The CCPH Featured Member is William Cody. William is Professor and Chair of the Family & Community Nursing Department at the University of North Carolina at Charlotte (UNC Charlotte). He is also the Executive Director of UNC Charlotte's Nursing Center for Health Promotion, which is an academically based free clinic serving women and children. William is passionate about healthcare that is community-based and truly centered on the needs of persons and families in communities. He communicates this vision to his students every chance he gets. He is proud that the Nursing Center is part of the solution and offers a demonstration of what is possible by providing healthcare effectively to some of the most underserved people in the United States. In the spring of 2003, William was selected for the Robert Wood Johnson (RWJ) Executive Nurse Fellow Program, a prestigious three-year advanced leadership program. He plans to leverage this fellowship to further community-campus partnerships and expand his work with underserved communities.
what is the mission of your organization?
A: The Nursing Center for Health Promotion is an on-going project of the School of Nursing at the University of North Carolina at Charlotte. Founded fourteen years ago, the Nursing Center was established on a volunteer service model. In subsequent years the additional components of clinical education, service-learning, faculty practice, and research and scholarship have grown and branched out. Our mission is to create opportunities for community-based education, professional healthcare practice, and scholarly inquiry while innovatively meeting the healthcare needs of persons who are homeless.
The Nursing Center is located on the grounds of
The Salvation Army Women and Children's Emergency Shelter, which houses
up to 250 persons at one time. We serve only the residents of this shelter,
utilizing the Charlotte Rainbow PRISM
Model. (PRISM stands for Presence, Respect, Information, Service,
and Movement — the five tenets of the framework.) We provide health
assessment, screening, treatment, nursing care, nursing case management,
health education, referrals, counseling, prescription assistance, and
other services. Our walk-in clinic is open five nights a week and we log
approximately 6,000 encounters a year, 1,000 of which are served by nurse
practitioners and 5,000 of which are served by registered nurses (RNs).
Approximately 200 students a year have at least one evening's experience
in our Nursing Center. Our community partners include the residents themselves,
The Salvation Army, and area nonprofits including Carolinas Medical Center,
A Child’s Place, Metrolina AIDS Project, Charlotte Community Health
Clinic, Community Health Services, and others.
A: We truly exist in the realm of possibility. As an academic nursing center, we offer a demonstration of what is possible by providing healthcare effectively to some of the most underserved people in the United States. We believe strongly in transprofessional practice, but as an on-going project of a school of nursing we also exist to demonstrate the value of a nurse-managed health center which reflects a growing national movement. Our identity is that of a nurse-managed center operating an on-site at a homeless shelter, guided by an exceptional model (the Charlotte Rainbow PRISM model). The term rainbow represents our commitment to the value of human diversity. We believe strongly in outreach to underserved persons in the places and ways that improve their access to services. Our model is anchored in the practices of attentive presence and listening. We are present with the community. This means actually being there face-to-face, being reliable, being with the community in spirit as well as immediate action, and staying with the community over time. We respect the community and the people who comprise it, profoundly, consistently, without exception, and demonstrably. This means that it is the community members’ visions of what is and what can be and their values and hopes and dreams, that drive our agenda as organizers and service providers. We listen as community members make their views and wishes known to us. We make information available to members of the community to support informed decision-making and self-sufficiency in healthcare. This means the information that people want and ask for, is in a context that acknowledges their personal freedom to make health-related choices and personal responsibility for self, family and community. We provide services to people in the community. This means that we bring something tangible, useful, desirable, and meaningful into collaboration with the members of the community. We encourage, support, and co-participate in the movement of individuals, families and groups. We follow the lead of the community members and change our agenda as the agenda of the people changes. We believe that by embodying this framework in practice, we communicate to students the values that guide our work.
A: I am passionate about healthcare
that is community-based and truly centered on the needs of persons and
families in the communities. I am also very passionate about communicating
this vision to students. I believe that the shifts in the healthcare system
to better serve those who are currently underserved should occur in tandem
with shifts in healthcare education to better prepare practitioner/providers
to offer care that is community-based and client centered. I am passionate
about nursing's role in the evolving healthcare system. Although nurses
are often referred to as the backbone of the healthcare system, there
are ways in which nurses are underutilized, especially around community-based
health promotion and care that extends beyond the simplistic parameters
of diagnosis and prescription. Finally, I am passionate about promoting
the vision of the registered nurse as a broad-based key practitioner/provider
A: My dream for the future of the Nursing Center for
Health Promotion is a greater integration of the education of nurses and
other health professionals, while expanding into other areas of serving
underserved persons. This would be a “center without walls.”
In addition, I envision multiple Nursing Centers and Neighborhood Health
Centers that address the needs and concerns of persons, families, and
communities across the board. I hope to see greater involvement of other
disciplines (beyond nursing), including social work, health promotion,
health fitness, and health administration. Presently I find that the needs
and concerns of the underserved and underprivileged are underrepresented
and misunderstood at most of the decision-making tables in our society.
It is my hope that by forging connections between students and the people
at a grassroots level, this will translate into a greater understanding
and greater representation of underserved populations in decision-making
discussions and ultimately a positive impact on all participants’
A: Have a clear, values-based model that drives your work and your organization. If you can’t find an appropriate model for your local needs, involve others in creating one, and make sure it is a good strong values-based model. Listen to the people you serve, respond to their concerns, make their agenda your agenda, and represent their views to others who wish to serve them. Look paternalism in the face and question what it is really all about. Some things in society are handled well paternalistically. MOST things are not! Unneeded paternalism is degrading to human dignity. The antidote to paternalism is listening to people’s concerns and working with them to address their concerns. The “beauty part” is that in actuality greater progress can be made, by anyone’s measure, when we practice this way.
A: Perhaps it is circular to say this, but the biggest challenge I face in working with the underserved is in recruiting and inspiring others to become involved. (I say that it may be circular because clearly this is why people are underserved in the first place.) People are afraid of and alienated by differences. Seeking middle-class and upper-class involvement with poor and underprivileged populations, one must be prepared to encounter “no” 90% of the time and focus on the 10% “yes” as a wonderful success. I have to admit that sometimes I struggle to stay positive in the face of societal apathy about the underserved. I remind myself that respect for human dignity also means respect for the freedom of the 90% to remain uninvolved! And I gravitate toward persons who share a value for working with the underserved while acknowledging others’ freedom to pursue other goals!
A: I urge all policymakers to provide substantial and tangible support to innovative models of non-traditional healthcare. The Nursing Center that we operate is amazingly cost efficient. For $500 we can provide in a 4-hour shift services for which a mainstream clinic would bill well over $2,000 (not including volunteerism or involved parties who write off a loss). And our client satisfaction surveys are overwhelmingly positive literally every single time we tally the results. We reach a population that mainstream providers do not and cannot reach. We partner with the system to mainstream every client to the greatest extent possible — working with the system and not against it. Yet support for such non-traditional models remains relatively thin on the ground and most policymakers are not familiar with these innovative models of care. So from my perspective there is no higher priority in healthcare in relation to serving the underserved than providing substantial support to innovative models of non-traditional healthcare.
A: I joined CCPH to learn and
to grow and ultimately to provide better leadership for fostering community-campus
partnerships at my home institution. I also want to support the organization,
become progressively more involved, and offer my talents as an actively
involved member when and where appropriate. I describe the organization
to colleagues as a wonderful organization that supports those of us working
in community-campus partnerships to do our work better and to advance
the movement. I believe very strongly in the purpose and goals of CCPH
and hope to become progressively more involved over time.
A: As an academic partner, I believe that community-campus partnerships offer opportunities for leaders in higher education to make their institutions and curricula more relevant and responsive to the needs and concerns of real people in the communities with whom they interact. Community-campus partnerships can dramatically enrich education, enhance learning, and promote good citizenship by providing the means by which students can make meaningful contributions to communities. I personally have learned from the Principles of Partnership established by CCPH. As I said earlier, it is an invaluable experience for students to be exposed to these principles in action early in their careers so that they can stay more in touch with the real needs of the people as their careers move along.
A: The CCPH
Principles of Partnership have been very helpful in guiding my thinking
about how to provide leadership to the Nursing Center and its operations.
I believe that everyone involved in community-campus partnerships should
familiarize herself or himself with those principles. They may actually
deepen the challenge, and in that way they are eye-opening, but they support
keeping a sustained focus on the needs of the people – keeping one’s
eyes on the prize -- which is what we know we must do to do the job right.
A: Through my work as a nurse academic, including some
philosophical and theoretical studies and writings, I have gained a deep
and thorough understanding of what it means to listen to people, to value
their perspective as they experience and describe it, and to interact
with people with a profound respect for their human dignity. This belief
system is at the core of everything I do and it energizes my will to organize,
collaborate, raise funds, manage, administer, and so on. Over the years
I have also picked up some skills in these latter areas! I like to think
that I have learned something over the years about how to bring a vision
to fruition, and that is what I hope to continue to do through my work
For more information please contact:
William K. Cody