After working 23 years as a Licensed Clinical Social Worker in both the private and public sectors, Susan Martin decided to pursue a new profession. Led by an interest in psychopharmacology and the desire for an intellectual challenge, she enrolled at the University of Southern Maine-College of Health Professions in Portland, and studied to become a Psychiatric Nurse Practitioner.
Susan heard about the National Health Service Corps (NHSC) through classmates and a physician recruiter at St. Mary’s Regional Medical Center in Lewiston, Maine. She received an NHSC loan repayment award.
Now one year into her NHSC service commitment, Susan has embarked on her new career providing psychiatric services at two community family practice clinics serving underserved patients in Lewiston. “One clinic is a more traditional family practice while the other is an inner city site caring for a more impoverished and disenfranchised population,” says Susan.
“The community has changed from a vibrant manufacturing and mill town to an economically depressed area, and there has also been an influx of African immigrants which includes many political refugees with serious issues of trauma,” she explains. “Working with refugees has heightened my awareness of trauma related to civil war. Many of these refugees were displaced in refugee camps, witnessed violent acts or have been victims of abuses such as rape and torture.”
Caring for up to a dozen patients a day, Susan collaborates with the clinics’ family practitioners in an integrated health model, providing behavioral health care and medication management. She has found that working with patients who are immigrants also requires her to frequently collaborate with cultural brokers and patients' family members in order to bridge cultural barriers and tribal traditions that often compete with traditional western medicine.
“Respecting patients’ beliefs and cultural and religious traditions about origins of mental illness promotes culturally competent care,” says Susan. “Educating patients and their families about the origins and scientific basis of psychiatric illness, together with positive clinical response to treatment, helps remove the stigma of behavioral health treatment and cultural barriers that inhibit use of psychiatric services.”
She notes that her relationship with patients is an important part of her role as a psychiatric nurse practitioner. “Establishing a positive rapport with patients who have not previously had access to psychiatric care is critical in letting patients know they have a provider they can trust. Gaining patient trust helps adherence with treatment recommendations and prevents hospital readmissions.”
The gains patients make clinically can greatly assist their assimilation into the community, observes Susan. “I’ve seen personal growth in some of my non-English speaking patients who have stabilized to the degree that they are able to complete English classes, obtain a driver’s license and seek employment.”
“Working with underserved multi-ethnic populations has increased my awareness of the barriers to health care,” says Susan. “Serving the underserved is rewarding. It is difficult to imagine another setting where I would encounter such a wide ranging spectrum of needs and diagnosis, mostly stemming from lack of opportunity and poverty.”