JAMHI welcomed two new nurse practitioners early this year to Midtown Clinic. Jen Graf-Perkins and Sean Plank bring diverse experience and skill sets to the Juneau community. Jen specializes in women’s health, gender-affirming care and chronic disease management. She was born and raised in Maine and has worked as a nurse in New Hampshire and North Carolina and done mission work in Guatemala, Honduras and Bolivia. Most recently, she went on a mission with Doctors Without Borders to South Sudan before moving to Juneau.
Jen chose to go into nursing because the holistic model of healthcare appeals to her. She likes to come up with a plan together with her patients in order to help them reach their goals and make positive changes. She approaches them in a non-judgmental way and cheers them on. Additionally, she enjoys teaching and educating patients about their health.
She became a nurse in 2006 after graduating from the University of New Hampshire. Fresh out of college, she began working at the trauma transplant stepdown unit at Duke Hospital. She describes her time there as both challenging and a great learning experience, “We were all brand new nurses. And we were in the trenches,” she said. Though Jen had been prepared for the physical challenges of the job, she had not anticipated the emotional toll, “No one really warned me about how much I would care about my patients and to this day I remember every single one that died during that time. I know the names. Because you just get close to them.”
Jen went back to school to become a nurse practitioner and graduated from Duke University in 2010. Her next position was at a walk-in clinic. It was a good first job after graduating as a nurse practitioner, but she loved public health, so moved on to a family planning clinic. About eighty percent of her patients there were undocumented Latinas. She loved hearing their unique perspective and practicing her Spanish. Because many of the women that she worked with were uninsured there was a limited scope of the care that she was able to provide, however, it was there that she first acquired experience in women’s health and got to specialize in that area. She went on to complete a doctorate of nursing practice from East Carolina University. Upon graduating she worked at Planned Parenthood while also working part-time at a local jail. At Planned Parenthood, Jen worked with the LGBTQ community and learned gender-affirming care. She said that as a member of the LGBTQ community herself, it is another way that she gives back. Jen enjoyed helping patients who were transitioning throughout their journey and watching how they changed in a year. “It’s such an honor to see that and be trusted,” she said.
Jen provided full-scope primary care at the jail, including chronic disease management, acute illnesses and medication-assisted substance use treatment. Jen connected with these patients by sharing her own recovery journey and found that they were more likely to open up to her because of her honesty. She was able to treat patients for ailments such as HIV and tuberculosis, which she normally would not have had the opportunity to do. Conversely, Jen faced frustration because she would help her patients become healthy, but because they did not have access to healthcare after being released, those same people would return to jail sick again. “We had people who purposely committed crimes because they knew they could get free healthcare,” Jen said.
Long waitlists at medical facilities that offered sliding fee discounts and lack of insurance contributed to gaps in continued care. It was difficult for her to coordinate continuing care upon discharge due to these factors and the transient nature of the jail system. All of this led to gaps in care once people were released. “That just makes me want to do better for our unhoused population,” Jen said, “people with addiction and people with mental illness. We could do better. I think that JAMHI is doing it. That’s why when I heard about this, I was just like this is the solution. I want to be part of it.”
Sean began his educational journey studying dance at California State University, Long Beach. He was six credits away from graduating when he decided to pursue a second degree in Asian American studies. Sean had an interest in studying Asian American heritage and biracialism because of his background of being half Korean and half white, “Being exposed to ethnic studies I learned so much about how things actually are versus how we’re kind of conditioned growing up,” Sean said.
After graduating, Sean began work in the non-profit sector in community outreach, substance use education and HIV prevention. Additionally, he served youth in a leadership program, sports program, and worked as a case manager for emancipated foster youth. Sean worked with underserved and at-risk populations including members of the LGBTQ community and immigrant Asian youth. Working with youth opened him up to the injustices that youth experience. When he worked in Oakland with emancipated foster youth most of his clients were African American, “I saw just how real racism is for that population,” Sean said. Working with youth made him angry with adults, because he saw how sometimes they did not acknowledge the struggles that youth are going through. “You know the whole, ‘children are the future’ thing? They really are. And the way that children are doing in a culture is very telling of how the culture is functioning,” Sean said.
Sean went back to school to pursue a master’s degree in nursing and spent his residency at the Los Angeles Children’s hospital in pediatric oncology. After graduating, he worked there for an additional two years. Patients were transferred there from across the Western United States and would often participate in clinical trials. Sean said that when they arrived they either had a lot of hope or were there to try one last treatment. He was able to deal with the difficult moments because of the relationships that he formed with the patients, “They give me stuff at the end of the day. Their joy and their love of life, their optimism, all these fantastic wonderful things about them that I’m able to be around and absorb.” Sean learned from his pediatric patients and would have spiritual conversations with them. It was crucial to Sean that they had a voice in their own care, “One of the important things to me was that the kids had choices,” Sean said, “A lot of times the parents were making all of the decisions.” He would encourage parents to have conversations with their children about their treatment.
Sean went on to earn a post-graduate certification and become a family nurse practitioner. He then moved to Hawaii. One of his first jobs there was at an FQHC community health center in Kokua Kalihi Valley. He enjoyed working there, but was then recruited to work at a state-run urgent care provider on Kauai island. He soon realized that he preferred working for nonprofits and returned to work at the FQHC. He worked there for a year and a half and then moved on to the University of Hawaii where he was a lecturer and clinical instructor. During this period he also worked part-time at a long-term care facility. He enjoyed working with the geriatric population due to their authenticity and because they don’t sweat the small stuff. “When we’re young and even when we’re adults, we worry so much about what other people think…that we’re not actually being our real selves. And as we’re growing older, we grow into who we actually are,” Sean said. Empowering patients to make their own decisions is something that Sean carried with him from pediatrics to his adult patients. Instead of telling a patient what to do, he asks what their goals are. For some of his elderly patients that goal was spending more time with grandchildren or loved ones. In those cases his patients preferred a lower dose of medication so that they could be more alert during those visits.
After living and working in Hawaii for five years, Sean was ready to move on. He initially explored opportunities in the pacific northwest, but unable to find anything that he connected with, he expanded his search and found JAMHI. He talked with some leaders and felt that their values aligned. He moved to Juneau sight unseen, arriving on New Year’s Eve. He is currently enrolled in a Doctor of Nursing Practice program through the University of New Hampshire.
Sean believes that mind, body and spirit need to be in sync for someone to be healthy. He takes into consideration aspects such as psycho-social components and enjoys thinking outside the box to reach patients and work with them creatively. In addition he is very honest with patients. He says that he is the person you go to when you want someone to be real with you. Sean decided to become a nurse practitioner as a way to help people, “The older I got, the more I got exposed to different communities and different populations, I saw how good I had it…and so I think for me, it’s a service thing. I was able to go to school. I was able to get educated. I earned a good living… For me, it’s a giving-back thing.”