Caring For Teens

There are 40 million people between the ages of 10 - 19 who could use healthcare professionals that are knowledgeable about their specific needs.

By Nancy Giguere, Star Tribune Sales and Marketing

Last update: September 4, 2007 - 3:45 PM

The patient had missed her appointment the day before. The following day, she arrived two hours late. Her problem was serious so the charge nurse squeezed her in. During the examination, she kept asking, "Are you almost finished? My ride is waiting." But she did listen to the doctor, and by her next appointment, her condition was clearing up.

Welcome to the wonderful world of adolescent medicine!

"Teenagers are a special population. They're not kids anymore, but they're not adults either," says Kari Bartholomew, a certified pediatric nurse at the Teenage Medical Service (TAMS), an adolescent outpatient program of Children's Hospitals and Clinics of Minnesota. Located just north of Children's Minneapolis campus in a comfortable old house that has been converted into a medical clinic, TAMS serves young people ages 10 to 23.

A Holistic Approach

"If a 5-year-old comes in with a simple problem like an earache, the visit would probably take 15 minutes," Bartholomew explains. "But when you're dealing with a teen, the earache may be less significant than the psycho-social issues that the adolescent is dealing with."

These can include drugs and alcohol use, smoking, social pressures, family problems, eating disorders, nutrition and mental health issues like depression. Sexual activity, along with the need for birth control and disease prevention, is another important issue.

An increasing number of TAMS patients have asthma. "We work on compliance with the treatment plan," Bartholomew says. "This involves teaching correct use of inhalers and other medications. We also discuss the need to recognize and avoid triggers such as smoke and extreme hot weather."

Focus On Decision-Making

In addition to caring for their physical ills, the staff at TAMS tries to help patients develop better decision-making skills. But Bartholomew and her colleagues understand that teens don't like to be told what to do. So they avoid lecturing patients. Instead they do a lot of "motivational interviewing."I ask teens to think about why they're doing things like smoking or misbehaving in school," Bartholomew says. "And then I ask them how they might change their behavior."

Making A Difference

Bartholomew came to TAMS after working as a float nurse at Children's. "I jumped at the chance to work at the clinic," she says.

"I only wish there had been something like this when I was a teenager."

Her colleague Nancy Huber began her nursing career in child and adolescent mental health, and then went into adult mental health. She also worked on a medical/surgical unit and in oncology. "Here at TAMS, I have the opportunity to blend medicine and mental health," Huber says.

She also enjoys working with a multi-disciplinary team that includes physicians, nurses and nurse practitioners, social workers, psychologists, health educators, a nutritionist and health unit coordinators.

Although there are about 40 million young people, ages 10 to 19, as well as millions more of college age in the U.S., adolescent medicine has yet to become a popular specialty. But for health professionals who enjoy teens, the field is both challenging and satisfying. "We have a chance to make a real difference in the lives of our patients," Bartholomew says.

Nancy Giguere is a freelance writer from St. Paul who has written about healthcare since 1995.

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