Charmaine Miller-Spencer, BSN, MTh, MS, APRN, AGNP-C, AAHIVS
Charmaine Miller-Spencer has worked in healthcare for four decades. She has served communities in Texas in many different ways over the years, as a healthcare provider as well as an ordained deacon with the United Methodist Church. She attended Incarnate Word University in San Antonio for nursing school and Texas Woman’s University in Dallas for her Master of Science and nurse practitioner programs. As a registered nurse at the University of Texas San Antonio, Charmaine worked as a study coordinator in the infectious disease division. After becoming a nurse practitioner, she worked in an oncology clinic and also had the opportunity to provide HIV/AIDS care at the Dallas County jail. Charmaine recalls, “It proved to be a great place to hone my skills. It was also a place where I could blend my pastoral background with my healthcare background to provide the compassionate care that was needed.” Charmaine remembers taking care of her first patient with HIV in 1983 as an RN in a hospital setting and in 2006, she began specializing in HIV/AIDS care as a nurse practitioner.
“Over the 40 years that I have worked in healthcare I have touched the lives of people living with HIV at different times in my career. I’ve seen the suffering in the early days of the disease. I’ve seen the devastation of a new diagnosis. I have always been aware of the need of these individuals to feel accepted, respected, and valued. I believe it is my personal calling to provide these elements while delivering healthcare,” says Charmaine, “It is my personal goal to treat everyone with dignity and respect.”
Today, Charmaine works in a Parkland Hospital HIV clinic in southeast Dallas. Together with a physician, she is one of two prescribing providers. They are joined by one RN and one LVN. Additionally, they are staffed with a RN case manager and a clerk. Her practice consists entirely of patients who have been diagnosed with HIV. Charmaine shares about her patients’ demographics, “The majority of our patients are minorities. We have approximately 80% male and 20% female. We see adults, starting at age 17 years. About half of our patients are over 50 years of age. Over the 14 years that I have been at this practice we have seen a steady increase in the number of patients over the age of 60 years. The majority of our patients are below the poverty level and qualify for Ryan White funding and/or Medicaid.”Charmaine and her team try to maintain an open door policy. If a patient shows up without an appointment, they will see them. “Some of our patients face a lot of challenges, so we try and help make life easier and see them when they can come,” shares Charmaine, “Seeing patients when they show up has increased patient access to care and our show rates.”
Charmaine supports her patients’ adherence to treatments by first recognizing the complexity of the issues often at play. “If I can get to the root of what is preventing my patients from taking their medications, then I can help find a solution,” says Charmaine. “Sometimes it’s treating depression. Sometimes it’s providing ways for them to disguise their medications. Sometimes it’s giving them tools, such as smart phone apps, that remind them. Sometimes it’s just hanging in there with them and not giving up on them.”
For Charmaine, one of the most rewarding parts of her job is helping someone with a new HIV diagnosis to move from a sense of ‘my life is over’ to living life to the fullest. “I love being able to say to patients, ‘whatever you had planned for your life before your diagnosis, you can still do.’ I love when I walk in the room and my patients smile and get off the table and hug me. I love when mothers who initially came to appointments with their young adult children stop coming because they trust the care they are receiving.” As for obstacles, Charmaine believes not speaking Spanish is one of her greatest. “While we have translators available, I think feelings and emotions get lost in translation.” Charmaine shares she has two goals she would like to accomplish before retirement. Learning to speak Spanish is one; the other, which she is already working at, is becoming a certified diabetes educator.
Looking to the future, Charmaine thinks HIV will become more mainstream and that caring for people with HIV will happen more regularly in primary care clinics. She believes there will be an important role for HIV Specialists within these clinics but that a shift to primary care will help reduce stigma around HIV. Outside of her work in healthcare, Charmaine provides pastoral care and grief counseling at her church. She also serves as president of a non-profit organization that provides scholarships to students attending college or technical programs.
Asked why she joined AAHIVM as an Academy member, Charmaine shares, “I joined the Academy because I wanted to be part of the organization that credentials providers as HIV Specialists. After joining, I became aware of all the work the Academy does, so I stayed a member.” Today Charmaine provides leadership for the Academy as a member of the Texas Steering Committee and the Academy Council for Racial Equity.
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