Health Center
faces changing
student needs
by Bill Smitherman
At five a.m. on a cold Wednesday morning the
student stands outside a door, watching a television
camera and talking to a metal box.
Then a harsh buzzer sounds and the student walks
into the hospital of the UNL Health Center. He may be
sick with the flu, freaked out on drugs, or have a serious
personal problem, but he is on his way to treatment.
IN THE PAST decade there have been many changes at
the UNL health center. A service which was called upon
ten years ago mainly to set bones and treat colds is now
facing the serious challenge of drugs, contraception,
unwanted pregnancies and increasing mental problems in
a crowded and competitive student society.
The change at NU's Health Center has not been a
violent one, but it is evident in all phases of the program.
And more change is on the way.
Ten years ago UNL had 8,000 students on its campus.
Today, with nearly 21,000 students, the physical
facilities of the health center have not changed
significantly.
BUT THE services inside the center have changed to
meet the needs of today, according to medical director
Dr. S.I. Fuenning.
"In 1961 we didn't have the almost epidemic
proportions of venereal disease which we have now," he
said. "We also didn't have the changes in student life
styles which have brought about the need for
contraceptives, drug treatment and, sometimes,
abortions."
The sheer increase in the number of students has also
brought about problems, he said. As well as a greater
number of accidents and illnesses there has been an
increase in mental strain from the pressure of existing in
a congested community of 21,000.
IN 1961 total visits to the health service clinic were
over 27,000 with a total of 2,135 patient hospital days.
Clinic visits soared to more than 56,000 in the 1970-71
school year.
Fuenning said that space problems have somewhat
hampered development of some needed programs. The
current health center was built in 1957 and designed for
a campus population of 10,000.
The center today should have the capability of seeing
between 400 and 500 patients a day, Fuening said. The
capability at present is between 200 and 300.
THERE IS an obvious need for extension of services
and two programs aid in filling this need.
The first program is a system of paramedical
personnel called health aides. Aides live on dormitory
floors, in Greek houses and in cooperative living units.
Trained in first aid and some counseling, they are a
campus dweller's closest link to the health service.
The health aide program which began in 1957 was
one of the first of its type in the country.
DOCTORS at the center provide a significant referal
service when students come to them. But the center last
year also instituted a crisis health aide program. This is a
telephone-in or come-in service which operates between
6 p.m. and 7 a.m. daily.
The crisis program, which is manned by students who
receive training in dealing with telephone crisis
intervention, has served as a valuable means of access to
treatment and other help in mental problems, illness,
durg problems, and other medical crises.
Fuenning said the service has had to work slowly in
the area of consumer involvement because it is a new
area in medicine. But recently criticism has mounted,
particularly among students, that there is not enough
consumer input.
THE GREATEST portion of the service fee paid by
UNL students goes to the service. This amounts to $21
per student per semester and students have begun to
demand some control over the use of their money.
The Council on Student Life last month instituted a
study of student input into the center and how it might
be broadened and formalized. Student input now comes
from the health aides and from questionaires mailed to
those students who have used the service.
It is the lack of a formal program of student input
that has concerned recent investigating groups. A
student involved in the investigations contends that most
students really don't know what is going on at the health
service. This makes it easy for rumors to start which
discourage students from ever using the facility.
A GROUP of students which has a formal voice in
service policy could be very helpful in communicating
with students, she said.
However because the service has made efforts to meet
student needs its programs have changed slowly as
necessary, Fuenning said. Because of -the policy of
constant re-evaluation of services the changes at the
center have been more evolutionary than revolutionary.
"We have taken most of the new demands and
resulting changes in stride," Fuenning said.
- -
Contraception,
drugs and minors
by Bill Smitherman
Contraception for
unmarried women, abortion,
treatment of venereal disease
and treatment for drug users
are some of the new challenges
and demands facing the UNL
health service.
But the service seems to
have taken these controversial
problems in stride and
provided solutions through
flexible and relatively liberal
programs.
"WE SAW the changes
coming as the result of changes
in philosophies and Univeristy
climate," Dr. Samuel I.
Fuenning, service medical
director, said. "We prepared
for them."
Fuenning said that since the
fall of 1970 student requests
for contraceptive pills have
increased greatly. In response
to this demand the center has
established a procedure for all
students who want the pill, the
medical director said.
A woman who comes to the
service for contraception is
first counseled about birth
controL The various methods
and their uses and hazards are
explained.
IF THE physician
determines that contraceptive
pills are medically advisable for
the woman she is given a pap
smear (the test for cervical
cancer) and a culture test for
gonorrhea.
A month after the pills are
begun the woman comes back
to the center for an evaluation
of the effects of the medicine.
If all is well she is given a
prescription for a year's supply
of pills and advised to return
for a check-up at the end of
the year.
WOMEN are considered for
contraceptive pills whether or
not they are married, Fuenning
said. Most students are
considered emanicpated and
parental permission for the
pills is not necessary.
"The woman is counseled
and makes her own decision
concerning contraception,"
Fuening said. "We simply make
sure the individual knows what
she wants and determine if it is
medically advisable to prescribe
contraceptives."
There have been some
student complaints that they
have been told by service
personnel that contraceptives
are not available for unmarried
women under 20. Fuenning
said that if this was indeed
occuring he would see it was
corrected and he reiterated
that contraceptives are
available regardless of marital
stdtus
THE CHARGE for the
contraceptive consultations,
examinations and tests is a flat
rate of $15. Though this is
significantly lower than private
medical services the price has
still raised some student
questions.
In most office calls to the
center a student is not charged.
However Fuenning said the
charge for the contraceptive
service was necessary simply to
make it available.
The 50 to 60 contraceptive
cases handled each week take
to total of about 80 man
hours, the director said. Since
the service is currently
operating on a deficit budget a
charge was necessary to finance
the program.
IN VENEREAL disease
cases it is possible to get
diagnosis and treatment at the
service without charge. There is
no charge for an office call and
tests for veneral disease are
free. The state health
department provides free
antibiotics for treatment.
A Nebraska state law
requires that parents of minors
under 16 be notified by the
doctor if their child has
venereal disease. However,
there is no law concerning
minors over 16 who are
emancipated from their
parents.
Since most University
students are considered
emancipated, parents are not
notified when students are
treated for VD. This makes it
much easier for students to
come in for treatment,
Fuenning said.
STUDENTS who want
abortions are not actually
counseled by the service.
Fuenning said that those who
inquire about unwanted
pregnancies are referred to
agencies where they can get
further information and
counseling.
In recent years the service
has also mounted a drug
education program and
provided increased treatment
for drug users.
Extensive information on
drugs is available through the
health aides in the living units.
The service has also distributed
extensive literature on drugs
and service staff members are
available for lectures and rap
sessions on drugs with campus
groups and living units.
One problem in the drug
program is the wording of a
statement contained in a
campus handbook which is
given to freshmen, Fuenning
said.
THE BOOK says, 'The
illegal use of drugs (including
barbituates, hallucinogens,
marijuana, etc.) or contributing
to such use by others, is in
strict violation of University
rules and state and federal
This statement is
"inaccurate and very
deceptive", Fuenning said. Only
possession and sales of drugs
are in violation of laws. Use is
not legally defined as a crime,
he said.
However the statement in
the handbook makes it soun
as if the drue user is breakin.
strict rules and would probably
be turned in by the health
service. Fuenning said the drug
use cases are not reported to
the authorities.
The statement is harmful to
both prevention and treatment
programs of the service but
repeated attempts have failed
to get the statement changed,
Fuenning said.
THOUGH THE policies of
the center are quite liberal for
Nebraska there has been no
great outcry from the people
of the state. This may be that
because until recently the
doings of the service have
received little publicity.
But the NU Board of
Regents is currently
conducting an investigation
into the policies of the service
and the resulting report is
likely to stir public opinion.
Fuenning defended all of
the service's programs saying
they are necessary to cope with
campus needs. There has been
no real opposition to meeting
these needs, he added.
Expanded
role for
center
by Bill Smitherman
Mental health, health education and physical fitness are some
of the areas which have increasingly concerned the UNL health
center in its quest to meet the demands of a growing student
body and changing student needs.
The center also provides some services for the spouses of
married students and for faculty and staff. Many of these
programs have been expanded in recent years.
A health education program has been growing and two health
educators have recently been added to the service staff. The
program covers both formal and informal education on many
topics concerning health, according to Medical Director Dr.
Samuel I. Fuenning.
As well as offering an academic program which offers several
classes for credit, the service also provides source people for
lectures and rap sesions on tops of drugs, venereal disease,
contraception and other areas of interest.
The mental health program at the center has been in operation
since 1954. It involves aspects of counseling, social work,
psychiatry and psychology.
"We are concerned with treatment of the whole person,"
Fuenning said. 'The central nervous system is just as important
as any other system in the body."
The increased student population has necessitated an increase
THE DAILY NEB RASKAN
in the number of staff members. Increasingly busy programs,
such as mental health, have also added staff members.
Fuenning said staff has been added most in those areas where
it has been needed most. Several doctors have been added to the
staff to serve part-time in the clinic service, and a second
full-time nurse has been added to the public health division.
Services are primarily concerned with student problems. But
some consideration is also made of the spouses of students and of
faculty and staff.
Though direct medical care is not available to spouses of
students some services are available. A spouse may have
perscriptions filled at the health center and may get
immunizations at the center. Screening x-rays, diabetes
detection tests and consultation on community health resources
are also available.
Faculty and staff are treated for work-connected injury and
illness at the center. The health service also works with faculty
and staff in areas of preventive medicine and environmental
health.
Other services available to faculty and staff include screening
x-rays, electrocardiogram scans and diabetes detection tests.
WEDNESDAY. NOVFMRFR 17 1Q71
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