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Licensed to care: Physician assistant,s nurse practitioners assume important role at rural clinics.


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  • THE COURIER PAGE cedar valley business

    By JIM

    TRIPOLI Erin Ott doesnt want to be a doctor, so she does what she thinks is the next-best thing:

    She is a physician assistant.

    Ott, who treats patients at Covenant clinics in Tripoli and Fairbank, is one of a growing number of medical profes-

    sionals who choose a so-called mid-level path between MDs and nurses and become PAs and nurse practitioners.

    Contrary to common belief among businesses that have well-ness programs, PAs and NPs the latter fall into a broader category of advanced practice nurses are distinct from each other.

    The majority of employers use APNs and PAs interchange-ably, said Roger Tracy, assistant dean and director with the Uni-versity of Iowas Carver College of Medicine, which trains both. Lets take an urgent care cen-ter or emergency department, for example. Most likely theyll fill an opening with either. NPs and PAs will tell you theyre different from one another. They dont take lightly the fact that employers think of them interchangeably.

    Volume 6 l No. 1

    ON ThE cOVER


    Cedar Valley Business Monthly is a free publication direct-mailed to more than 6,500 area businesses.

    Contact us at (319) 291-1527 or P.O. Box 540, Waterloo, IA 50704. Physicians assistant Erin Ott of Waterloo.

    See MId-LEVEL, page 6

    EdITORIAL cONTENTNancy Raffensperger 291-1445

    Jim 291-1598

    AdVERTISINGDavid 291-1403

    Jackie 291-1527

    Sheila 291-1448

    SPONSORScONTENTSUniversity of Northern IowaStruggling economy promotes burst of necessity entreprenuership ............ page 9

    Wartburg collegeWartburg extends student recruiting to the international stage ........................ page 24

    Outsourcing poses cybersecurity risks for some, opportunity for others ........ page 36

    dECEMBER 2011

    Mid-level medicinePhysician assistants, nurse practitioners fill key roles in rural communities

    RICK CHASE / Courier Staff Photographer

    Physician assistant Erin Ott of Waterloo helps fill the need for medical personnel in rural areas. Ott splits her time between covenant clinics in Tripoli and Fairbank.

    Inside:Students hone skills at Salvation Army clinic.PAGE 4

  • THE COURIERPAGE cedar valley business monthly

    By JIM

    WATERLOO A patient drops by the Waterloo Salvation Army office in need of medical help. Another drops by asking for vita-min tablets. Yet another is having a scheduled blood-sugar check.

    Its all possible because Allen College runs a free clinic Thurs-days and every other Wednesday at the Salvation Armys head-quarters at 218 Logan Ave.

    Both providers and patients benefit, said Ruselle DeBonis, a doctor of nursing practice who teaches in Allen Colleges nurse practitioner program.

    Those are skills theyll need in order to diagnose, said DeBonis, the director of the clinic one of only two in Iowa staffed entirely by nursing personnel.

    This is the first time theyre getting out to see patients, at least this way,DeBonis said.

    On this particular raw, gray November day, three nurse prac-titioner students are present to treat as many as 15 to 20 drop-in patients during the clinics 9 a.m.-to-5 p.m. shift.

    Each student puts in 20 hours of volunteer service at the clinic launched by DeBonis, herself a member of the NP programs inaugural class of 2000.

    The patients, bless their hearts, are very patient and allow

    us to take our time, DeBonis said.

    All students treating patients are well into their two-year sequence in the program. Two of them, Amy Macal, a 15-year registered nurse from LeMars, and Julie Leary, a five-year RN from Cedar Falls, are reporting for duty for the first time.

    Both got into Allens NP pro-gram because they saw an oppor-tunity to fill a need created by a

    lack of family physicians in Iowa, particularly in rural areas.

    Theres a growing need for nurse practitioners to help with the shortage of doctors, said Macal, a nursing graduate of Northern Iowa Community College in Calmar who earned a bachelors degree at Winona State University in Minnesota.

    Macal said her goal is to operate a practice in a rural area.

    Its harder to get family phy-

    sicians in the rural areas, and health care demands are 24-7, and many people dont want to work 24-7 anymore, so its nice to have the nurses being able to step up and cover those odd

    hours, weekends, holidays, that many physicians dont want to do, said Macal, a third-semes-ter NP student.

    dECEmbER 2011

    Student NPs hone craft at Salvation Army clinic

    RICK CHASE / Courier Staff Photographer

    Salvation Army Clinic Director Ruselle DeBonis and Amy Macal, who is studying under DeBonis to be a nurse practitioner, look over a patient file Nov. 3 at the clinic in Waterloo.

    See CLINIC, page 5

  • THE COURIER PAGE cedar valley business

    LEARNING WITH LUNCH Dealing with Bullies at Work December 7, 11:30 a.m. - 1:00 p.m.

    Eldercare and Your Employees January 10, 11:30 a.m. - 1:00 p.m.

    Creative Problem Solving January 26, 11:30 a.m. - 1:00 p.m.

    SUPERVISION AddrDecember 9, 1:00 p.m. - 3:00 p.m.

    Motivating Your Employees December 15, 12:30 p.m. - 2:30 p.m.

    Constructive Performance Reviews December 15, 2:30 p.m. - 4:30 p.m.

    Constructive Performance Reviews January 13, 1:00 p.m. - 3:00 p.m.

    January 26, 12:30 p.m. - 2:30 p.m.

    AddrJanuary 26, 2:30 p.m. - 4:30 p.m.

    For more information or to register, call 319-296-4290.



    The varied experience Macal as getting in NP training is crucial, she said.

    The experience is pretty vast in school, she said. Obviously, you have Salvation Army, public health, emergency rooms, ICU. Its a wide variety if you want it to be. If you prefer one specific area, thats an opportunity for you as well.

    Becoming a nurse practitioner seemed like a logical career step for Leary, a graduate of Hawkeye Community Colleges nursing program.

    I became fairly proficient and felt very confident in my nurs-ing skills, and I wanted to boost that, said Leary, who earned a B.S. in general studies from the University of Northern Iowa.

    The career transition brings plenty of challenges, particularly time, Leary said.

    It takes two years, but its every day, she said. I have two little girls, and its just busy. When Im not working Im on call, and when Im on call Im on call for more than one thing.

    Leary said when her training is done, shell go where shes

    needed.Wherever theres a need,

    something thats available when I get out of school in a year, she said. Im very open to what is available and where I can be helpful.

    The move to NP also is a career step for Erica Jensen, a Waterloo native who became a registered nurse in 2008 through Allens accelerated program.

    When I was in nursing school I knew I wanted to go on and further my degree, so I knew this was the path I was going to take, said Jensen, who was starting her second day at the Salvation Army clinic.

    Its wonderful, she said of her clinic experience. You dont get the opportunity to volunteer much when youre in school just because youre so busy. You enjoy the experience. You get to see people youre going to be seeing every day.

    Jensen said much of her nurs-ing experience has been in fast-paced settings, such as emer-gency rooms, and she said she is comfortable in that kind of high-pressure environment.

    But I also am kind of looking forward to a slower pace, so well see where it goes, she said. Im not sure where I want to go with it.

    CLINICFrom page 4

    dECEmbER 2011

    UPSexpects6%riseinholidayshipmentsNEW YORK (AP) Online

    gift-buying procrastinators are expected to drive a 6 percent increase in UPS package deliver-ies the week before Christmas this year.

    The worlds largest package delivery company says it expects a total of 120 million packages around the world during the companys peak week, com-pared with 113 million last year.

    The Atlanta company predicts its busiest day will be Dec. 22, when it expects to deliver 26 mil-lion parcels.

    UPS smaller rival, FedEx Corp., expects to handle 17 mil-lion packages on its busiest day, Dec. 12. Thats 10 percent more than its busiest day last year. Both companies have seen steady growth in shipments through-

    out the holiday season because of growth of online shopping.

    UPS said shoppers are ordering gifts online closer to Christmas. Thats creating a compression of the companys busiest days in the last two weeks before Christ-mas. The peak season tradition-ally started around Thanks-giving before the rapid rise of e-commerce.

    United Parcel Service In