Through two clinical placements within a summer, Megan Madole honed her clinical assessment skills and learned more about providing health care in rural areas.

Madole, a doctor of nursing practice (DNP) student, completed placements at the Beaver Island Rural Health Center and the Peshawbestown health clinic that serves the Grand Traverse Band of Ottawa and Chippewa Indians.

Tribal Clinic

Madole is the first DNP student from Grand Valley’s Kirkhof College of Nursing (KCON) to work at the tribal clinic. Mary Robinson, regional nursing programs coordinator at KCON, has a longstanding relationship with the clinic's administrator and broached the idea of placing a DNP student there.

"I knew this would be a wonderful opportunity for our students," Robinson said. "Most of their clinical assignments are in urban and suburban settings. We are grateful the Grand Traverse Tribe is welcoming our nursing students and providing such an incredible rural care experience for them."

Clinic administrator Ruth Bussey said it has been a longtime initiative to develop local resources before sending patients to other providers for follow-up care. “Collaborating with the Kirkhof College of Nursing is one more way we can provide our community with the health care and resources they deserve,” said Bussey. 

Madole, who lives in Traverse City, said working at the clinic fully leveraged her DNP training, as nurse practitioners care for the whole patient and consider the many factors impacting the health of a patient. Madole worked closely with Robinson and Bussey on cultural orientation prior to starting her work at the clinic.

“I wanted to go into primary care to make an impact outside of the hospital," she said. "Working at the tribal clinic has been an invaluable opportunity to better understand rural health, the unique challenges rural communities face, and the importance of culture." 

Beaver Island Rural Health Center

Madole's placement on Beaver Island was the start of a partnership between KCON and the health center, and paved the way for other Grand Valley students to follow.

Beaver Island is a popular summer tourist destination in Lake Michigan; most visitors arrive by ferry or airplane from Charlevoix. During the summer, the island's population swells from 600 year-round residents to 5,000.

The health center is operated by nurse practitioners, which Karen Burritt, associate dean for graduate programs for KCON, said makes it a perfect partner for Grand Valley. "It's run by nurse practitioners who are eager to help rising nurse practitioners while also learning from them," Burritt said.

Madole stayed on the island in a guest house owned by Don Spencer, who is on the health center's board of directors. He said board members enthusiastically supported the partnership with KCON.

"It’s terrific," Spencer said. "The students have experience in outreach, and getting someone to serve on Beaver Island is tough, it's so isolated, and it places a burden on staff and budget. Maybe over time, through one of these students, we will find new staff."

The center’s board collaborates directly with part-time physicians and specialists. Donna Kubic, managing director, said the staff can see about 20-25 patients daily in the summer and less than five a day during the winter months.

Madole said she enjoyed the mix of tourists who needed acute care for dog bites or bee stings and the islanders who needed preventative care.

"It's been very interesting to see how a nurse practitioner has developed such a role in rural health and how health care is delivered," she said. "During an assessment of a patient, we're utilizing their whole history and taking the time to hear their entire story."