an STD screen. If they are just coming to the clinic for immunizations or treatment for a prior appointment or for a refill on birth control, they can come straight to the nurse. The nurse (me) then can complete TB testing, give birth control, or other medication if the nurse practioner has previously placed an order to do so. Then the patient can leave. However- if the patient requires a regular exam, the patient returns to the waiting room until the nurse practioner is ready to see them. The NP completes an exam, has the patient leave a urine specimen, and the NP then goes to the lab to check the samples she has taken (urethral or vaginal or anal swab) under a microscope to test for STDs. The urine specimen and a gram stain are sent to a lab for culturing (so the patient receives the final results 7-10 days after their visit- which is why they sometimes have to return to the clinic for treatment only). Finally, after the NP makes a diagnoses based on what she finds during that initial visit, the patient can see the nurse (me) for treatment and confirmation of diagnoses and for education. I gave patients a variety of every diagnoses in the STD world: positive for HIV, chlamydia, gonorrhea, syphilis, trichomoniasis, herpes, genital warts, and non-gonoccal urethritis. Not to mention informing the patients of non-STD related infections, such as bacterial vaginosis, yeast infections, and fungal infections. I also had to inform women whether they were pregnant or not, and provide information on resources if they had a positive Hcg test.

     This was extremely exciting at times and interesting- the patients were as young as 12-13 and as old as 77! I love working with a large variety of people, so hearing their stories was great for me. I'm very thankful that I had this experience and that I was placed at this clinic- it was definitely an excellent fit for me.