Nurses partner to care for rural Acadiana

The Fleur de Lis Community Clinic in Cankton averages between 50 and 55 patients each day. Most patients arrive at the clinic in cars or trucks, but bicycles, tractors, lawn mowers and occasionally even a horse can be seen in the parking lot.

“This is a very rural population,” said Judy Guillory, FNP, MSN, RN. “A majority of our patients qualify for Medicaid, and they have nowhere else to go nearby.”

Guillory and her partner, Angela Neely, FNP, MSN, RN, opened the clinic in 2005 using a business plan they wrote as a joint project while working on their nurse practitioner degrees.

“It was a plan for a community health clinic,” said Neely. “We looked at it and thought, ‘why not?’ The more we talked about it, the more we knew we could do it together.”

Cankton, a village of 487 according to 2012 population data, is located midway between Lafayette and Church Point in St. Landry Parish. Some patients travel 20 miles or more to be seen at the clinic.

“Our patients come from Acadia, Lafayette and St. Landry parishes,” said Guillory. “Some of them end up here because they can’t get in to see their regular doctors.”

The clinic sees a large number of patients from Church Point, a town west of Cankton. “There’s not much west of here,” said Neely. “There are a few doctors, but they all practice part time and will be retiring soon. We probably see five or six new patients a week from Church Point.”

To help meet the growing need for accessible health care in the area, Guillory and Neely have plans in the works to open a satellite clinic in Church Point. “We’ll manage the clinic ourselves and hire two additional nurse practitioners to see patients,” said Guillory. “We’re very hands-on here. We don’t hire somebody to take care of the business end. We manage the finances, order the supplies and do all of the day-to-day tasks required to run the business as well as see patients.”

The clinic provides care for patients of all ages. Staff members perform physicals and minor procedures, treat chronic diseases, give immunizations and provide all other services within a nurse practitioner’s scope of practice. According to Guillory, it’s the interpersonal contact with patients that sets a nurse practitioner apart from other providers. “We listen to them; we touch them. That’s what we learn to do as nurses,” she said.

Guillory and Neely said the biggest challenge to providing services is government regulation. “The regulations don’t make sense,” said Neely. “For instance, we can monitor a patient’s diabetes and prescribe drugs, but we are not allowed to prescribe diabetic shoes. We can admit to the local hospital, but we can’t admit for home health services.”

Nationally and in Louisiana the Future of Nursing Campaign for Action is working to ensure nurses are able to practice to the full extent of their education and training. That will require the health care community and policy makers to come together and put the needs of patients first.

“We just want to be able to take care of our patients,” said Neely. “If some of these needless barriers were removed, our patients would benefit because it would shorten the amount of time it now takes for them to access needed medical services, equipment and supplies.”

Photo: From left: Angela Neely, FNP, MSN, RN, and Judy Guillory, FNP, MSN, RN, stand at the entrance of their clinic.