Tag Archive for community

Senior Year – Community Health Interventions

This past week, multiple groups of students finishing their Community Health Clinical rotations gave presentations to fellow students, faculty, and staff on the experience of working as student nurses in a Community Health setting. For many of the students, this was the first time we had worked in a larger, population-based community setting. Some of the areas represented included: The Gateway Center for homeless men and women in downtown Atlanta, Moultrie migrant farm-worker populations, the Clarkston Community Center (home to a variety of ethnicities and refugee populations), and Café 458 Restaurant for the homeless. Overall, the majority of students expressed that they had an incredibly informative, moving, and successful experience working in the community.

Student activities ranged from education with the populations, to interventions to address specific issues – such as high rates of teen pregnancy or increased rates of hypertension. Many of the main health topics and interventions focused on exercise promotion, healthy diet promotion, and prevention activities. The levels of prevention included primary, where clients were provided education; secondary, where clients were screened for different ailments; and tertiary, where clients already suffering from diseases were taught ways to decrease morbidity and mortality from their illnesses. Many of the groups were able to evaluate the effectiveness of their interventions through the use of surveys and data collection of community members’ thoughts. The prevention activities were based on the goals and objectives of Healthy People 2020, a US Department of Health and Human Services nationwide program dedicated to disease prevention and treatment. As a part of these Healthy People goals, it is especially important to reduce the disease burden in vulnerable populations – such as the homeless, minority groups, and immigrants.

One of the most common themes described by the students when reflecting on their experiences included the importance of cultural sensitivity, such as respecting cultural differences and different beliefs. Many students expressed that they learned a variety of new information about different cultures and communities that they had not previously come into contact with. Another similarity discussed among the students was the importance of recognizing the heterogeneity inside of the groups. We learned that community groups often have more intra-group variation among their individual members, as compared to inter-group variation. It quickly became apparent that members of the same community cannot necessarily be easily categorized or stereotyped into one or two broad descriptors.  In this sense, we learned the importance of breaking down barriers, such as stereotypes and assumptions about group needs and desires, in order to deliver the most culturally-relevant and appropriate care.

The feedback that students received from the Community Health Interventions was overwhelmingly positive. The majority of community participants were incredibly appreciative of our work with them in multiple areas. In addition, all of the students were mutually grateful that we were so readily accepted into these different communities. The people we worked with embraced not only our education and teaching, but also our cooperative spirit and developing sense of unity with them.

Senior Year – Community Health Clinical

Throughout the last semester of Nursing School, the seniors have either one of two clinicals – Community Health or Role Transition (i.e., practicum/preceptorship). After half of the semester is completed, the students switch from one to the other. For the first half of this year, I’ve been in my Community Health Clinical at the Gateway Center in downtown Atlanta. This facility serves homeless men, women, and children that have come to the Atlanta area for a variety of different reasons.

The Gateway facility is able to provide temporary shelter to these clients, but it places a special emphasis on gaining work and education. Many of the clients are enrolled in a variety of educational or treatment programs in an attempt to restore their lives and regain their independence. The initial intake area is a large, open room with a variety of clientele – all different ages, races, genders, and ethnicities. One of the first things I learned very quickly in this clinical rotation is that there is no stereotypical “face of homelessness.” Many people have preconceived notions about what a homeless man or woman looks like. However, just from working in this Center for only a few weeks, it is quite clear to me that this is not the case at all. Many of the clients we work with were once in very stable positions, but due to some unforeseen event, they have come to find themselves homeless. In fact, one of the staff members of Gateway was even a former client of the facility. Working with this population makes it quite obvious that all of us, no matter what our situation or background, are susceptible to homelessness.

During our clinical shifts at Gateway, we participate in a variety of different activities, such as educational sessions, art therapy, and health fairs. Some of the topics that the clients are most interested in include hypertension, diabetes, stress management, and heart health. We usually get a pretty good turn-out at each event, with a record set for our group of 39 participants in last week’s health fair on Heart Health (conducted by students Chelsea Pharr and Marcus Whitlow). The patients are always especially interested in finding out what their blood pressure is, ways to reduce these numbers, and information on healthy diets. I’ve been so impressed by how interactive and receptive the majority of them are with all of the students; they’re genuinely interested in hearing what health advice we can provide, and ways to improve their situations.

The nursing students at Gateway act in many different roles during the clinicals – student nurse (of course!), educator, counselor, and listener. I’ve found that the latter role, listener, is often one that the clients appreciate most. As our clinical instructors, Prof. Monica Donohue and Jordan Simcox, have informed us – many of these men and women are never even routinely called by their own name when living on the streets. So many of us get caught up in all of the busy work we have to do each day with school, friends, and family, and while this work is difficult and time-consuming, it’s important to think of populations that are quite worse off than us. Imagine living on the street and having most people avert their eyes whenever they walk past you, as if to ward off any type of conversation or pretend you aren’t even there. When a student, or anyone, sits down with any of these men or women and takes the time to talk to them, and especially listen, it truly seems to improve their outlook. Once again, the “art of listening,” that is often highlighted as a gift of nurses, serves to provide a connection with these clients that may have been missing in their lives for quite some time.

Alternative Winter Breaks – Recap of Bahamas, Dominican Republic, Jamaica

The weeks following my Alternative Winter Break – Bahamas trip have been both challenging and rewarding. With the start of my final semester in Nursing School, I’ve begun a variety of different tasks and processes to complete my transition from “Student Nurse” to “BSN-prepared Registered Nurse”! There have been so many wonderful moments throughout the past years of Nursing School, but I can’t say I’m not incredibly excited to graduate and begin working. However, that process can still seem quite far away, especially when getting caught up in readings, assignments, papers, quizzes, and tests. I know I’m not alone, though, as many of my fellow Senior Year classmates are always able to provide the exact countdown to graduation – 96 days as of today! Overall, though, it’s the little things throughout the process that make the entire journey worthwhile – one of the most recent ones being the presentations of all the Alternative Winter Break students.

Over 30 Emory School of Nursing students (from juniors to nurses in Master’s programs) traveled to either Jamaica, the Bahamas, or the Dominican Republic in the early part of January. We reconvened just a short while ago to present our trip highlights and information taught (and most importantly – learned) to a variety of fellow students and faculty at the School of Nursing.

The Bahamas group focused on the variety of care that the nurses provide on the rural island of Eleuthera, and the way that these nurses act in a variety of roles that far surpasses the work I’ve ever done as a student nurse. We spent a great deal of time either in the clinics, working directly with these nurses, or at schools providing health talks and education on a variety of topics. The Bahamas group was also especially amazed by the level of community involvement, knowledge, and caring throughout this culture. We couldn’t overemphasize how welcomed, respected, and appreciated we felt throughout the entire trip.

The Dominican Republic group similarly felt this same sense of welcoming and appreciation while they were working with a variety of different patients in the DR. Many of these students were able to work in a maternity/labor & delivery clinic, where they were able to perform perinatal and neonatal assessments, as well as actually deliver some infants! They described how the nurses in this community were able to do so much with the limited resources that they had; a finding also similar in the Bahamas. Many of these students participated in a new infant care system in this clinic known as “Kangaroo Care” – a process in which there is almost constant skin-to-skin contact between mother and baby during the initial days after birth. This Kangaroo Care is able to keep a great deal of premature babies alive at this clinic, despite the fact that they do not have many technologically advanced tools and resources.

The Jamaica group had a variety of different experiences, some of them arguably the most challenging of all three groups. These students explained how the majority of the patients they interacted with were incredibly poor, needy, or abandoned. Much of the time was spent at the “Missionaries of the Poor” Catholic monastery near Kingston, where different missionary Brothers provided care to anyone who was in need. They described the importance of religion in this care, and how it was incorporated into their daily lives. These students also had the initially heartbreaking experience of working with many abandoned and disabled children through this program. The students expressed their initial feelings of overwhelming sadness, but soon learned to see the joy and resilience of these young children. One of the students emphasized how much happiness she found in these patients, despite their obvious hardships. Finally, two of the Missionary Brothers actually came from Jamaica to sing a song for us and promote a concert they are having in March to raise money for the Missionary, which is funded completely through donations.

Overall, it seemed quite clear that all of the students not only had an amazing experience and provided a great deal of teaching while abroad, but they also learned so incredibly much. Some of the common words throughout all three presentations included: “helping,” humbling,” and “enlightening.” We all expressed that all of the hard work before and during the trip was more than paid off whenever we received a smile, hug, or “thank you” from any of the patients we interacted with. We’ve all gained so much respect for these countries, and especially the work that the nurses and medical personnel do there. We’ve learned how dedication, perseverance, and motivation in any situation can enable such incredible things to be accomplished, especially in healthcare settings with such low resources. I’m sure that for many of us, including myself, these trips were some of the best highlights of our entire Student Nursing career.

Day 4 in Eleuthera, Bahamas

For our fourth day on Eleuthera, we had the opportunity for some sight-seeing and touring across the island. Our first stop was to the new Centre for the Arts that is being built in Tarpum Bay, an area that will soon hold an outdoor amphitheatre and stage. In fact, this very stage will hold a concert for Earth Day this coming year with a variety of well-known American artists. While construction is being completed on this new addition to the area, we were also able to see where time has stood still on another part of the island. Part of our tour included visiting the abandoned VentaClub, an Italian resort/club that was abandoned decades ago due to lack of sustainability. As we walked through the remains of the resort, we saw a once beautiful property with direct access to the soft sands of the Atlantic Ocean. Unfortunately, the lot was deserted, and is now only minimally maintained by one sole caretaker. VentaClub is not the only abandoned resort on the island; farther down, there is also a deserted and overgrown Club Med that was once a popular, elegant place for tourists.  However, neither of the resorts was properly built for sustainability on the island, and eventually both were simply left as empty buildings.

Despite seeing these beautiful shells of a wealthy time once past, we also saw that many people on the island are busy working hard towards promoting sustainability and sustainable projects on the island. In addition to the new Arts Centre being built in Tarpum Bay, we also visited the Leon Levy Native Plant Preserve. This area is a 25 acre stretch of land that was renovated through a donation by Mr. Leon Levy to be a preserve to a large variety of native plants, and even some animal species. During the tour, we saw numerous plants that are used for natural bush medicine in Eleuthera, such as certain leaves that one would make into a tonic or tea in order to cure different problems like colds or the flu. In addition to the growth that we were able to see at the Native Plant Preserve, we were also able to see the work the community has done for their own volunteer fire station, which also houses the area’s ambulance. Shaun Ingraham, one of the top community leaders, and the contact from Island Journeys that sets up the Bahamas alternative winter break trips for Emory, even took the student nurses on a special trip on top of the fire truck. Shaun has been incredibly helpful to us the entire time we’ve been here, and has let some of the students stay in his childhood home throughout the trip. Although, I think he may have a special place for Emory in his heart, as he is a master’s graduate of Emory University’s Candler School of Theology.

After the excitement of taking our first ride on a fire truck, we traveled farther up north to a unique, historical spot known as “Preacher’s Cave”. The specifics behind Preacher’s Cave vary, but the general story is that it is the original founding spot of the Bahamas. There were missionaries traveling throughout the Atlantic Ocean who wrecked their ship on a dangerous spot near Eleuthera called “Devil’s Backbone.” When they survived the shipwreck, they took cover in a nearby cave that came to be known as “Preacher’s Cave.” This is the spot considered to be the founding place of the Bahamas.

Finally, we were allowed a very special treat to attend the Eleuthera Rotary Club’s meeting, where some of the strongest and most progressive leaders in the community meet monthly to discuss community needs and goals. Dr. Thomas has been working with a variety of the Rotary Club members for a number of years now, and they were very excited to meet another group of her nursing students. We all loved the warm, good-humored atmosphere that the members kept even while discussing important events on the island. It was refreshing to see so many people coming together with honest, sincere interest in bettering the island of Eleuthera. And, as we have noticed is custom on Eleuthera, we were made to feel right at home amongst all of the most important members of the community, and like they truly appreciated our work here. I think all of us felt proud of not only ourselves as Emory nurses, but also of the Bahamian nurses that we have learned so much from throughout this journey.

SuperNurses and Community

Being here in Eleuthera has been truly amazing. Physically interacting with the people in the clinics and schools has changed our perspectives of community. The people of Eleuthera have been welcoming and pleasant!

Following our experiences in the schools, actually talking with the students and hearing feedback from the teachers, I was proud, knowing I was able to make a difference. After a young, teenage girl asked if there was a way for her to keep in contact with me following our STD Presentation, I was ecstatic! I hope the knowledge we shared will save lives and encourage the students to make responsible decisions. They can now use and share the knowledge they learned with others. Hopefully, our efforts can assist with slowing the spread of STD’s, especially herpes. According to an Eleuthera nurse, it is currently on the rise on the island. It was truly an experience I value and wish to continue in schools and other “at risk” populations.
I definitely honor volunteering and sharing knowledge. When I think over my goals of serving the underserved, I definitely see the possibilities here. These amazing people of Eleuthera deal with what they have, hope for the better, but the are not greedy or wasteful. They don’t fret over what they do not have available, they simply value their blessings.
Everyone knows everyone and they all help and share with each other. I have still been unable to digest how amazing the nurses are in Eleuthera. They are literally “Superwomen!” They have to work autonomously as they are sometimes the only healthcare personnel available. They can do everything except major surgeries, trust me, they do! The main focus for Eleuthera nurses is preventive health and hypertension and diabetes surveillance, although they respond to all patient concerns. Under the Eleuthera’s Government and the Department of Health, the healthcare workers attend to school aged children, in at least grades 1, 5, and 10. It is mandatory for them to do health screenings for the students at the schools. I remember a similar process when I was in elementary school, so assisting with the screenings, brought back memories. The nurses do general screenings of height, weight, blood pressure, vision with Snellen charts, immunizations, and sometimes hemoglobin tests. The doctor then follows up with “at risk children,” or children with abnormal values.

The Eleuthera nurses definitely have encouraged me to go far, embrace nursing and my explore my capabilities to heal and impact the lives of my patients.