Each February, students and scholars of all ages have opportunities to focus on important people and events in the history of the African diaspora.

Since 1976, Black History Month has been observed annually in the United States and Canada. The remembrance has its roots in 1926, when historian Carter G. Woodson called for the observance of “Negro History Week.” Woodson chose February because it marked the birthdays of two Americans who greatly influenced the lives and social condition of African Americans: President Abraham Lincoln, who was born on Feb. 12, 1809; and abolitionist and former slave Frederick Douglass, whose exact date of birth in February 1818 is unknown.

For some, February is a time to celebrate accomplishments of people who were ignored in the history books of previous generations. Others, however, question whether the time for this form of segregation is over. The Beacon used the Public Insight Network to ask what Black History month means in 2012.

Jeanette Hencken responded that she believes it is important for all people, regardless of race, to learn about African Americans and all who are not white males.

“Our textbooks give very little recognition to the part that these people played in contributions to our world,” she wrote. “There is even less discussion of why history is overwhelmingly [about] white males. It is very important for our young people to realize that there is a reason why so many women and men of color were not included in discoveries and contributions to our lives.”

Hencken is white. She teaches chemistry and forensic science at Webster Groves High School. “Having a specific observance time helps remind me that I need to talk with my students about these issues,” she wrote. “It is very easy to get caught up in the need to teach the required standards and forget to teach them about the everyday things that are important for them to know about.”

In February, Hencken, 52, talks with her students about the difficulties faced by men and women of color who wanted to be scientists.

“My students and I talk about the overwhelming number of white males who contributed to our understanding of the atom when we learn about models of the atom at the beginning of the year. I also share with them the few scientists I am aware of who were female or African American who contributed, but really were not supported or given credited early in the history of science.”

Provided

Diane Lynn

To Diane Lynn, the history of African Americans is important “because we are several generations of humans who have been cut off from their ancestors.”

“This country should have a month in which we learn, either through books or television, about different cultures or ways of life of the ethnic groups that make up this United States.”

Lynn, of St. Louis, is 52, identifies herself as black. She wrote that she attends ethnic festivals held throughout the year and reads National Geographic magazine to learn about people of various ethnic groups. She also enjoys books and foreign films that teach about other cultures and races.

Joy Moll, of Kirkwood, is interested in historical events. She wrote that she believes African-American history is important because it is American history. But Moll doesn’t not believe it is necessary, for her personally, to hold special observances at prescribed times of the year.

Moll, who is white and was born in 1962, facilitates a book club in Kirkwood that focuses on books about race in America. “For us, every month is black history month,” she wrote.

Carol Wright wrote that she could remember first when she first heard about “the troubling history of African Americans. I think that I only began to understand the depth of it with the historic crossing of the bridge in Selma, Ala.” in 1965. The event was a turning point in the American civil rights movement when white police attacked civil rights marchers — most of whom where African American — as they attempted to cross the Edmund Pettus Bridge. The marchers were trying to reach the state capital in Montgomery to push for equal voting rights.

Provided

From left, Carol Wright’s nephews, Graham Wright and Satya Thiel, and her grandson Brandon Becherer-Bailey.

“Until the history of all American groups is recognized, I think the observances will remain important,” Wright wrote.

“I belong to a multiracial family and it is interesting to me that when I take grandchildren who happen to be black/Caucasian, they often say to me, ‘Grandma, lots of people look at us.’ We are very far from a ‘post-racial’ society” wrote Wright, 69, who identifies herself as Caucasian. “I was never very aware of racism until I was in college and after college during the civil rights movement. I worked in Mississippi teaching adults to read in the late ’60s and was appalled to see how people lived (but yet had such a deep love and open heart for others). I know that I was quite naive at that time, but it was the beginning of my understanding. I took part in the Selma-Montgomery march and in the picketing of the Veiled Prophet Parade — I learned a lot through these exposures and never have been able to understand the hate that exists.”

June Green, of Tampa, Fla., is a historian who has specialized in African-American research. To her, “it is important to set aside a prescribed time to honor African Americans. We set aside a prescribed time to honor white Americans, such as Abraham Lincoln, Christopher Columbus and other white Americans who have contributed to this country’s history.”

Green, 60, identifies herself as black. She wrote that she participates in events each February “to remember Black-American contributions.” She wrote that she has learned about black history “from my parents, from my early childhood church lessons, from my college professors, and from reading books, and documents about black Americans on my on.”

As a former teacher I was so excited about the effort to “redesign the imagery” around teachers. I have had my share of apple ornaments for my Christmas tree, apple designed aprons, apple candles and wooden apples for my desk. It was so refreshing to see some activity on this topic of teacher image.

So check out Studio360’s video that outlines how this design firm arrived at a new “image for teachers”.

After viewing it, come back to this site and let me know what you think by leaving your comment in the comment box below this article.

Thanks and enjoy!

http://www.studio360.org/2012/jan/20/teacher-redesign-revealed/

Consumers filled 88 million discounted prescriptions at Walgreens last year under the chain’s agreement with Express Scripts, the pharmacy benefit company based in St. Louis. The arrangement gave Walgreens access to millions of additional customers while allowing Express Scripts to negotiate lower prices for company, government and union health plans.

While it may have seemed like a good deal for both parties, on Jan. 1, the relationship came to a halt. Walgreens decided not to renew the contract after negotiations broke down over new pricing for prescriptions. The upshot, says the drug chain, is disruption for customers whose drug plans are managed by Express Script.

“A lot of people are trying to find where they can go now to pick up their prescriptions,” says Robert Elfinger, spokesperson for Walgreens. He says many consumers are missing the convenience of filling prescriptions at his stores, some of which offered 24-hour pharmacies and drive-through service.

“A lot of them have long-standing personal relationships with their pharmacists, and they don’t want to give that up.”

To help customers make the transition, Walgreens is offering discount cards to give customers a break on many generic and brand-name drugs. But the catch is that customers must pay a small fee to get the discounts. The fee is reduced this year to $5 for individuals and $10 for families, instead of $25 for individuals and $35 for families.

Thom Gross, spokesperson for Express Scripts, says the disruptions have been minimal because Express Scripts has many members to accommodate those leaving Walgreens. Besides independent and hospital-based pharmacies, the network includes several major pharmacies, including CVS, Medicine Shoppe, Walmart, Sam’s Club, Costco, Target, Schnucks, Shop ‘n Save, Dierbergs, and Kmart, says Gross.

“We’re sorry that Walgreens unilaterally decided to leave our network,” he adds. “But we’ve been working with our clients and members to transfer prescriptions to other pharmacies in our network. There have been fewer calls or complaints than we anticipated. Our clients have decided overwhelmingly to move forward without Walgreens.”

CONSUMERS SCRAMBLE FOR ALTERNATIVES

But some consumers have complained, blaming both sides for the inconvenience.

“I think it is terrible they could not work out the deal,” says Scott Rhoades (right), 38, a resident of St. Charles. “It is inconvenient. Walgreens is my closest pharmacy. Now I have to go to another one that is farther away and in a grocery store.”

Echoing some of those views was Peggy Kruse (left), 68, a retiree who lives in Florissant.

“We switched our pharmacy prescriptions to Schnucks. We’re also switching more of our prescriptions to the Express Scripts mail order, which results in less co-pays. It’s OK, but the Schnucks is about 10 minutes and several stoplights away, while the Walgreens is less than five minutes and no stoplights away.”

Some consumers question the motives of both sides.

“It is a deplorable situation,” says Alice Geary Sgroi, a St. Louisan who did not want to disclose her age. “Two giant corporations, both of which I am sure are making profits hand over fist, will not budge to come to an agreement.”

Robert Valle (right, with his great grand daughter, Charli Clevert), 91, of Glen Echo Park, says he liked the convenience of using Walgreens. His new pharmacy, he says, “is not as convenient” while Walgreens was closer to his home and offered 24-hour service. He says he doesn’t understand why the parties have to fight “and leave patients out in the cold.”

He adds that he couldn’t have made the transition to another pharmacy without help. “I’ll bet lots of senior citizens are still confused and not getting their medication.”

Marilyn Vollet, 55, of Ballwin, chose CVS after no longer being able to have her prescriptions filled at a Walgreens. She says the switch has advantages.

“I don’t have to fight crowds at larger stores to get prescriptions filled. CVS will now get my shopping business as well.”

She described the dispute as “an unfortunate example of two businesses who made a non-consumer-driven decision and who put American’s health-care needs last. This situation is the poster child for the many things wrong with health insurance in this country.”

In addition to being charged a fee to join the Walgreens prescription club, customers face other disadvantages, Gross argues. He notes that the discounts apply only to certain drugs and that federal law forbids their use by recipients of Medicare, Medicaid and the Defense Department health benefit plan, one of Express Scripts’ biggest clients.

“We feel patients are better off transferring their prescriptions to a network pharmacy that can manage all their needs at no extra fee,” Gross says. “Transferring to another network pharmacy is very simple and very safe.”

OTHER PHARMACIES MAY SEE BENEFITS

Like many other area pharmacies, Schnucks has seen an increase in business since Walgreens left the Express Scripts network.

“Toward the end of last year, we did see an increase in the number of new prescriptions,” says Paul Simon, a spokesperson for Schnucks. “That has continued through the new year.”

Walmart spokesperson Tara Raddohl says many customers from Walgreens are also transferring their prescriptions to Walmart and that his company remains “prepared to take care of any customers put out by the situation.”

Prices offered through the Walgreens discount program don’t necessarily match those by some other area pharmacies. Raddohl notes that Walmart charges $4 for a 30-day supply of hundreds of prescription drugs and $10 for a 90-day supply. Schnucks offers a similar pricing schedule. At Walgreens, the prices of some of those same prescriptions range from $9.99 for a 30 day supply and $12 for a 90-day supply.

Although many pharmacies have been wooing Walgreens customers, none would reveal the exact amount of prescription business they have reaped. But the volume may be significant. Nobody could offer a breakdown of the local volume or value of Walgreens’ prescription through the Express Scripts network. But, nationwide, Walgreens recorded $5.3 billion annually in sales through its agreement with Express Scripts. The agreement with Express Scripts represented less than 10 percent of Walgreens’ prescription business, Elfinger said. By contrast, Express Scripts says the agreement represented two of every 10 prescriptions (or 20 percent) filled by all of its members last year.

“It’s important to know that the retail pharmacy network is very important to us and to our members,” Gross says. “We’re not trying to replace it with mail order.”

Still, each side says its decision amounted to doing what was in its best interest.

Express Scripts negotiates new contracts with its suppliers every three years and usually seeks lower prices.

“If you are dispensing drug X, you are doing the same service whether drug X costs $5 or $50,” Gross says. “If the price of that drug moves from $5 to $10, you are getting more money for doing exactly the same thing that you were doing back when the cost was $5. That’s why we try to negotiate a lower rate to make up for that inflationary impact.”

During the negotiations, Gross says Walgreens said it wanted an increase in rates.

“A whole lot of major brand drugs will lose their patents over the next few years and will be subject to generic competition,” Gross says. “Some of the changes Walgreens proposed would have restricted the savings available to our clients and patients.”

Walgreens spokesperson Elfinger says Express Scripts wanted to “cut our reimbursement rates to levels below the industry average cost of providing each prescription.”

He says the company offered to keep reimbursement rates at the level in effect at the end of last year. “We were not seeking an increase in rates,” he says.

Gross says his company was still open to negotiations even though a new contract year already had begun, but Walgreens says it has no plans for further talks.

WALGREENS REINVENTS ITSELF

This standoff comes as Walgreens is trying to remake itself. Just as pharmacies have changed from the days when customers could once find soda fountains and ice cream cones at every corner drug store, Walgreens says it wants to offer a new model.

The chain is beginning to stock fresh fruits and vegetables in some stores in neighborhoods having few supermarkets. The centerpiece of the new model is what’s known as a “health and daily living store,” whichs offer preventive care services, like vaccines, and in some cases, nurse practitioners to treat minor illnesses and injuries.

It’s unclear whether the parting with Express Scripts will cause Walgreens to scale back that model or expand it. But this much is known: No new health and daily living stores, or those selling fresh fruits and vegetables, will show up any time soon in St. Louis.

Eflinger, the Walgreens spokesperson, says, “We do have fresh food stores coming on line, but at this point we still don’t have any announcements about St. Louis.”

Meaning it won’t happen here soon?

“Right,” he says.

As this year comes to a close, the Beacon, with the help of the Public Insight Network, asked readers to share their assessments of 2011. In recent weeks, we posted two year-end PIN queries. The first asked readers whether their personal economic conditions — and that of the nation as a whole — were better, worse or the same as last year. In the second, we asked folks to tell us something specifically good that happened to them over the last 12 months.

The responses came in quickly to both queries. Over all, those who volunteered to share their stories, while totally unscientific, were more positive than negative. Still, there are those who are still struggling financially. They, too, are an important part of the story. Here, in their own words, are reader reflections on 2011. The answers have been edited for length and clarity.

ECONOMY

Provided

Joan Bohac

Joan Bohac of south St. Louis: “My economic condition is worse than it was a year ago. I have been out of work for almost two and a half years.”

Bohac, 60, has worked as an administrative assistant in college administration, and left her previous job at Fontbonne University because she wanted to “step back” to something a little less demanding.

“Most people think I want to step up,” she said in a telephone interview. “They don’t understand that I want to go down a notch.”

In her written response, Bohack said, “Our savings have been depleted, as has my inheritance. My husband gets paid at the end of the month and that money was gone by the fifth of the month because we were $800-plus in the hole when his paycheck was deposited, from the previous month’s overdrafts and bank charges to pay for those overdrafts. We are trying to stay focused to buy only groceries, gasoline and medicine… We live in a nice neighborhood in a house we love, but we are considering moving if I can get a job at Truman State University.”

Regarding the nation’s economy, Bohac said: “I feel like it is making progress. It seems like the jobs I can apply for have increased and I have received more contact following the submission of an application.” Still, she said, she’s waiting for an offer.

Joseph Czaicki of Crestwood: “My economic condition is better than it was a year ago.”

Czaicki, 52, worked for 20 years as an enforcement officer with the federal Occupational Health and Safety Administration before he took early retirement in 2009. After two and a half years of contract work, including projects for BP related to the Gulf oil spill, this year Czaicki was hired as a health and safety professional for the Missouri Department of Labor.

Czaicki said he believes the nation’s economy “is trending a little better, but nobody really knows.” He said he was troubled by the high volume of contract jobs. “Companies contract out for every little thing. As a contract employee, you are treated differently. You don’t feel like part of the team. Companies are trying to make more money because sometimes they don’t always pay as much to contractors as they do staff employees, and they don’t have to pay benefits.”

In addition, he said, sometimes the quality of the work suffers. “The jobs get done in a minimal way. That has added, in part, to some of our problems.”

Brian Hook of south St. Louis: “My economic condition is about the same as it was a year ago. I resigned from a full-time job to restart my own business.”

Hooks, 40, owns a media development and consulting business. “In the last few months I launchedB.R. Hook at and Missouri Journal. I think now is a great time to be an entrepreneur.” On a personal level, Hooks said his “economic picture is bright.”

J.D. Wolfe of Manchester: “We held our own financially. One of the good things about this past year is the number of people who have moved toward fiscal responsibility and away from crass consumerism… Moving away from the excesses of the consumerism of the past decade or more has made people focus more on the value of their families.

“Part of this is simply attitudinal,” said Wolfe, 63. “Today is always better than yesterday. And tomorrow will be better yet. Two of my children are in law school, incurring huge debt, but looking forward with positive attitudes to finding satisfying jobs that will allow them to live reasonably and pay off those debts. This is good.”

PERSONAL ACCOMPLISHMENTS

Lois Sechrist of University City: “After three years of being between jobs and being self-employed, I started a wonderful job in my chosen field, with terrific people, with good pay. ”

Sechrist, 51, is a sustainability analyst with Ascension Health. “I am an interior designer by training. After many years as a project manager and designer with architectural firms, I was a victim of the poor economy. I chose to reinvent myself and focus on sustainability practices. After three years of self-education, consulting, networking and volunteering in the field of green practices, I now have a position as an analyst at Ascension Health, responsible for monitoring environmental stewardship at 70-plus hospitals across the U.S.”

Brian Whitehead of Kansas City: “I ran the fastest marathon of my life (2:29:59).”

Whitehead, 29, who until recently lived in Richmond Heights, said he ran his first marathon in 2007. “I started running early in school — I ran in college. It became part me and part of my life.” He said he enjoyed running for the competition, the fitness and for fun.

Whitehead is an unemployed environmental consultant. He worked for several years for a firm that conducts environmental assessments, but found himself looking for work as the economy went bad. For a while, he was able to find part-time, contract work, he said. “It’s dried up since then. Running was one thing I could focus on that gave me something positive to work toward.”

Provided

Debora Davidson

Debora Davidson of Chesterfield: “I am an occupational therapist, and I have enacted a decades-long dream of having a private practice. In June of this year I began working with adults who have special needs and who want some help to achieve their life goals in terms of work, education, leisure and independent living.”

Davidson, 55, is a co-founder of Bright Futures: Personalized Transition Consulting. She is also an adjunct professor at Saint Louis University.

“Through my practice, I have been able to help many wonderful people to become active and productive. They have become happy and confident, and their families have felt relieved and pleased, too. I love my new career.”

FAMILY

Beth von Behren of Olivette: “I became the parent of adults, when one child graduated from high school and the other graduated from college. It’s hard to let go, but I am so proud of both of them that I haven’t yet noticed how empty the nest is getting. I was the first in my family to go to college, so we are now (thankfully) a two-generation college family.”

Provided

Beth von Behren (left) with daughter Sara Thomas.

Von Behren, 53, is the information officer for the city of Kirkwood. She said that for her family, the good outweighed the bad in 2011. “It was the best year in years. Everything is going well,” even though daughter Sara Thomas moved back home after graduating last spring from Wesleyan University in Middletown, Ct. “She’s looking for a job and writing a novel,” von Behren said of her daughter. Son Simon Thomas, who graduated from Ladue Horton Watkins High School, is a freshman at the University of Missouri, St. Louis.

Jessica Saigh of St. Louis: “I spend a lot of time with my family and friends. Experiences are worth more than money.”

Saigh, 45, lives in the Dogtown neighborhood with her husband and their two young sons. “It was a very hard year for us financially. My husband is self-employed, and I work part-time. Still, with a little creativity, we managed to find ways to have fun. My husband and I love the arts, but we couldn’t afford the ticket prices, so we volunteered to usher for the symphony and theater. We got to see the shows for free. We also visited parks and free museums with the kids. We also had potluck parties with friends.”

Saigh works part time as an adjunct professor at the University of Missouri, St. Louis, where she teaches English as a second language.

“The economy stinks, but I’m hopeful that 2012 will be better,” Saigh said. She invests in memberships at the Science Center and the Botanical Garden. And they live near the Zoo. “When we are completely broke, we can still go to these places and do all kinds of things.”

The videos really apply to the student in all of us. Take a look – just 5 minutes of your time and be sure to peak at the program resources in the bottom link too. The videos got me really excited!

Roadtrip overview video link: http://vimeo.com/32954496

PBS Season 8 RTN Release – Overview Video:
http://vimeo.com/25486027

The Roadtrip Nation Experience curriculum empowers students to define their own Roads in life by connecting their individual interests, as well as their education, to the real world.

To learn more about Roadtrip Nation Education’s programs, resources, and pricing, go to:
http://www.roadtripnation.org/programs.php

State laws linking truancy and suspension of drivers license for teens under 18 has mixed results – the jury is still out on its impact. The following article questions its effect for several important reasons especially the lack of understanding of “why” teens drop out of school.  Read the article and take the poll – what do you think about the effect of such a law?

StoryCorps visited Nashville Public Television in December as part of the American Graduate Let’s Make it Happen initiative. The Tennessean published a nice article on the visit and the project.

Click here to read the article

After reading the article, I was struck by these statements: “She (the teacher)  made me excited about being a learner. She would come into the class with things that even she learned. She taught you how to be a learner outside the classroom.”

These statements reminded me of what I had been reading in articles for American Graduate that show evidence that some students drop out because they cannot see the relationship between school and careers or future jobs. Do you think schools should move to an educational model that connects students (failing or disinterested) to community mentors and businesses and encourage entrepreneurial skills?

There are no doctors in Pilot Grove, Mo., but the town’s 825 residents have perhaps the best alternative source of health care, thanks to an enterprising nurse practitioner. She is Laurie A. Beach, who owns and operates the Pilot Grove Rural Health Clinic in the central Missouri town.

Beach also grew up in Pilot Grove, which is near Boonville. That she decided to return home and open a medical services business is unusual, health officials say, because few of the state’s 367 rural clinics are owned by nurse practitioners.

Health-care providers point to Beach as an example of the growing role that nurse practitioners are playing to bring medical care to rural Missouri communities where primary-care doctors are nonexistent or in short supply. Before opening the clinic in 2005, Beach worked for two decades at a health clinic at the University of Missouri at Columbia, where she also got her nurse practitioner training. Her clinic draws thousands of patients from within a 50-mile radius.

Nurse practitioners represent one of four specialties for people who obtain certification as advanced practice registered nurses, or APRNs. The other three are certified registered nurse anesthetists, nurse midwives and clinical nurse specialists. APRNs must complete over two years of college work for a master’s degree, followed by testing by a certification board. Missouri has more than 6,200 APRNs, two-thirds of whom are nurse practitioners. Depending on the specialty, average annual salaries range from $79,000 to $91,000.

Because of their advanced medical training, nurse practitioners are equipped to perform many functions of primary-care doctors, including diagnosing and managing some acute and chronic diseases and writing prescriptions. Their authority to write prescriptions in Missouri was expanded this month to include controlled substances. This new rule applies to all APRNs except nurse anesthetists.

NURSE PRACTITIONERS FILL A GAP

The demand for advanced practice RNs is expected to rise due mainly to projected growth in the number of patients, the influential federal Institute of Medicine says in a report, IOM: Future of Nursing Report Recommendations. Given that millions more patients are expected to gain access to health coverage through the Affordable Care Act (ACA), the report says the health system should tap into the capabilities of advanced practice RNs.

In Missouri, the new health-care law is projected to give a minimum of 374,000 more patients access to health insurance, which could put primary care within their reach. Because Missouri is not producing or attracting enough primary-care doctors, many say nurse practitioners could provide some of that care.

“Many of our physicians are going into specialties instead of family practice,” says Jill Kliethermes, the chief executive officer of the Missouri Nurses Association. “A good place for our nurse practitioners to fit in is by being primary-care providers, especially in rural Missouri.”

In addition, she says, using nurse practitioners saves money. They are reimbursed 85 percent of what the federal government pays a doctor to treat a Medicare patient.

But that doesn’t mean nurse practitioners are universally accepted. Some patients and businesses prefer physicians even though the evidence suggests that nurse practitioners are just as capable and, in some instances, more empathetic toward patients.

Patricia Brennan, a former health-care financial analyst at Barnes-Jewish Hospital, especially values the work of nurse practitioners. She used to work with patients sent to her employer for job-connected health needs, ranging from drug tests to work-related injuries. Although she personally didn’t mind receiving care from nurse practitioners, Brennan said a small number of companies requested doctors see their workers.

“Of course, we had to honor what the employers requested because they were paying the bills,” she says. “In many ways the nurse practitioners were better at observation and documentation than the physicians. As in most things, however, there were exceptions to this both ways.”

NURSE PRACTITIONERS EDUCATE PATIENTS

For the most part, patients have an added reason to feel comfortable with a nurse practitioner, says Susan Kendig, an attorney and nurse practitioner who coordinates the women’s health nurse practitioner program at the University of Missouri at St. Louis.

“One of the things that’s important to remember is that we were nurses first,” she says. “One of the primary things that we are taught and that we are expected to do and, quite honestly, are graded on is patient education — learning how to work with people, learning how to watch patient cues so that you can figure out that, while you may be here for a regular exam, you seem really stressed.”

While some doctors might focus only on the stated reason for the patient’s visit, a nurse practitioner might go further by chatting with the patient about the perceived stress, Kendig says.

“That’s the key to it, the fact that we’re bringing that background as nurses into that primary-care picture,” she says.

She says studies show that patients have good experiences with nurse practitioners.

“They like us. They tend to say that we’re better at helping them understand what they are supposed to do to stay well and because of that, they are more likely to do it.”

Her specialty as an nurse practitioner has been women’s health, providing care through home visits, schools and community agencies. In addition to delivering services, ranging from improving prenatal care to preventing osteoporosis, she says, “I could help them leverage resources in the community that were so important to them in staying well. Being a nurse practitioner helped me bring everything I was passionate about together.” (Gov. Jay Nixon recently appointed her to a state board to address prenatal care.)

NURSE PRACTITIONERS COMPLEMENT WHAT PHYSICIANS DO

Would it make sense, then, to put a nurse practitioner in every doctor’s office?

“We like to think so,” Kendig says, adding that she has lots of respect for what doctors do. “More physicians are beginning to see that it’s really not replacing the physician but working with the physician because it takes a team approach to get people as healthy as possible, to manage disease and keep it in control.”

One big bottleneck in the delivery of care, she says, is fragmentation of services. It occurs because a lot of information is lost as patients move from one part of care to another. Nurse practitioners can address the disconnect between people providing different levels of service to a patient. This is true, she says, “because we are already educated to help manage the care, help the patient go to the right place, help them navigate the system so there is better coordination of the care. That’s part of nursing education.”

RESTRICTIONS CAUSE CONCERN

She and other nurse practitioners also are concerned about barriers to doing things they were trained to do. The Institute of Medicine took up this issue in its report, calling on states and federal boards to remove restrictions that prevent advanced practice RNs and others “from practicing to the full extent of their education and training.” Barriers in Missouri, says the MNA, include the requirement that nurse practitioners coordinate their work with a physician no farther than 50 miles from the nurse practitioner’s practice in rural communities and 30 miles in urban areas. The doctors are required to check or review a nurse practitioner’s work every two weeks.

Kliethermes and others say this rule gets in the way of delivering services to rural areas where a doctor might be unavailable within a 50-mile radius of the nurse practitioner’s practice. If this were the case in Pilot Grove, Beach’s clinic would be out of business. But that’s where the folks in Pilot Grove, which is in Cooper County, have been lucky. While not many doctors practice in the county, a few work at Cooper County Memorial Hospital. That presumably makes it easier for Beach to meet the requirement to collaborate with a physician twice a month.

In any case, Kliethermes says, “The miles rule is unnecessary and very arbitrary and restrictive. With mobile communication, we can get in contact with the collaborating physician or whomever we need. It’s not as though the physician is going to go back and change the plan of care. A physician could monitor, but there is not any research data showing that this is necessary.”

Photo by Robert Joiner | St. Louis Beacon

Christine Smith, foreground, is a nurse practitioner at the UMSL health clinic. Looking on is Elise Grigaitis, an RN at the clinic.

Kendig said that most nurse practitioners are women, probably because most nurses are women and the path to becoming an nurse practitioner is through nursing. She says more men are entering the field.

Like many other former nurses, Kendig cites a variety of reasons for moving up to nurse practitioner or beyond. Earning a law degree, she says, has been valuable in helping her understand the legal framework surrounding health-care policy. She also has been a consultant to companies seeking insight into health issues, including the federal health-reform law.

Others, like Christine Smith, a nurse practitioner at UMSL Health Services, got into the field because of family experiences. She followed the work of her father and brothers who are either firefighters or EMTs in St. Louis.

“I always wanted to go and see what was going on if an ambulance drove by,” she says. “In the medical field, there is always room for learning because the field is always changing.”

She says her curiosity is more than satisfied these days just by caring for students and faculty who visit the UMSL clinic.

“This work keeps me on my toes.”

Contact Beacon staff writer Robert Joiner. Funding for the Beacon’s health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves. This report appeared first in the St. Louis Beacon on Dec. 15, 2011

Bullying has gotten a lot of press in the news lately from around the country. One of our PIN sources, Saras, pointed out an article that shows even teachers can turn into bullies. Saras has also written an interesting article on the subject.

Do you have insight to share on this issue? Do you see bullies in your school or even place of work? Share below in comments or even better share your insights in the PIN query: Bullying: Should you be concerned?

We hope to get enough interested people for an in-person conversation which could lead to a website video spot!