Nurse practitioner takes holistic approach to care

Posted on: 5/15/2014; Updated on: 5/15/2014
By Page Ivey, 803-777-3085

Sabra Smith found her calling doing research while working on her master's degree in public health at the University of South Carolina. She was studying symptom control among patients infected with HIV.

"I just discovered what a huge epidemic it is here and how strong the stigma around that disease is here in the Southeast and in South Carolina," says Smith, '04 MS, '07 BSN, '10 DNP. "The main reason I went to nursing school and got my graduate degree was to work with patients who were HIV-positive."

Smith is a professor in the College of Nursing, sees patients at the Immunology Center, one of the School of Medicine University Specialty Clinics, and is doing research on treatment for HIV-positive women after they give birth.

According to the U.S. Centers for Disease Control and Prevention, women who take antiretroviral medication during pregnancy can virtually eliminate the chance of passing the virus along to their children.

"We know medically how to prevent perinatal transmission, but the issue surrounding women actually getting tested during their pregnancies and then the care of women after they deliver a baby is what I am interested in," Smith says.

After medicine has successfully prevented the baby from getting HIV from its mother, Smith says, it can be difficult to get women to continue with their treatment.

"If you have a single mother, if she has low income, if she has no support system, taking care of that baby on a day-to-day basis and keeping a house together or having somewhere to stay may be a higher priority for her than coming to appointments and taking her medicines every day," Smith says.

Smith says she has to remind herself every day that her patients' priorities are different than her priorities and understanding that is the key to effective health care treatment.

"At my practice at the clinic, most of my patients are low-income. Several of them have unstable housing situations. They have mental health concerns. They have chaotic lives in general," she says. "Often those problems have to be addressed and helped and stabilized before that patient really cares about taking their medicines for their HIV."

It is that holistic approach to health care that led her to become a nurse practitioner rather than going to medical school.

"By the time I was making that choice, because it wasn't my first degree, I think I had a sense of my own outlook and approach to health care and treating patients and disease prevention," she says. "Nurses are not as disease-focused. We try to treat the patient, treat the family."

She brings that same approach to the classroom, says Kimberly Glenn, assistant dean of undergraduate studies for the College of Nursing.

"It's been said that nursing is an art and a science and she truly blends that," Glenn says. "The science part is her knowledge and her understanding from those major courses. Her art is she can be very nurturing and very consoling, yet still hold students to the standard that we want them to have as nurses."


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