Shireen: Shirley Roberts is a registered nurse and certified case manager with over 30 years experience in health care and management for the last six and a half years, surely has been employed as the clinic nurse manager at the grace community clinic, a faith based nonprofit free charitable clinic located in Grapevine, Texas. But welcome, Shirley.

Shirley: Thank you.

Shireen: Great to have you on. So with that, surely I want to go into a little bit about your story. What prompted you to become a nurse? What was that journey like?

Shirley: Well, I have always wanted to be a nurse. When I was a little child, I wanted to be a nurse and I would read all the books, the novels, the stories about nurses, some biographies about nurses. So this was something I always wanted to do. And my journey through school, and then I was a lighter starting college, I started college, and then I ended up getting married. And so then life changed, took some other changes, but then I didn't ever let go of that dream. And so here I am, as a nurse, and been doing it for over 30 years globally.

Shireen: And then how did you make your way to integrate and specifically community clinics?

Shirley: Well, the beauty about nursing is that there's a lot of avenues you can take. I started out or just an ER nurse. I did that for 11 years, I went into doing case management. So as managing the catastrophic patients, medically complex patients, I did that for probably about five or six years. And then I ended up doing many different things, hospice and lots of other things. And I guess the last seven years before I came to grace, I was working at a surgical hospital, managing a surgical unit. And I will tell you that the direction that I took, God was speaking to me in my heart, and he was speaking to me probably for about four months that there was something that I needed to do. And I have never experienced that feeling that there was something there was something telling me that I needed to just give it to God and that he's going to point me in a direction that I've never taken before. And so during that period of time, we made some other changes. And that little nagging feeling went away for a short period of time. But it still wasn't that God was still speaking to me. And so one day, I just happened one Saturday, I opened up my personal email, I'm in working mail all the time. So don't normally don't do that with home email, but I did. And there was this position that was available to run a grace community clinic. I was a little familiar with that clinic as I had submitted a volunteer application some time ago. But because I was so busy with my mother and my regular job, I was unable to do it at that time. So I thought, Oh my gosh, let me look into this. And I did. And it was a six weeks journey before I made that decision. But after I made that decision, I didn't have that gnawing feeling anymore. So it was I would, I would know for sure that this is where I need to be.

Shireen:  

Oh, that's so lovely. I love this story. So naturally I want to learn a little bit about the types of services that you provide to your patients, generally free COVID what kind of services you guys provide there?

Shirley: Okay, well, we are as you said, nonprofits so there's a lot we have many programs within grace and the program that course is tied to write uh, you know, here is with the clinic, and we provide a medical home for clients that do not have another place to go for a medical home. We provide internal medicine family practice. We provide the GYN for the women, the mammograms we provide a array of services we can provide podiatry, we can provide orthopedics consults, we can provide other services but we're like a medical home. So our clients rely on us a lot. And we're really close to our clients and we're helping them the big thing with not having these clients do not have any insurance, and most of them are not eligible for other insurance programs. So we have our big goal here at Grace is to keep them healthy. And so we do that with a lot of education, a lot of motivation, helping these clients. A lot of Have comorbidities and so we're working with them to understand their comorbidities and how they can improve their health. So there's a lot of education that goes on besides the physician does the provider visits, a lot of education with diabetes, pre diabetes, we provide nutritional classes, lots of nutritional classes. a registered dietitian that also works with our clients on a one on one. And then group classes also, of course, we've provided some services for your diabetes patients as well, when and that was an amazing six weeks class that we provided for the diabetic clients. And it really gave them another avenue to get education. And also, it was very, they were very connected with our registered dietician that you had on board, they related to him, they worked, I was just very impressed with that class. And then from that class, I was very impressed with the next three months or so when we started looking at their lab work, they had decreased their hemoglobin a one C's, and there, they were losing some weight and and that was very motivational for them to feel like that these changes that they had learned were really making a difference on their health.

Shireen: One of the one of the biggest things that I like, and thank you for that, because one of the biggest things I like is to see that impact at the end of it. All right, when you start seeing people sort of change their way they're used to eating and sometimes it is as simple as helping them figure out from an educational standpoint, hey, these are the foods that you're eating and building that consciousness for this is actually not good for you. And they're like what I didn't, you know, so it is really, it's an interesting journey.

Shirley: It was, it's been a very interesting journey, and anything that we can do to help our clients give them more education, that's what we want to do. We want to prevent them from having to go into the hospital and having to seek other services that we're not able to provide here.

Shireen: Yeah. Now given and so of course, this was pre COVID. But given everything with, with COVID-19. With folks, you know, staying at home, not able to come in as much into the clinic, how have things changed? How were you able to provide the services that you normally do in this time? 

Shirley: Yeah, that was an interesting journey in itself. Because here we were in the middle of March, you know, trying to figure this COVID-19 out and how we're going to continue to service our clients. And then all of a sudden, when things started shutting down, and this, you know, shelter at home started, then we had to immediately had to make some other changes. And I've been blessed to be a part of the Texas Association of charitable clinics and the National Association of charitable clinics. And one of the things that we looked at immediately was telehealth. And we researched a couple of avenues for that and immediately put that in place in march towards the end of March. And we got the buy in with our medical director, Dr. Lee and our other providers, and we just started doing it. And I don't know how we did it, but we did it. And that was the most amazing journey. We are still doing telehealth, we will probably continue to Intel health through this COVID-19 but even maybe after COVID-19 because code, telehealth has a place and healthcare and this is a way we can provide another way to get with our clients and have a face to face because we're doing it with the video. And have another way too, if they can't come into a clinic visit, this is another way to meet their needs.

Shireen: And I like that, that you talk about how telehealth will also be valid, you know, posts all of you know all of this COVID. And you know, sort of going through this, but I like that point because I think one of the main things that telehealth has now done is to say we can provide that service and people don't have to come in and sometimes it's not. It's not only a pandemic, sometimes it's people just having a busy life and not being able to, you know, physically come in for an appointment.

Shirley: Or they don't have the transportation to get in and you know, their transportation has broke down or they don't have a ride. They thought they were going to have a ride and they don't have a ride. Well then we can do this. We can even do you know what we were talking with the other providers about. We can do some on site visits once we open up completely, but then we can also offer telehealth also during that clinic time maybe towards the end of our clinic for the ones that weren't able to come in.

Shireen: With the patients that you serve, and first I want to get an idea for the types of patients that you serve Shirley, but also, where have you seen the biggest gap in care, even their education about COVID-19?

Shirley: The biggest gap? Probably they were scared to death when they heard things were closing down and that we were not going to be, they thought we weren't available. So that was one gap. And we had to get on the phone and do a lot of I know, I rely. 80% of my clients are Hispanic, and I am not bilingual. So I rely on my two employees, and now a lot of volunteers to help us with translation with our clients. So we started reaching out to our diabetic clients, and I pre diabetic clients, and some of our other clients that have comorbidities to let them know, we're still here, we're just not officially doing clinics here. But we are also doing telehealth. So that was a gap. You know, and I think that we had to hurry up and, and get that education out. So there was a lot of time for my employees with that initially. But once the word of mouth got out there, then they were calling us and, and realizing and, and grace Besides this, we have a food pantry. And we have Client Services. And so they had to find another way, you know, to service it. So instead of clients coming in and shopping into food pantry, they had to figure out, okay, they're putting boxes together, and then they're there, they will drive do a drive through and pick those boxes, that we had to educate them also to let them know, we're still we're still here, even though COVID-19 is going on. And you know, one of the hard things that I will point out is with our clientele, it's a low income and loss. And most of our clients do work, but they're working in a service organization. And so they're working in hotels, they're working in restaurants, well, those were immediately, you know, they started closing down all those restaurants. And so that was hard for them, because, you know, probably 90 something percent of our clients lost their jobs. And so here they are home with no income. So that education to get out that graces here we have a client service that can see if we can assist them temporarily with their rent, or, or help with a utility bill or something that keep them afloat till things started opening up again.

Shireen: That's one of the wonderful things that I admire about grace, because you're not only looking at it from one lens, but you're sort of have this this multi lens approach to where you're looking at the health and wellness, you're also looking at financial assistance, you're also looking at food access, I love how all of those different components sort of come together and provide a comprehensive service rather than services and silos.

Shirley: And I think that we have 60 some odd employees at Grace and I think one of the things, you know, because we had just closed our stores down. We have three retail stores that we have a donation station, and they had to close down just like our other community cert, you know, stores and things had to close down. And so just figuring out another way to serve them and figuring out how we use our employees and maybe put them in different areas to keep them you know, from having to stay home and some of them did have to stay home for a little bit till we could start opening up again. But then, you know, when you look at the community as a whole, I guess I look at you know, my clients here at Grace, usually they don't have jobs they can do at home. So you know, a lot of employers were able to take some of these employees and put them working at home, but our clients didn't have that option. So Grace's was even more important. Places like grace, were important to help during that period of time to get them back on their feet.

Shireen: Has there been a, from the clinic aside, has there been an impact on their health from the stress, the anxiety, just the uncertainty? 

Shirley: There has been and we're seeing people and the blessing here and I could use another counselor or two, we're seeing them being more open to counseling and without so service that we provide here. So we were able to do that telehealth too. And so we're seeing more clients need that service, we see more stress in the community. And I think that we just have to be open to helping these people during this period of time. It's called a strike. It's called trust for us too, because, you know, to think that we had to change our whole way of doing business and to ensure that we are still providing and I think I was scared at one point of that we were going to be able to provide maybe don't get away have donated medications over the counter medication. And that's a big piece of their treatment and, and donated insolence of what if we couldn't provide that and what would happen. And the blessing that we have been able to is to continue doing that, but in a different way. I think one of the other things is the well woman visits and the mammograms those have had to put be put on hold for a few months during the this time, and we use Texas Health mobile unit for our mammograms, and they're going to start hopefully, we're going to be starting back up, they don't maybe they're going to start up in May, but they're not going to be able to so we're hoping in June, we'll be able to get that back on for a service because that is a service that is needed for these ladies. And we have identified. I know last year, we had, I think three clients that we had in depth three or four clients that we identified with breast cancer, if we hadn't had that surface, those ladies wouldn't have had that, you know, and they would have been more advanced before it got diagnosed. So the blessing is that we'll be able to pick that back up next month. And our well walnuts are going to start at the end of this month. I have two GYN doctors that are volunteers for us that will be here on the 28th of the 29th. And all of this is going to be done all everybody that once we start back up, we're going to be doing pre screenings, we're going to make sure that we don't bring someone in that could be have a condition that could you know, it can be contagious, we can have COVID-19. So there's a lot of behind the scenes, we'll be doing a lot of what we'll have to do, you know, to keep everybody safe to keep our client safe or our employees safe, and you know, all of our volunteers safe. 

Shireen: Right. So just have to screen them and make sure they're there okay to come in and then provide services as you were before.

Shirley: The beauty of everything is that we're working together as a community. And Terry, I will say Tarrant County, I'm so blessed to be in Tarrant County. And Dallas has done a great job too. But Karen county has a pre screening tool. And so there's our electronic health record, but it's a little bit more detail with Tarrant County Health Department. And we're helping our clients, if they feel like they have symptoms, we're doing, helping them with that pre screening tool. And we've had a couple that once we do this pre screening tool, if they show that they need to be tested, then we can make an appointment for them to get tested through terron. County, at one of the sides. And that's a blessing.

Shireen: So you talked about all the ways in which you're helping folks really, how can folks learn to find a way to help you what are, what are the needs of the of the clinic? How can folks sort of get plugged in and be able to help?

Shirley: Well, with Grace, we can't do it without our community support. So one of the things they can do, they can go online at Grace grapevine.org on our website, and there is a list of food needs. There's a list of over the counter medication dates that are there. They're also, they can go on Amazon and order things through Amazon that will go directly and be delivered to Grace. That's another way to do that. And it's all on the website. And then you know, there's always We appreciate all the financial donations that have come in during this period of time to really help us help with these clients that need assistance with their utilities, and they're real, and things like that. So there's always that way. And then the other I will always say, as if none of that is something that someone can do. They can pray for us and pray for our clients and help us during this period of time. We've been getting some wonderful, wonderful donations, and I've just been really amazed. pp, which is personal protective equipment. That's something that's a shortage across you know, the country and we have been blessed. Just recently people have made facemask fours. People have donated PP for us. I've had students that in high school, that and it was on the news a few weeks ago they made faceman this boy got this idea. Well, his mom is an anesthesiologist and he wanted to get back and do something to help with this PP shortage. So he developed a way to make face shields, and he had two other students help him and his private school in South Lake Clarendon and they have been amazing. They had delivered 100 facials to us. They're also going out in the community and delivering food to some of the other charitable clinics to help them with this need. Once we open up we're gonna be wearing PP, we're going to be needing to wear these protective things to protect ourselves and our clients.

Shireen: Lovely. And that's such an endearing story when we have students and young members of the community actually step in and provide this.

Shirley: Oh, I'm so impressed with these guys that did this and and just, oh my gosh, they're serving hearts is wonderful..

Shireen: So with that, surely we're toward the end of the episode, I would love to ask at this point, how can people connect with you, learn more about your work?

Shirley: Well, go on Gracegrapevine.org. and you can find Shirley Roberts, you can find my email address, my telephone number. You can look at some of our other programs that we have and you can also communicate with them directly.

Shireen: Sounds great. Well, it was a pleasure having you on, Shirley.

Shirley: You're paying for everything, you're doing to help our community.

Shireen: Thank you so much for your time.

Shirley: Thank you.

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