Posted: Saturday, January 25, 2014
As a psychiatric nurse, Vilma Guevara, RN, saw many clients whose physical health challenges were getting in the way of managing their mental health symptoms, but her capacity to address their hypertension or diabetes was limited. Now Guevara is a nurse care manager on The Providence Center’s community support teams, where she can make a difference in the primary care of her clients.
Nurse care managers are part of a team of professionals dedicated to serving TPC clients experiencing severe and persistent mental illnesses. These nurses help their patients to understand physical health issues like diabetes, obesity, heart disease and high blood pressure.
“I always wanted to do more for clients who had physical issues that were creating a roadblock to achieving better mental health,” said Guevara. “Now I can help a client make diet changes or understand diabetes better. That is so fulfilling.”
Guevara is joined by JoAnn DeNapoli, RN, in the mission to help clients reach optimal health. A nurse in the mental health field for 16 years, DeNapoli also recognizes the benefit of integrated primary care and behavioral health. “When I began in this field, integration of mental and physical health didn’t formally exist, but I always saw the connection,” DeNapoli explains.
The nurses’ work centers around helping clients manage chronic illnesses, meeting with them approximately every three months. Often, this involves improving their health literacy, teaching clients how to test blood sugar levels with glucometers, suggesting better food choices and directing clients to smoking cessation groups held at The Providence Center. They connect clients to primary care, a task made simple by PCHC’s health clinic on site at 530 North Main Street.
Teaching clients how to advocate for themselves in the physician’s office is an important piece of the work Guevara and DeNapoli do. They encourage clients to write down questions ahead of time for the doctor.
Because clients often don’t feel the effects of a chronic illness until it has escalated, the nurses take an educational approach to motivate clients to introduce changes at the onset of issues. Showing clients the five-pound fat model is often effective. “They see what fat really looks like and they start to think differently about reaching for that fast food,” said DeNapoli.
Both bilingual and bicultural, Guevara is able to make a connection with TPC’s Latino population. “Food and celebrations are important parts of the Latino culture,” said Guevara. “We don’t want to lose those traditions, but I help clients make healthy adjustments to cooking styles and food choices.”
Guevara’s and DeNapoli’s work has proven itself. They have seen clients who no longer need cholesterol medication, a 100-pound weight loss, and countless other clients who simply feel better as a result of making a few healthy changes in their lives.