Since its foundation in 1939, Frontier Nursing University (FNU) has adopted a mission of reaching rural, diverse and underserved populations. This mission is still being lived out today, where more than 80 FNU alumni are answering the call in Alaska. In the coming months, we will be highlighting several of these alumni who serve in our country’s most remote and unforgiving state.
Karolina Priebe, DNP, ANP, FNP, Class 17 is the final alumna featured in our Alaska Spotlight series. She is a family nurse practitioner at Solstice Medicine and Wellness in Fairbanks.
Fairbanks represents the last chance for medical care for many Alaskans living in the extreme northeast regions of the state.
“We are isolated from other areas of Alaska,” said Karolina. “We are really the northernmost city in northeast Alaska in terms of access to healthcare. We cover thousands of miles of the area.”
Born and raised in Poland, Karolina’s family moved to Chicago when she was 16. She eventually became a U.S. citizen and served as a medic in the military where she met her husband. His last station before retiring was Fairbanks in 2015. They fell in love with the community and continue to make their home there.
At Solstice Medicine and Wellness clinic, Karolina is the only primary care provider doing family practice daily. She is joined by an internal medicine physician and a physician’s assistant. Many of the patients they treat come from very remote locations and only visit the city once or twice a year.
“The bush people of Alaska have no roads,” Karolina said of the population made famous by the ‘Alaskan Bush People’ television series. “In summer they get to us via boat or four wheeler, and in the wintertime many travel by snow machine until they either reach a road system or a small airport. They come to town once every six months or once a year. We address as much as we can in one visit.”
That means a lot of acute care and little time left over for addressing lifestyle, education and preventative medicine, resulting in a gap that Karolina is trying to fill.
Noting a significant issue with obesity in her patient population, Karolina launched an obesity program in August 2018. She devotes approximately half her time providing primary care and the other half on the 60-80 people in the obesity program.
“Nobody is doing obesity management. In primary care, there’s no time to address that,” Karolina said. “Weight management is built into my work schedule for patients interested in medical weight loss. I’m treating chronic conditions such as diabetes and high blood pressure along with obesity at the same time. It saves the patient time and money.”
Patients in the program begin by keeping a food journal for a month. Karolina then reviews it and helps them find healthier alternatives to the foods they enjoy. Access to fresh and affordable healthy food is a significant hurdle for many in the community.
“There are many components to the obesity problem,” Karolina said. “A lot of my patients don’t have access to proper food. Fresh produce is very expensive here, especially in winter. Our food bank is a great resource but it mainly has packaged foods. A lot of people can’t afford the fresher, healthier foods.”
Affordability is also an issue when it comes to medical bills and, as a result, many are reluctant to seek the care they need. To help address this issue, Karolina serves on the board of KarmaCare, a local nonprofit that offers people assistance with their bills. Patients who qualify for the program are asked to volunteer in their community. In exchange for their service, KarmaCare will pay up to $4,000 per year toward their medical bills. “That’s the community we have,” Karolina said. “There is a unity of the community in Fairbanks and that’s why we stayed here.”
Another challenge facing the Fairbanks community is the limited amount of specialized care, so Karolina and her team arrange appointments with specialty care providers in Anchorage or Seattle. “Thankfully there’s a good working relationship between us and Anchorage and Seattle,” Karolina said. “They are good about working our referrals in. We have to sit on the phone for many hours to figure out where to send these patients.”
Karolina credits Frontier Nursing University with helping to prepare her to be innovative and community-driven in her work. “Frontier was all about going where there’s a need and making an impact,” Karolina said. “Every day I’m trying to see how I can help my patients, what’s needed, and how I can make an impact. I’m still trying to figure out how we can make medical care better here.
“Frontier is so focused on meeting patients where they are and making improvements in the community,” Karolina continued. “It prepared me to open my eyes to look at bigger issues, to look at what needs need to be addressed in the community to benefit not only the patients but their families as well.”