Grand Forks' first addiction registered nurse is dedicated to helping others

Jan. 20—GRAND FORKS — Korrine Stephani is the first health professional in Grand Forks — and one of five in North Dakota — to qualify as a certified addiction registered nurse.

Stephani, the registered nurse case manager at LaGrave on First, earned certification by passing an Addictions Nursing Certification Board examination last month. Certification has been available for about five years.

"I really wanted to pursue the best information, the best care ... (for) people experiencing addiction," said Stephani, an Altru Health System employee.

In seeking this certification, the 2009 UND graduate also was focused on taking the next step in her career, she said. "I felt that it would really benefit the people I work with and the organizations I work with. ... I learned a lot in the process."

Certification does not permit additional privileges — such as conducting medical procedures or prescriptive rights — but "it gives me more tools in my pocket to use in situations," she said.

In traditional nursing, typically, there are "tools between us and the patient," such as a stethoscope or blood pressure device, she said.

"With mental health (care), you kind of are that tool. You and your skills and knowledge, that's all you've got. ... I've always felt like this is where I fit and this is where I enjoy and where I'm comfortable. The more tools and knowledge that I can put in my pocket to feel comfortable in situations, the better it is for me and the client. ...

"I'm hoping that it opens doors for the people that I serve."

Stephani started working as a certified nurse assistant with Altru while still in high school; she graduated from Grand Forks Central in 2005. In college, she worked as a psychiatric technician for Altru and earned her bachelor's degree in nursing at UND in 2009. She has also worked at the Grand Forks County Correctional Center as a Grand Forks Public Health employee.

At LaGrave on First, Stephani acts as the clinic nurse — registering patients and doing minor lab work — when Dr. Jamie Roed and other physicians with Altru's Family Medicine Residency Program visit biweekly to see patients there.

It's critical that Roed visits regularly, she said. "Consistency and trust are so important" in providing health care for these residents.

Addiction, substance use disorder and homelessness issues are often intertwined, Stephani has found in her work, and resulted in the push to build LaGrave on First. She began working there in late September 2018, a month after the facility opened.

The facility provides permanent supportive housing for people experiencing chronic homelessness. Its capacity is 84, with up to two individuals in each of its 42 apartments, although single occupancy is the norm.

Chronic homelessness is a growing concern in North Dakota, with rates climbing 200% from 2013 to 2014, according to the North Dakota Continuum of Care, an entity whose sole purpose is to address homelessness statewide.

In 2015, Grand Forks experienced a 75% increase in homelessness, according to COC data. Since then, the annual rate has decreased, but "we are seeing a lot more families experiencing homelessness in Grand Forks," said Katie Jo Armbrust, director of program development and advocacy with the Grand Forks Housing Authority.

People qualify to live at LaGrave on First not based on the length of time they've been on a list, but on risk, Stephani said.

"They can live here for the rest of their lives if they choose to," she said. "We don't want anyone living here to feel any shame for living here."

Most residents are men in their 30s, 40s and 50s; the youngest resident was 19 and the oldest were in their 70s. The majority are from North Dakota, especially from the Grand Forks area and Fargo.

"We can help them as much or as little as they want," she said.

"We don't know everybody's story," Stephani said.

In her work with LaGrave residents, "I hear about the goods and bads, and the hurdles" to overcome. You have to check all the boxes to get needed resources — there are hoops to go through," she said. "Eventually, it can become overwhelming."

Among those who live here, not everyone has a mental health issue, she said. Some residents have jobs.

"It would be a generalization to say everyone living at LaGrave is not working," said Stephani, who helps residents connect with the Vocational Rehabilitation office, for example, to meet their goals.

Stigma surrounding mental health issues presents a barrier, so much of her work is focused on advocacy and education, she said.

In recent years, the situations that lead to homelessness may be caused, in part, to the economic struggle some face as a result of increased inflation, she said.

"The cost of everything has increased. And so if you're on a really strict budget, and something's got to give, one month it might be the heat in the house, the next month it might be the amount of food in our house, and eventually it might be our home.

"I suspect people are trying to do the best they can with what they have, while also managing mental health, medical health, and addiction."

Common misconceptions surround the issue of homelessness, Stephani said.

"Some people think they don't have jobs because of laziness, or they're living off the system," she said. But many do not know the barriers they have to get over, or what has happened in their lives that led to homelessness.

Addiction affects "all ages, all genders and all medical issues — you could run into a variety of situations," Stephani said.

"We know that mental health and addiction are always ebbing and flowing, because of a variety of issues and the nature of addiction," she said.

One of her main goals is providing "advocacy that results in feelings of dignity in the people I work with — and just to meet them where they're at."