WALK-IN CLINIC MAKES A DIFFERENCE

Bridgett Bell Kraft, ARNP, assesses the ear canal of Heather Bullock, the receptionist with Primary Care Sequim & Walk-in Clinic.

Urgent care dispensed in mini-ER

By Patricia Morrison Coate
Staff writer

Because “urgent” is such a subjective term, you’re going to want to be first in line for treatment with your acute earache over someone else’s illness or injury. It’s just human nature. Your pain is an emergency — theirs isn’t.

“Most of the time people understand when someone comes in and is bleeding ? but then some don’t,” Bridgett Bell Kraft said with a wry smile and a shrug.

Bell Kraft embraces all the definitions of “urgent” and stands ready to triage and treat everything from colds and coughs to cardiac failure at her Primary Care Sequim & Walk-in Clinic. An advanced registered nurse practitioner specializing in primary care, she opened Sequim's one and only walk-in or urgent clinic Nov. 20, 2006. Her assessment that there was a significant need for a walk-in clinic has been right on target.

“We’ve been very busy on the walk-in side. We’ve had more than 6,000 visits and we’ve seen very sick people that weren’t able to get into their physicians,” Bell Kraft said. “We were able to start treatment or get them referred.” The clinic’s three nurse practitioners also have had patients “code” or go into cardiopulmonary arrest and although they are trained in how to intervene, they rely on the advanced life support skills of the fire department’s medical personnel two blocks away.

“While the clinic’s referred to as “urgent,” it’s with a small “u” and not a capital “U,” Bell Kraft said. “The urgent side has done a lot more than I envisioned. I thought the urgent clinic would be available to help people without established physicians or who had an accident. What I didn’t anticipate is being a support to patients and physicians. When physician practices are so full they can’t see their patients as they would prefer, we’re able to do that. We can help until patients can see their own physicians.”

Bell Kraft noted most of the walk-in cases are for upper respiratory infections, closed fractures, suturing lacerations and occupational injuries. Other frequently treated diseases are out-of-control diabetes, high blood pressure, congestive heart failure and severe pneumonia.

Then there are the once-in-a-blue-moon ones.

“Weird infections — I treated a patient with a raging infected abscess that potentially was life-threatening ? and we get an awful lot of psychiatric urgencies — suicidal thoughts and plans,” Bell Kraft said. “The other day we saw 61 patients, mostly through the urgent side.”

Bell Kraft opened the urgent care half of the clinic first because the she saw the need was more critical. Primary care services began two months ago. Each side has five rooms, the walk-in section with three bays and two private rooms outfitted like an emergency room with an EKG machine, spirometer, suture lamps, orthopedic equipment for fractures, sprains and strains, a cast cart, portable oxygen and a computer for each patient bed with wireless Internet. Bell Kraft said Internet access is another diagnostic tool for unusual signs and symptoms.

The primary care side is where patients with appointments see Bell Kraft and two other ARNPs, Marci Newlon and Hollie Kaufman, for management of chronic illnesses including anxiety and depression, routine exams, sports physicals, Labor and Industry checkups, pregnancy, STD tests, drug screening, audiograms and pulmonary functions tests and much more.

“We’re seeing a lot of occupational and L&I patients and drug screening for employment,” Bell Kraft noted, “and I consider it such an important service to the community. Employers have to know their employees are not doing drugs and that employees are fit to do the job they’re being employed for. The liability of employees using meth (amphetamine) is tremendous. If there’s an accident on the job, the employee is treated and a drug test is done. We’re able to take care of all of that for local employers.”

Bell Kraft’s long-term goal is to have eight providers and she’s striving to be open seven days a week in 2008. Another nurse practitioner will join the practice in February. She foresees recruiting four more even though applicants seem to “think we’re the end of the world or something! We are the only independent nurse practitioner practice on the peninsula.

Sometimes I think it’s a good thing and sometimes not.”

Despite her hectic and full schedule, plus marriage and a family, Bell Kraft grins like a Cheshire cat. After 20 years in medicine, she still can say, “I’m so lucky to do this work. I didn’t expect it to be as much fun as it is. We have fun every day! I know why I come to work and I can tell my husband I did good work today — I made a difference in somebody’s life.”

Primary Care Sequim & Walk-in Clinic
520 N. Fifth Ave, Sequim
582-1200
Hours: 9 a.m.-7:30 p.m. Mon.-Fri.