It was 1994, and Michelle Rigsby, CPNP, was the nurse practitioner on the maiden voyage of Community Outreach Assistance for Children's Health (COACH) for Kids and Their Families. The Los Angeles-based program of Cedars-Sinai Medical Center was inaugurating its 38-foot, fully equipped mobile medical unit-or "clinic on wheels"-which it planned to use to provide free primary and preventive health care to low-income and medically underserved populations. FIGURE
Because the clinic had yet to stock medication, Rigsby told a woman whose child had an upper respiratory infection to buy an over-the-counter remedy. "She couldn't afford it," Rigsby recalls. "But when I suggested she try a shower with steam to relieve his congestion, I found out she didn't have a shower."
It was the first hint of how creative her thinking was going to have to be. As she puts it, "cookbook" solutions just won't work. Today, Rigsby is the program manager and director of clinical services for COACH, which was recently selected to join a national network of pediatric programs supported by the Children's Health Care Fund. COACH has provided more than 20,000 visits to more than 7,500 children and their families during scheduled stops at more than eight locations. Yet Rigsby is still rewarded by the chance to help parents prevent problems, which is why she chose to become a nurse practitioner. "Most parents want to be good," she says. With her help, they can be.