An interview with the Director of College Health Services

Maura Marshall has always been a care giver; and, with her mother and her aunt as examples, her career choice was easy. She graduated from nursing school at Fitchburg State College and earned her nurse practitioner credentials at Rivier College. Her career began at Beth Israel Hospital, but after moving to New Hampshire, she has worked in the intensive care unit and the emergency room at Catholic Medical Center. It was in the ER that Marshall came to know Saint Anselm students who were studying nursing-and liked what she saw. She began working at the college by filling in for health services staff on weekends. She is in her third year as director of the Office of College Health services. She co-chairs the College Health Committee and serves on several state and New England committees. The mother of two children, she is an avid water skier and cyclist. "The saddest day of the year is when we take the boat out of the lake," she says.

What does college health service encompass?

It encompasses three things: medical care, counseling, and health education, all under one roof. We're a walk-in clinic open Monday to Friday 8-6 and Saturday 12-4. We have 24-hour coverage from the EMTs and an emergency counseling number that students can call off hours. It's unique to have counseling and medical services under the same roof, but we really believe in collaboration between the two.

Why is that?

If a student has an eating disorder, or needs treatment for anxiety or depression, you need the physical care and the mental health follow-up. A nurse practitioner can prescribe medication and collaborate with the counselor.

What is the size of your staff?

Fourteen including part-time. We have seven R.N.s, three nurse practitioners, one M.D., two counselors, and an administrative assistant. We work as a team. I make myself available 24 hours a day, but I have a fantastic staff to whom I can delegate.

What are the challenges?

Day to day, you never know what's going to come through the door. It's like an emergency room. It could be someone coming in for a band-aid or Tylenol; someone with a blood clot or a concussion; or a true mental health crisis where someone comes in crying or someone's suicidal. We're always ready.

What are the broader challenges?

Being prepared for what's coming down the pike. Being proactive about things like pandemic flu, and preparing not just the students but the campus. We have to be alert for trends or threats that are out there and might come to our campus. Also I have to be on top of legal issues and deal with state and federal agencies.

What are the major things you deal with?

Mental health issues. If students come to college with a mental health issue, we have to identify them and provide for them and intervene before they get into trouble academically or health wise. Eating disorders and issues relating to anxiety and depression are big. I have one nurse practitioner whose schedule is dedicated to these issues. There is also one who is dedicated to women's health.

What about alcohol abuse?

It's a problem on all campuses. I'm on the Alcohol and Other Drugs Committee and it's very proactive and has made a huge difference. The number of transports for alcohol overdose has gone down dramatically. We have a licensed drug and alcohol counselor who teaches a class several times a year for students who have been identified as being at risk for these issues. We are also trying to change the perception of drinking and make students aware that if they don't drink they are not different: 68 percent of Saint Anselm students do not drink in a high risk manner.

How do you identify such problems?

SupportNet is a committee which meets every Monday, comprising representatives from the Dean of Students, Academic Dean, Residence Life, Campus Ministry, Student Activities, Multicultural Center, and Counseling to identify high-risk students on campus and reach out to offer support.

What about injuries?

Concussion is a major issue getting media attention right now. It's not so much an issue with varsity athletes because the trainers intervene so quickly. They have computerized tools for baseline assessment and follow-up. It's more of an issue with athletes who are not varsity, because they don't have the baseline testing. They may not understand how ill they are or when they have to seek help. There's a whole host of symptoms students may not be aware of and the only treatment for severe concussion is complete rest. One of the goals for this year is to be more proactive about that, especially with the rugby players.

Other major issues?

Food allergies are an issue that's come to the forefront in the last few years. We work very closely with Dining Services and Residence Life to educate around these issues and make accommodations.

Do we have students with video game addiction?

I'm absolutely sure it's an issue, but we probably don't see it called that. We might see carpal tunnel syndrome. We do have parents who call to express concern about their child gaming too much. I haven't seen it to the extent that it's affecting health or academics; maybe because it's not being self-identified. But that may be coming.

What health scares have you had to deal with?

The first big issue I was faced with when I started here was H1N1. Fortunately, I was proactive in getting the vaccine here.

Is stress a common problem?

It's generally a big issue among any college population. We work with students and Residence Life staff to provide relaxation and meditation workshops and programs. We facilitate classes like Zumba and Yoga and we refer them to our counselors for stress management strategies. If needed, we collaborate with other departments to work on the problem causing the stress. We work with the academic deans if it is an academic issue, for example, or with the Dean of Students or athletics office depending what the issues are.

It sounds like your job touches every aspect of the college.

It does. We work very, very closely with athletics, student affairs, security, dining services, and campus ministry. I've talked
many times in the middle of the night with a residence director or R.A. when there's a student in crisis.

Does your job take you off campus?

I'm on a lot of committees: the New Hampshire Violence Against Women Campus Consortium, Higher Education Alcohol and Other Drug Committee, New England College Health Committee, New Hampshire College Health Committee.

Could you describe a typical day in the Office of Health Services?

There is no typical day. I've learned to go with the flow. I'm a problem solver. Whatever problem comes up, that's my priority.

Do people generally understand what you do here?

Students and parents are very surprised to know how much we can do. A student athlete will come in with an injury and say, "Wow, I didn't know a place like this existed!" Because of my ER experience, I can stitch them up. We can draw blood, do hepatitis titers. They're surprised at the resources we have. If someone has an eye injury we can get them an appointment with the doctor that day instead of having their mom or dad try to do it from Connecticut.

What would you like people to know about your office?

That we're here, and we can help in a lot of ways. Even if we don't have the service, we can find it. I'd like parents to realize that if students have health issues off campus or are in the hospital over the summer, it would be nice for us to be aware of that. We're extended parents. We're here to take care of them.