Tag Archive for Emory Nursing Students

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.

V.L. Franklin Conference on Psychiatric Manifestations of Physical Illnesses

One of my many great experiences throughout nursing school, and consequently one of my passions and interests, was my mental health/psychiatric clinical rotation. While working at the Behavioral Health Hospital, Peachford, I found that I truly enjoyed working with the populations there, especially the adolescent group. Because of this, I chose to attend the 2012 Virginia Lee Franklin Memorial Conference, hosted by the Emory University School of Nursing. This year’s topic was “Psychiatric Manifestations of Physical Illnesses.” Mental health and well-being assessment and treatment should be emphasized in every aspect of nursing, even if a nurse is not specifically working in a behavioral health facility.

The Virginia Lee Franklin Memorial Conference has been held by Emory’s School of Nursing every year for the past few years in honor of former Emory Nursing Student Virginia Lee Franklin. Ms. Franklin graduated from Emory in 1957 with a Master’s Degree in Nursing, with her expertise in neurology. The program brochure stated that she was well-known for being “an excellent teacher, an advocate for the nursing profession, and a compassionate nurse.” Originally, her parents started a fund in her honor, which has since grown into the present day Conference.

The “Psychiatric Manifestations of Physical Illnesses” topic covered the objectives of discussing psychiatric symptoms commonly seen with physical disorders, describing “red flag” physical symptoms that can be associated with psychiatric disorders, and examining specific physical illnesses commonly associated with psychiatric symptoms. The program faculty included the Dean of the School of Nursing, Dr. Linda McCauley, and the main speaker, Dr. Nzinga Harrison, Clinical Adjunct Faculty at Emory’s Department of Behavioral Health and Sciences. In addition, a variety of other well-known School of Nursing Professors and Clinical Faculty Members also participated on the planning committee. The majority of the attendees were nursing students or nurses in the community, with a wide variety of backgrounds. Some of the nursing specialty areas that were represented included: psychiatric, med/surg, neurology, rehabilitation, emergency room, social health, and advanced practice.

Dr. Nzinga Harrison provided an informative, engaging lecture on a variety of different symptoms, both physiological and psychological, in mental health and non-mental health patients. We learned about a variety of different factors that are associated between psychological and physical disorders. For example, we spent time discussing symptoms of Anxiety Disorders (such as Post-Traumatic Stress Disorder), including: increased heart rate, insomnia, nightmares, decreased concentration, irrational thoughts, irritability, and hyper-vigilance, among others. One of the most important things that I learned was to document symptoms of any patient in terms of the following areas: physical, cognitive, emotional, and behavioral. The vast majority of illnesses present with symptoms in a variety of these areas. Therefore, taking an assessment with this framework in mind will help to include as much information as possible in the diagnosis and treatment.

One of the greatest benefits of Emory is having such a strong, interdisciplinary group of schools and departments. In this instance, the School of Nursing and Dr. Harrison, from the Department of Behavioral Health and Sciences, worked together to share their strengths and knowledge with a variety of students and professionals. This Conference is one of many wonderful educational opportunities that nursing students are able to participate in throughout the year.

Senior Year – Topics in Class

The last semester of Senior year is somewhat hectic for most of the students. Not only are we busy keeping up with schoolwork, we’re also applying to jobs, applying to graduate programs, culminating research projects, and practicing for our NCLEX Licensure Exam. In addition, we all have two 12-hour clinical shifts per week. Needless to say, there isn’t a lot of free time! Our courses this year are geared towards bringing together all of the fundamental information we’ve learned in the previous three semesters. Senior Year courses include: Synthesis, Core Concepts: Acute Care Nursing, Community Health, Role Transition, and Professional Development: Politics and Public Policy.

Synthesis is a course that focuses on preparing Nursing Students to take the NCLEX Licensure Exam. We take practice quizzes every week on a variety of different topics, such as general Medical/Surgical care, Psychiatrics, Pediatrics, Maternal/Infant Care, and many others. Overall, we’re reviewing what areas we need to review prior to taking the NCLEX exam.

Core Concepts: Acute Care Nursing focuses on the “sickest of the sick.” Many of the patients that nurses come into contact with, especially in the hospital setting, have some type of illness. However, this course instructs students on how to care for the “acute” patients – such as those patients experiencing Hypovolemic Shock and Cardiac Instability. Thus far in the course, we’ve learned a variety of different monitoring devices for patients with Cardiac Output issues (i.e., patients whose hearts aren’t functioning/pumping effectively). In addition, we’ve also learned techniques never before discussed in Nursing School – Emergency/Disaster Nursing. We’ve covered many different subtopics under this umbrella, from care during an environmental emergency (e.g., flood or tornado), to care during biological terrorism events (e.g., Anthrax and Viral Hemorrhagic Fever).

The Community Health Nursing course addresses nursing care on a larger, population-based level. Students participate in a Community Health Clinical two days a week at a variety of different locations, working with vulnerable community groups, such as immigrants and the homeless. As mentioned in some of my previous posts, my clinical is at the Gateway Center in downtown Atlanta. This facility caters to homeless men and women in the area, and provides them with shelter, healthcare, educational opportunities, and assistance finding work.

The additional Clinical course this semester is Role Transition. This course focuses on the students’ involvement and experiences in their Role Transition/Practicum site, where they are placed based on their particular interest. Students participate in either the Community Clinical or the Role Transition Clinical for half of the semester, and then switch mid-way through. I will be finishing up my Community Health Clinical in a few more weeks, after which I will begin my Role Transition Clinical. I’m placed at the Mother-Baby/Postpartum Unit at Emory University Hospital, Midtown. During this clinical, I’ll have two 12-hour shifts to complete each week. It sounds a little hectic, but the students in Role Transition now are somehow managing to meet the requirements, so I know it’s possible!

Our last course is Professional Development: Politics and Public Policy, specifically relating to Healthcare. Because of the rising costs of healthcare, and new policies being enacted regarding healthcare, it is imperative that students become informed and aware of these changes. This course provides invaluable information to us about a variety of different topics, such as the economics of healthcare, healthcare reform, and quality improvement. In addition, we also attend some type of legislative day for this course. I attended the Georgia Nurses Association Legislative Day this past January, where I was able to speak with a variety of senators and representatives about Healthcare delivery.

This is a busy semester for virtually all of the students, but I think we’re gaining information that will be highly useful for our future careers as BSN nurses. I think one of our biggest motivators to keep working through this semester is the countdown to our graduation on May 14th!!

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.