Carver Living Center
Jennifer Gentry uses her nurse practitioner training and specialization in palliative care to provide medical care for the residents of Carver Living Center (CLC), a 272-bed long-term care facility in Durham, North Carolina. One of the largest nursing homes in the state, CLC offers short-term rehabilitation, long-term care and hospice care. “Our motto is function and comfort,” Gentry explains. “In everything we do, we ask how it will benefit the patient— and how it will make the patient more comfortable or more functional.”
As a nurse practitioner in North Carolina, Gentry is able to act independently as an on-site primary care provider for facility residents. Rather than waiting for a patient’s doctor to visit or for a clinic appointment, Gentry can evaluate and treat a CLC patient with minimal delay. Often, problems that might have required emergency treatment and hospitalization are averted.
CLC’s progressive medical director, William F. Uthe, MD, has worked closely with Gentry to integrate palliative care into the normal flow of clinical care at the nursing home. Rarely does a week go by without a family meeting to discuss issues of palliative care and to determine what steps should be taken to ensure a resident’s comfort and continuing excellent care.
Careful Case Management
People are admitted to CLC from the hospital, from home and from hospice. At times, it is clear that the patient being admitted has only a short time to live. In these cases, Gentry convenes a meeting with the physician and family. “I sit down with family and review the patient’s advanced directive,” she explains. “We talk about what to expect. Everyone is different, and taking individual differences into consideration is one of the secrets to success.”
Collaboration at Work
Gentry frequently consults with the CLC nurses at the bedside. “I validate their nursing skills and teach them techniques of palliative assessment and care,” she explains. She also conducts in-service training for staff, teaches nurse practitioners and resident physicians, and serves as a mentor for nurse practitioner students from University of North Carolina–Chapel Hill and from Duke University.