Tag Archive for Gateway Center

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.