2019 Tennessee Nurses Association Book of Reports

2019 TNA-TSNA JOINT CONFERENCE | NURSES: THE REAL SUPER HEROES
Findings:
Resiliency can mitigate the stress of the workplace environment to protect against burnout symptoms in new
nurses. Education and organizational support can increase individual resiliency. More resilient nurses report higher
intent to stay.
Recommendations for Practice/Research:
Incorporating resiliency education and tools into orientation for new nurses can help to reduce reported burnout
symptoms and increase intent to stay. Retention of nursing staff is essential for patient safety and high quality care.
Implementation of a Medical-Legal Partnership for a Low-Income Community at a Nurse-
Managed Health Center
Problem Addressed:
Carrie Plummer (Presenter)
Jillian Scott (Co-Presenter)
The Clinic at Mercury Courts (CMC) is a nurse-managed, community health center serving low-income patients
experiencing homelessness in Davidson County, Tennessee. In 2017, 68% of CMC patients lived 200% below the
poverty threshold and 38% experienced extended periods of homelessness. A review of the evidence-based
literature reveals that health-harming legal needs (HHLNs) negatively impact health outcomes. CMC patients
report having HHLNs, which currently are beyond the scope of the services provided by the CMC.
Objectives:
1. To determine how best to integrate a medical-legal partnership (MLP) into the existing care delivery
infrastructure of the Clinic at Mercury Courts.
2. To identify the most common Health-Harming Legal Needs experienced by CMC patients
3. To identify necessary key stakeholders for successful establishment and integration of an MLP
Methods/Procedures:
Students established relationships with key stakeholders, including: 1) CMC leadership, staff, and patients; 2)
Belmont Law faculty, and; 3) Legal Aid. After obtaining IRB approval students conducted a focus group with CMC
patients to identify commonly experienced HHLNs. Qualitative data was transcribed, coded, and analyzed for
emergent themes.
Findings:
Twelve participants identified tangible (lack of transportation, mobility limitations) and structural (powerlessness,
lack of dignity) barriers to accessing care, as well as HHLNs, including: lack of health insurance, disability, and
records expungement. Participants highlighted the need for continuity and follow-through to establish a sense of
community, compassion, and trustworthiness.
Recommendations for Practice/Research:
Over the course of 6 months, a team of nursing students identified the steps necessary to integrate a medical-legal
partnership into the existing structure of the Clinic at Mercury Courts. In addition, they established relationships
with key stakeholders in both the community, the clinic, and consolidated the necessary academic partnership
between the nursing and law schools. This provides the next cohort of MLP students access to a network of
collaborators ready to engage in the next steps towards implementation of the MLP. Analysis of the focus group
data identified patient interest in and need for specific medical-legal services. Given the importance of continuity
and follow-through for patients, a continuous and structured leadership team will provide stability as students
cycle through each academic year.
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