The first sign Gloria Graham remembers that she might have a future in nursing came many years ago from her dog, Blackie. Growing up in eastern Arkansas with her mother and grandmother, Graham used to practice bandaging on the uninjured pooch and wrap him in a blanket and cuddle him. "He liked it," she recalls. "He used to make a kind of cooing sound. That was my first nursing experience. I always had that nurturing thing about me."
As a teenager in the 1960s, Graham volunteered as a candy striper and especially liked working with the elderly. She set her heart on becoming a nurse. But an early marriage and pregnancy kept her from finishing high school. Some might have given up the dream; but Graham did not.
In 1972, she earned her high school equivalency degree. "That allowed me to go to school to become a licensed practical nurse," she says. Shortly thereafter, Graham began what has become an ongoing, three-decade-long association with Crittenden Memorial Hospital in West Memphis, Ark. In 1980 she became a registered nurse (RN). In 1987, she earned her bachelor's degree in nursing from Arkansas State in Jonesboro. Meanwhile, she and her husband had raised three children.
Graham had realized her dream, but now she developed another—becoming a nurse practitioner. Nurse practitioners are registered nurses with advanced training who provide primary care services—such as performing physical examinations and diagnostic testing, interpreting findings, prescribing medications, and conducting patient education and counseling, often working in collaboration with physicians. Yet with Arkansas State 65 miles away in Jonesboro, it did not seem possible to enroll without giving up her job—her only means to pay for the training.
Over the next decade, Graham was promoted to administrative supervisor, "but I always kept up my clinical skills." Then, in 1998, she read a newspaper article about Partnerships for Training and a distance-learning project it was setting up with Arkansas State. Partnerships for Training: Regional Education Systems for Nurse Practitioners, Certified Nurse-Midwives and Physician Assistants, is a national program of RWJF to develop regional models for the education of mid-level practitioners to increase their numbers in underserved areas.
Graham leaped at the opportunity to finally realize her larger dream. She and about 15 other students would meet regularly at Mid-South Community College in West Memphis to participate in interactive lectures piped in by computer from Jonesboro or other locations. On her own computer at home, she would study and complete assignments at night.
"My mother was sick with cancer at the time," she says. "It was good that I could take classes in West Memphis and still be home with her and take her of her and then do my work on the computer. So I can't say enough about how great the program was for me. It's been wonderful."
In 2000, Graham graduated and was certified as a nurse practitioner. She went to work for Midsouth Pediatrics in Marion, Ark., a clinic run by Crittenden Memorial. After her mother died in 2001, Graham devoted herself fully to the job—and to her brood of now nine grandchildren.
After she got acclimated to the job, "the doctor would come in about once a week," she relates, "so pretty much I was in the clinic by myself. There were about 20 patients a day when I started. Now I see 30 to 40 patients a day." Marion, the seat of Crittenden County, is a small town with a population of about 9,000. Much of the surrounding area is agricultural, and most of Graham's patients live at least 20 miles from the clinic.
"I do a lot of things that you can't do as an RN," she says. "I'm able to diagnose, prescribe medication, order lab tests, do referrals. I take care of them. They're my patients."