Tag Archive for migrant farm workers

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.

Looking Back

Now that we are back in Atlanta and South Georgia once again seems very far away, I have had some time to reflect on this experience and what it has meant to me. The experience was so incredible in so many ways that is hard for me to pinpoint exactly how it has changed me… and yet I know that I look at the world differently than I did six weeks ago.

Before the Moultrie experience, the migrant farm worker population was not one that I had ever really considered before. Like most people, I hadn’t ever really stopped to think about who picked the fruits and vegetables that I ate. I had never considered what their life might be like or the challenges they face. Now I can’t stop thinking about it. When I was at the grocery store the other day looking through the produce I found myself wondering who had picked it…. Did they have a family? When was the last time they saw a doctor? Did they have macerated feet and a tiny flap skin encroaching on their eyesight? It makes me feel both proud to have served these people, however briefly, as well as helpless. Although I know that the work we did in South Georgia benefited the farm workers that we saw, the whole operation sort of feels like putting a bandaid on an artery. I sometimes wonder if the people we saw with hypertension will ever get medication for it or if they even have the means to make the lifestyle changes that we suggested. It’s so heartbreaking to think about the children that we saw in the schools, so full of energy and potential, may end up dropping out of high school to work in the fields just like their parents. This population faces so many challenges, which are only increasing in the current political environment and sometimes the scale of the problems just seems way too big to even conceive of a solution. I know that as nurses it is our job to care for individuals, but in a setting like this, the inadequacy of the whole system can be very frustrating. I guess that is the constant struggle of the public health nurse… which brings me to the other great impact that this experience has left on me.

Ever since I started nursing school I have been doing hospital clinical rotations and I know that as a nurse you are supposed to be excited about working in a hospital but I was not. Ever. Hospitals are not where I fit; they are not where I feel that I make a difference or where my skills are best used. Although I knew that there were other options out there, I didn’t really know what being a community health nurse would look like.  Being able to work in a community setting with a vulnerable population has really renewed my faith in nursing and has confirmed for me that I am definitely in the right place. This is the kind of nursing that I want to do, I just felt like it fit! I am so encouraged about having such a great first experience with public health nursing and I know that it is where I am meant to be.