Clinical Partner Spotlight: Bridgeport Rescue Mission

The dynamic founder of Sage HealthCare is the driving force behind the year-old Health Resource Center

Irene Bihl, DNP, MBA, FNP-BC, PMHNP-BC, CNE is a dynamo – a dual-certified nurse practitioner, entrepreneur and woman of faith. As founder of Sage HealthCare, she is the driving force behind the year-old Health Resource Center at Bridgeport Rescue Mission (BRM), a new clinical site for Dr. Susan L. Davis, R.N., & Richard J. Henley College of Nursing students. BRM has been in Bridgeport for 19 years and its mission is simple, yet profound – providing shelter, food, recovery services and assistance from abuse and violence for the greater Bridgeport community. With Bihl’s leadership and a committed team of staff and volunteers, BRM provides free, episodic primary care and a range of mental and behavioral health services through an innovative faculty-led student clinical practice model.

Bihl is a clinical instructor at Yale University and has taught at the University of North Carolina at Chapel Hill, SHU and St. Vincent’s College. A family and psychiatric-mental health nurse practitioner and former clinical director, hospitalist and consultant, Bihl holds two DNPs from the University of Minnesota, and an MBA from Widener University.

Bihl sat down with Associate Dean of Online Programs Karen Bauce, DNP, MPA, RN, NEA-BC, former Sage Steering Committee vice chair and now the vice chair of Sage’s Board of Directors, to reflect on DHCON’s partnership with BRM.

You have had a long educational journey from your post-high school start at a community college to earning two DNPs and an MBA. What made you interested in nursing as a profession?

I always wanted to be a doctor, a pediatrician. I’m one of seven children, so that was always my love. My family were immigrants. They came from Europe. I was born in Canada and there wasn’t a lot of money to goes around for the opportunity for paying for medical school. In high school, I took my SAT exams early and scored a merit scholarship and I could get into Penn and Pittsburgh…. But I remember the tuition was $17,000 – and that was with the scholarship. My dad made $29,000 a year, so I didn’t foresee that in my future. I ended up leaving high school because I had to do something differently. I started at the community college and started in science and the nursing program recruited me and I said, “You know what? This is the job for me. This is perfect.” And I met my husband there and it was just the way my life was supposed to be. I think it’s the most wonderful career on earth. So sometimes, if you give it up to God, it’s always the right answer. That’s what I say.

Then you became an advanced practice nurse. Tell us what led you to that?

That was a life-changing moment. I got my MBA because there wasn’t really a master’s in nursing available then where I was. Managed care started so I decided I’m going to go the business route. I ended up managing for a hospital system’s high-risk Medicare programs. That’s what got me started on the entrepreneurial side – layering the clinical stuff on top of financial -- and that was a skill set not many people had. I also started my own business and then sold that. After a while, I took a job as director of operations for a research organization in New York City. It was Columbia Presbyterian cardiac people who ran that and I really enjoyed it. Then I got a call from my daughter, she was 26 years old, and she said, “Mom, I went to the doctor and he told me I have melanoma.” That was a life-changing moment for me. I thought why am I not in clinical? That’s where my skill set is. Making money is not what I’m about. That was really the impetus for going back to get my DNP. And I haven’t regretted it. Not for one single second.

Tell us about your role here at Bridgeport Rescue Mission? You’ve done everything with the nonprofit – from soup to nuts.

With help. I couldn’t have done it if the local universities hadn’t gotten involved. That gave me a caliber of membership to the steering committee that you can’t just recruit. I did something similar to this at UNC-Chapel Hill. Once the universities, such as SHU, have become interested, it truly has become organic since then. And since then, someone mentioned to me, “People are happy when they come here. They’re just so happy. The clients are happy, the students are happy. Where do you ever come to a place you work and you think it shouldn’t be happy, but it’s very happy?” And he said, “You know, it’s the Holy Spirit filling people with grace.” I just thought that was a profound explanation.

Assistant Clinical Professors Dorothea Esposito and Connie Glenn are our faculty who teach in our FNP-DNP program and who see clients here. How do they work with your clients?

They see anybody. People come off the streets. The appointments are made at the door and they have a full register of appointments. I was in awe of how strong they are clinically and other ways. Wow. Talk about getting a staff person you don’t even have to train on the clinical record because they know how to use it and can figure it out themselves. This is too good to be true! And the students are actually learning what they need to know in real life to be able to be good assistants to their providers. It bridges the gap between the classroom work and reality.

What are some of your biggest challenges? I know getting funding and donations is an ongoing challenge for a nonprofit.

When you talk about a nonprofit, right now our costs are about $28,000 a year. We provide all of this for $28,000 a year. The universities provide all the faculty as volunteers, so that’s huge. The largest part of that cost then is malpractice insurance. The second thing in an organization like this is we’re not longitudinal. So, we see who we see and we service the need at the time, but this patient population needs longitudinal coverage. The mental health piece is just incredible. Besides the two days I’ve committed to being here (in family practice and for psychiatric-mental health services) I now carry some patients longitudinally because you just can’t not do that. They’re so desperate. What are you going to do? If they’re in residence here and they want to see me every week, I will see them every week.

Please tell us about BRM’s partnership with DHCON.

The University is looking to place nursing students with a preceptor and we have patients who need to be seen. If you put a faculty member on site, you can have as many students as you want. With a sizable community like this and a building like this, it was the perfect model. And the relationship has been amazing. I step back and think how did this turn into this?! You can’t help but be impressed. And it’s not me. We have a higher caliber of people who are coming into the organization. In general, you don’t get that kind of commitment to this kind of organization. This is so unique. 

What are some of the most important ingredients of an academic-clinical partnership?

I don’t have to train staff. The faculty come in and know exactly what they’re supposed to do and what they want to do. They bring the students and we basically provide a framework and outline – we’re doing foot care, we’re doing screenings, we’re loading up the pantry. We give them an orientation in the morning with a couple of videos and – kaboom – that’s it. They just do it. They started last September and we have anywhere from 40 to 50 students providing hours during the week (from a few universities). Sacred Heart usually does two days a week. That’s 24 hours of eight to 10 students each day. That’s 240 hours of volunteer care. The numbers are phenomenal. It is hugely making an impact. The community is coming in and asking for these services.

What are some of the things you hear from our students exposed to the realities of families who are often living without insurance or access to preventive care?

Sometimes they’ll say, “this is life-changing.” And sometimes they learn to work where the client is. We had a woman come in with a foot wound and I told the students to apply some Vaseline because sometimes that’s where we’re at. We’re at Vaseline and gauze. Our lectures go through “What kind of antibiotic can you find at home? How about vinegar? Lemon juice? It’s an antibiotic.” This is where we are doing nursing the way Florence Nightingale did it. And that was clean wounds, get rid of bacteria. We are really honing our craft. We take students back down to basics. You have to be good clinically in order to be able to work here. I also tell students that in a clinical experience, you have to take what you learn and apply it. This helps you connect the classroom to real life. Your faculty are amazing at helping their students to overcome any fears and anxieties they have in the clinical setting here. Your students are dedicated, want to be great nurses, and have pride in becoming nurses.

I fell in love with nursing because we have healing hands. That’s it. We put our hands on the patient day one of our careers. We hold them holistically – mind, body, soul. There isn’t any part of their needs that we can’t address here. Places like this should be everywhere because nurses need to learn how to be nurses and where’s a better place than here? 

What advice would you give to our nursing students to help them go out and be successful nurses?

I tell them all when they leave here that the most important thing that they were able to do while they were here was look into the eyes of a patient that they are working with. They get to see the humanity of the clients. One of the most surprising comments back to me is “We never thought these people would be like this. I got this picture on TV of who these people are, homeless off the street.” The thing that’s clear to them by the end is the clients are not that far away from them. There’s just a moment in time that put their trajectory here and mine in a different place. And that’s what they finally connect to. And if I can get them to do that, that is going to turn them into a real healthcare provider. And if they can lead and contribute to innovation as nurses, that is critical.