By Peggy O'Farrell
Enquirer staff writer

When Sister Phyllis Kemper entered the convent 36 years ago, she wasn't sure whether she wanted to be a teacher or a nurse.

As it happens, she's been both: She started out teaching home economics, then went to nursing school. Now Kemper tends to some of Cincinnati's poorest in soup kitchens and community centers, or visits them at their homes in Over-the-Rhine and North Fairmount.

Kemper, one of a dozen parish nurses who work for TriHealth, has learned a few things over the years. Probably the most important: Don't judge anyone by his ZIP code.

Starting the day

Kemper, 54, greets several familiar faces as she makes her way through a long line of men and women outside the St. Francis Seraph Center at Vine and Liberty.

Sister Phyllis Kemper (Enquirer photo/CRAIG RUTTLE)

It's almost 9 o'clock on a sunny Monday morning.

"It's the end of the month," Kemper says. The people clustered outside have run out of money, but not out of bills.

The center's emergency assistance program office opens promptly at 9 a.m.

Inside at her desk, Kemper consults her planner - she calls it her brain - and checks for messages. A client died over the weekend and the family needs help paying for the funeral. Kemper has just enough left from one small grant to help cover the costs.

At 9:15, she heads out again, packing up her planner and cell phone.

Her first stop is at Our Daily Bread, a soup kitchen at Race and Elder near Findlay Market.

For the next two hours, she checks patients' blood pressure and blood sugar levels and hears complaints. Many of the people in line are regulars, and she tracks the readings over several weeks to see what patterns emerge.

A woman complains of knee pain. "It's killing me," she says. She needs an X-ray, but doesn't have bus tokens to get to a hospital. Kemper sends her to St. Francis Seraph for the tokens, then instructs her to take the bus to University Hospital. Another man's blood pressure is dangerously high, and he needs an IV to bring it to safe levels. There are free clinics in the neighborhood, but he needs a hospital.

"We're only two miles from (University Hospital), but we might as well be a hundred sometimes," she says.

Bobby, a regular, is diabetic, but he just finished coffee with real sugar, not sweetener.

"Remember what we said about the sugar? Use the pink kind," Kemper tells him.

Dallas hasn't taken his blood pressure medicine yet, and it shows: His reading is 164/102. He goes to dialysis three days a week because chronic blood pressure is causing his kidneys to fail.

"You need to take your medicine at the same time every day," Kemper reminds him. But he has to take the medicine with food, and he hasn't eaten yet. He gets back in line for breakfast.

Linda, also a regular, has medicine for her blood pressure. But she just moved and the medicine, a diuretic, is still in a box.

She has to take it at night, she tells Kemper: She works at a warehouse during the day and can't take bathroom breaks.

Her blood pressure is 242/120.

"You're going to have a stroke," Kemper warns her, shaking a head full of cropped silver curls. "There's a difference between having the medicine in the bottle and having the pill in your stomach every day."

From time to time, her regulars drop off the radar. That's when Kemper starts to worry.

"I always wonder what happened to them," she says. "But because they're transient, they might have moved, and maybe a few months later they'll show up again."

Precautionary measures

Kemper's mother, who still lives in the Finneytown home where Kemper and her nine brothers and sisters grew up, worries about her safety sometimes.

Kemper reassures her that she's as careful as she can be.

"It's not that I don't trust the people, but I do use my head. I'll be careful where I go. Some places I go in the morning rather than the afternoon because it's quieter in the morning. I've never been scared to get out of the car. There are places I've learned I can't go, because of activities there," she says.

One client who lived near 15th and Republic Streets asked Kemper not to come to her home because drug trafficking made the area too dangerous. So Kemper helped her find a safer place to live.

Of the women who work in TriHealth's parish nurse program, two work as school nurses in inner-city parishes. The other 10, including Kemper, work with residents and transients in Over-the-Rhine, Walnut Hills, Fairmount, Clifton, Mount Auburn, Price Hill, Bond Hill, Avondale and Winton Place/Winton Terrace.

In some ways, Kemper says, residents in Over-the-Rhine have it easier than some of those in the other neighborhoods. Over-the-Rhine has resources such as free clinics, soup kitchens and homeless shelters within walking distance. Many of the other neighborhoods do not.

The nurses try to meet the health-care needs of people who've fallen through the cracks, says Wendy Hess, director of the program. "The cracks are getting more and more enormous all the time."

It doesn't all come down to checking blood pressure: Parish nurses help their patients find safer housing and transportation and refer them to agencies for help with food and other means of assistance.

For the first year she worked in Price Hill, Hess says, she really wasn't sure what she needed to do. She worked out of an apartment complex. "I hung out in the laundry room, because that's where the people were," she says.

Arlene Turner, the director of the Sarah Center at St. Francis Seraph, says Kemper helps clients "take ownership" of their health as she offers advice on how to lower their blood pressure or tweak their diet.

Turner says Kemper can be feisty in finding ways to help her clients. "She has to be. She has to go in some trenches to get the job done."

Last stops before home

After the Our Daily Bread visit, Kemper grabs a burger at a tiny restaurant on Vine Street for lunch, then walks a few blocks up Walnut Street for a home visit.

Cal, who's in his 70s, learned he was diabetic while awaiting surgery to clear a blocked carotid artery.

He's now taking medicine to get his blood sugar under control, and he's made some changes to his diet. He's in the process of buying a glucometer and test strips so he can check his blood sugar himself. In the meantime, Kemper does it for him, pulling the supplies from the green fanny pack on her hip.

His blood sugar measures 180. Last time it was 277.

"That's good," she tells him.

It's almost 2 p.m. now. Next on the agenda is a support group for women with diabetes back at the St. Francis Seraph Center. Kemper sets up a table and chairs, then sets out a plateful of fruit kebabs she's made.

Diet is one of the biggest hurdles Kemper's patients face. "When you depend on a soup kitchen, you can't pick out your own food," she says.

Half a dozen women soon file in for the support group meeting, and the fruit kebabs are a hit. They hold a cup of fruit - one of the daily servings of fruits and vegetables the women are supposed to eat.

They watch a videotape on meal planning, which leads to a discussion on how hard it is to stick to a diabetic diet.

One woman complains she made a healthy meal for a family get-together, "and my nieces and nephews just looked at me like, 'Oh, you poor thing,' " and refused to eat it.

"Stick with it," Kemper advises.

She cleans up after the meeting, checks her messages again and pulls out her planner.

Next on the agenda?

"Laundry," she says, smiling. And it's time to go home.

To learn more

TriHealth's parish nurse program serves residents in Over-the-Rhine, Fairmount, Walnut Hills, Clifton, Mount Auburn, Price Hill, Bond Hill, Avondale and Winton Place/Winton Terrace. For information, call 569-6138.

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E-mail pofarrell@enquirer.com