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Like Mother, Like Daughter: UTHSC Nursing Legacy Continues in Houston County

Mother and daughter share love for nursing instilled in them by the UTHSC College of Nursing.
Mother, Robin Black, in back of photo, and daughter, Piper Black, share love for nursing instilled in them by the UTHSC College of Nursing. They are delivering health care together at the Hilcrest Clinic in the rural community of Erin, Tennessee.

Continuity of care is more than a philosophy at the Hilcrest Clinic in Erin, Tennessee. It is a way of life.

For nearly 30 years, Robin Black, FNP, BC, PNP, BC, has worked as a nurse practitioner at the small, privately-owned clinic in rural Houston County. Her daughter Piper Black, BSN, hopes to follow in her mother’s footsteps upon graduation from the Doctor of Nursing Practice (DNP) program at the University of Tennessee Health Science Center’s College of Nursing. Robin Black earned her master’s degree at UTHSC to become a nurse practitioner in 1989, and Piper is scheduled to graduate from UTHSC in May 2022 with her DNP.

When Robin, 56, took the nurse practitioner position in Erin years ago, it was just a one-year commitment. “I fell in love with the people of this community, and 28 years later here I am,” she said.

Piper, 28, said that she has always known that she wanted to work in rural primary health care. “I watched my mom love coming to work every day.”

Located in Middle Tennessee, Houston County has a population of about 8,100. The county seat of Erin is known for its Irish Day Parade and Arts and Crafts Festival. The county also is home to Danville Landing on the Tennessee River.

Piper grew up at the Hilcrest Clinic, getting off the school bus there every afternoon. “The nurses would let me help bring the kids back and pick out their Band-Aids,” she said.

Robin added, “She would hold other kids’ hands when they got their blood drawn.” And when her mother brought home blank patient charts, Piper would set up a clinic in the basement.

Supporting Rural Health Care

Piper is one of five DNP students at UTHSC whose education is being funded, in part, with scholarships provided through a four-year $2.79 million HRSA grant to the College of Nursing that is dedicated to educating nurse practitioners and nurse midwives to practice in rural and underserved areas.

It can be difficult to attract young physicians to a small, rural community like Houston County, Robin said. But she wouldn’t want to work anywhere else.

The United States could see an estimated primary care physician shortage of between 21,400 and 55,200 by 2033, according to data published recently by the Association of American Medical Colleges. More than 85% of nurse practitioners are trained in primary care, and nurse practitioners represent one out of four providers in rural practices, according to the American Association of Nurse Practitioners.

Robin loves the small-town atmosphere of Houston County and the way it affects her work at the Hilcrest Clinic. “You see people from birth to the grave. The patients I had when I arrived here are now my elderly patients, and I remember their history, their life,” she said.

“They aren’t just chart numbers to us,” Piper adds. “When you live in Erin, you know every family and it’s personal. It makes the job so much less of a job.”

Robin’s patients are like an extended family. “I love taking care of people,” she said. “I love when they improve, and I love holding their hands and loving on them when they don’t. At least once a day I say, ‘I have the best patients in the whole world.’ ”

And some might say that they have the best nurse practitioner in the world. Robin recounted a story of a patient who had recently thanked her for insisting that the woman’s husband receive a prostate test three years ago. The test resulted in the diagnosis of an aggressive cancer. The man was treated and recovered. “She told me I was a Godsend, and it just gave me chills,” Robin said.

Another local family sends Robin flowers every year on a very significant day. It is the anniversary of the date that Robin ordered lab work on their 2-year-old daughter. Robin immediately noticed how pale she was. The lab work showed leukemia. “We caught it in time,” Robin said. The little girl is a healthy 9-year-old now.

The holistic nursing perspective informs the care she gives, Robin said. If someone comes in with a stomach virus, she will also take the time to ask that patient whether she has received a pap smear or mammogram recently.

And it is that holistic view that Piper values so much, although she had originally planned to become a medical doctor. As valedictorian of her Houston County High School class, Piper set her sights on being a physician. However, conversations with the local doctor at the Hilcrest Clinic helped her see that she could provide consistent patient care and enjoy greater work-life balance as a nurse practitioner.

A Passion for Nursing
Piper Black is proud to carry on the family nursing tradition.

After earning a microbiology degree at the University of Tennessee in Knoxville, Piper said that learning how to think like a nurse presented a steep learning curve. “You take a step back and you don’t just look at the symptoms and science; you look at the person and ask what the symptoms are doing to their life and lifestyle,” she said.

She earned her BSN in the accelerated program at the UTHSC College of Nursing and lauds her instructors for their commitment to ensuring that their students adopt a true nursing mindset. “Nursing changed my outlook. I see the person as a person, not as a checklist of things to fix.”

UTHSC Nursing Instructor Anita Settles-Seymour, MSN, RN, taught Piper in the BSN program and recalls her passion for nursing. “She always possessed a positive attitude and spent time with her patients. Her mom and her community are important to her. I think that her positive attitude, listening skills, and dedication to serving her community will make her successful as a practitioner in rural health. She is one of the best.”

Piper hopes to transition from UTHSC directly to practice at the Hilcrest Clinic, where she recently completed a clinical rotation for her DNP program. “I can honestly say this is it for me. I never envisioned anything differently.”

Hilcrest Clinic owner Michael A. Carter, MD, said Piper has wanted to work in rural health care as long as he has known her. “I believe she is going to be an excellent provider once she completes her training,” he said. “It’s difficult to know what the future holds, particularly in health care, but I certainly intend to keep Piper here in her hometown if at all possible.”

And Robin is thrilled to see Piper grow into the nurse practitioner role. “I love that she is following in my footsteps. I think she will be wonderful in this position,” she said. “Her knowledge base is way more advanced than mine was when I was in the program 30 years ago. The role of the nurse practitioner has evolved, and UTHSC has done a fabulous job of training her.”

The UTHSC College of Nursing’s DNP program is ranked 26th in the nation on the U.S. News and World Report list of Best Graduate Schools. Applications for the DNP program are open through January 10, 2022. More information is at uthsc.edu/nursing. This story was first published in the Fall 2021 Nursing Magazine.