For several years two Chicago nurses, Karon White Gibson, 35, and Joy Smith Catterson, 41, have provided a service most physicians don’t—house calls. More unusual, they also enjoy a privilege most nurses don’t have: They work out of their own independently run clinic.
The two are “nurse practitioners,” a growing nursing specialty they have pioneered in a modest storefront office three blocks from Midway Airport. There, Gibson and Catterson perform routine and diagnostic lab tests and procedures, from urinalysis to blood tests: however, unlike a doctor, they do not dispense drugs (which the law forbids) or make diagnoses. There are no MDs on the premises, but the nurse practitioners are a critical—and cost-saving—liaison between the community and local, less accessible doctors. As Gibson sees it, “We enable really overworked MDs to spend time with the critically ill.”
The more familiar “visiting nurse” who makes house calls differs from the nurse practitioner in that the former merely carries out physicians’ orders in caring for patients. “The real novel part of our work,” says Gibson, whose clinic handles up to 40 cases a week, “is to have a private practice in an office where our own patients come to us.”
Their “outreach” work, as Gibson calls visits to homebound patients, may require them to change a catheter or IV unit well past midnight. They often turn over part of their caseload, an average of two to five calls a week, to local registered nurses eager for part-time work. Gibson and Catterson have also taken on routine insurance physicals, as well as manning nursing stations on Chicago film sets. “It’s never dull,” says Gibson.
One appreciative MD is gastroenterologist John Ponsiglione, who regularly receives patients from the nurses’ clinic. “They are physicians’ surrogates,” he says. “They save doctors a lot of wear and tear.” And patients a lot of money. Fees at the clinic range from $10 for an injection to $100 for a complete diagnostic test on a diabetes patient, well below average doctor’s bills. Their work is clearly having an impact. To date, nursing colleagues from 26 states have visited or called to learn how to set up similar units back home.
“Patients,” says Gibson, “always ask us if doctors are afraid we’re taking business away from them. On the contrary, we get patients to see doctors who haven’t gone in years. We are no threat to doctors.”
The health profession did not always agree. When the two began their work in the mid-’70s, they were staff psychiatric nurses at suburban Oak Lawn Christ Hospital. After 15 months of moonlighting as independent practitioners, they were fired for what the administration called “outside interests.”
They filed a sex-discrimination complaint, charging men on staff could do outside work without jeopardizing their jobs. Court records show that four years later a federal judge approved a settlement with the hospital in which each nurse recouped some $2,500, plus legal fees. Last year they collaborated on a book, On Our Own (St. Martin’s), about their medical and legal tribulations.
For Gibson, the suit propelled her well beyond her childhood dreams of the stereotyped RN. The daughter of a Chicago-area insurance executive, she lied about her age at 15 to become a volunteer “candy striper” at local hospitals. After graduating from Mount Sinai Hospital’s School of Nursing in Chicago, she chose a specialty in psychiatry. Ten years ago she married Ralph Gibson, a 20-year veteran of the Chicago police force. Karon has ruled out children, “because when I decided to be a nurse I knew that sick people would always be needing me.”
Catterson, a Chicago native as well, graduated from Augustana Hospital School of Nursing (and first met Gibson while both were working in the psychiatric unit). She, too, is married to a policeman, Gordon, whom she helped to beat alcoholism four years ago. He is now a marathon runner. They have four children, aged 10 to 18, and live a mile from the clinic.
The nurses are finding work harder but better on their own. “Getting fired was shocking, then enlightening,” says Karon. “I had to be kicked out. I never would have left myself. Sure, we work longer hours, but now we’re in control.”