10 Superhero Nurses Making a Big Difference
Every May, thousands of spectators swan through the stands at the Kentucky Derby, wearing floppy hats and drinking mint juleps. Meanwhile, in the barn area, sweat trickling from under their baseball caps, the "backside workers" muck the stables and walk, bathe, and rub down the horses. These mostly Latino laborers, who typically arrive in Louisville on temporary work visas, are up at 4 a.m. six days a week to keep the $4 billion Kentucky racing economy galloping along.
The laborers, most of whom lack health insurance and can ill afford to miss a day's pay, have been known to work through crippling pneumonia. Marina, a 35-year-old horse walker from Guatemala, once spent weeks ignoring near-blinding headaches. Then she stumbled upon a health fair at which free blood-sugar screenings were being offered by the Kentucky Racing Health Services Center—a clinic providing medical care for track workers for a $5 co-pay. Marina made an appointment for the following week.
The center, established in 2005 by the Kentucky Racing Health and Welfare Fund, was intended to be a walk-in clinic dispensing first aid and antibiotics. But founding director Whitney Nash, PhD, a nurse practitioner from the fund's partner, the University of Louisville School of Nursing, soon learned that many of the laborers had never been to a doctor; she'd do work-ups that revealed chronic issues the clinic was unequipped to handle. Nash, along with nurse practitioner Sara Robertson, wanted to do more for the patients. As Robertson says, "You can't treat a UTI without treating the diabetes causing it."
Over several years, the duo grew the clinic to furnish ongoing care for diabetes, hypertension, and allergies, and offer Pap smears and wellness exams. To encourage workers to come in at the first sign of a problem, Nash and Robertson became a two-woman PR campaign. They printed fliers that said, "Cuando estás enferma, podemos ayudarte. When you are sick, we can help you." They published health articles in the laborers' newspaper and enlisted the track's chaplain to spread the word. And it worked: Mammograms caught breast cancer; patients were diagnosed with serious but manageable heart problems. Says Robertson, "People are still alive because they were screened."
Marina is one of them. At her first visit, she was diagnosed with diabetes and taught to manage it with insulin; at her second, she discovered she was pregnant; in her eighth month, Robertson found she had preeclampsia and sent her straight to the hospital, likely saving Marina's—and her baby's—life.
Today the racetrack clinic is a full-service medical center booking 1,400 office visits every year. Patients can get same-day appointments three days a week; nurses are available for phone consultation daily. Diabetes and psychiatric prescriptions can be filled months in advance for workers who leave town to follow the racing circuit. They can also get counseling for depression, common among laborers who are painfully separated from home and family.
Other states have taken notice: Robertson has consulted with California activists about setting up clinics for agricultural laborers. "Healthy workers, healthy industry," Nash says. "It's a win for everybody."