Nurses on a mission: a professional service learning experience with the inner-city homeless

Nursing students can play a vital role in addressing the health care needs of the homeless. Through professional service learning experiences in community-based settings, students learn how to partner with key community leaders and agencies to meet the needs of underserved populations and provide culturally competent care to diverse populations. This article describes the development of a professional service learning experience with the homeless in which a community-academic partnership was created to meet community needs. In an era of declining health care resources, such innovative partnerships serve to reduce health disparities and improve access to care while preparing students for community-based practice with at-risk and vulnerable populations.     

Development of a student nurses' clinic for homeless men

A nursing clinic for homeless men was developed by a faculty member and her senior community health nursing students in a city mission over a 2.5-year period. The development of this clinic and a conceptualization of their nursing roles are described. Nursing care focused on promoting access to primary care through screening and referral and through nursing interventions of education, counseling, advocacy, and collaboration. Because the Student Nurses' Clinic was instrumental in clarifying and conceptualizing what nurses can do to promote primary care, mission administrators and staff gained insights about nursing and are better prepared to plan programs for the health care needs of the homeless men-the "guests" at the mission.     

Students in the community: An interprofessional student-run free clinic

Students in the Community (SITC) is an interprofessional collaboration of health science students at the University of Washington. SITC runs a weekly free clinic at the Aloha Inn, a transitional housing facility for 70 homeless men and women in downtown Seattle. The focus of this clinic is on health education, chronic disease management, and re-integration of patients into the healthcare infrastructure. SITC serves as a valuable service learning opportunity for students. In addition to direct clinical services, students gain experience in planning health education strategies, community collaboration, and evaluating intervention outcomes. SITC also oversees a lecture and discussion-based elective course at the University of Washington focused on health issues of the homeless community and provides formal teaching which complements the service-learning component of the endeavor.     

Students in the community: an interprofessional student-run free clinic

Students in the Community (SITC) is an interprofessional collaboration of health science students at the University of Washington. SITC runs a weekly free clinic at the Aloha Inn, a transitional housing facility for 70 homeless men and women in downtown Seattle. The focus of this clinic is on health education, chronic disease management, and re-integration of patients into the healthcare infrastructure. SITC serves as a valuable service learning opportunity for students. In addition to direct clinical services, students gain experience in planning health education strategies, community collaboration, and evaluating intervention outcomes. SITC also oversees a lecture and discussion-based elective course at the University of Washington focused on health issues of the homeless community and provides formal teaching which complements the service-learning component of the endeavor.     

“岗位体验”实践教学法在社区护理学教学中的应用

目的 :探讨社区护理学实践教学模式,培养社区实用型护理人才。方法:将2007级260名高职护生随机分为试验组159名和对照组101名,组织试验组同学假期开展"关爱社区人群健康"的社会实践活动。实施"岗位体验-任务引领-标准化评价"的实践教学方法。结果:100%的护生积极参与课堂教学,试验组同学综合素质评价优于对照组,差异有统计学意义(P<0.05)。结论:学习社区护理课程前,护生到自己熟悉的社区观察人群健康状况,能促进护生对社区人群健康现状的早认识,同时认识到社区需要高素质的护理人员,提高其学习社区护理兴趣。     

Service learning: a strategy to develop group collaboration and research skills.

Many colleges and universities currently are implementing service learning as an educational strategy into their curricula. The goal of service learning is a dynamic partnership between educational institutions and communities resulting in the mutual benefits of service and learning. Although service learning has significance for teaching nursing students, educators must differentiate service learning from clinical practicum. This article provides a definition of service learning, identifies the relevance of service learning for nursing education, presents an example of service learning integrated into a nursing course, and evaluates service learning as a methodology for teaching group collaboration and research skills. Student surveys, a focus group, and community partner evaluations indicated service learning contributed to the development of group collaboration and research skills among baccalaureate nursing students. To enhance faculty, student, and community partner satisfaction with service learning, instructors should clearly define service learning experiences for a specific setting and offer structured guidance that does not interfere with student decision-making.     

'A Juggling Act': an analysis of the impact of providing clinical placements for pre-registration students on the organisation of community nursing and health visiting work

Modernising policies for the NHS have aimed to strengthen the nursing workforce through enhancing professional roles and increasing the numbers of pre-registration students. The current emphasis upon community based health care has led to an increase in the quantity and complexity of the workload for community nurses and health visitors, whilst at the same time educational developments have led to additional responsibilities supporting nursing students on community placements. These issues are explored in this paper which reports findings from a qualitative study in a large city based Primary Care Trust (PCT). The findings demonstrate that the provision of clinical placements for nursing students leads community nurses and health visitors to juggle the demands of their workload with meeting the needs of nursing students and clients. This requires a (re)-organisation of their work, often impacting on the wider team. Additionally the nature of community nursing/health visiting work, shaped by time, space, resources and location, constrains opportunities for clinical learning. If government policies are to be implemented successfully, community nursing and health visiting staff require appropriate support to enable them to fulfil their educational and clinical roles.     

Using an Academic‐Community Partnership Model and Blended Learning to Advance Community Health Nursing Pedagogy

This article describes a model of teaching community health nursing that evolved from a long‐term partnership with a community with limited existing health programs. The partnership supported RN–BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face‐to‐face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community‐based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery.     

The Longitudinal Elder Initiative: helping students learn to care for older adults

This paper describes an educational innovation called the Longitudinal Elder Initiative (LEI), which was developed by a BSN program to improve students' knowledge about the health needs and nursing care of older adults. In the LEI, new nursing students are paired with older adults in the community and develop a relationship with them over the duration of the nursing program. Students complete a variety of assignments designed to facilitate learning gerontological nursing concepts. They also complete specific assessments designed to target common problems in aging. Students develop nursing care plans and interventions during the course of the project and monitor progress toward goals over time. Through the LEI, students develop relationships with older adults in the community and view their health changes longitudinally. In addition, students can observe how social, financial, and health-related factors affect health and well-being over time.     

School nursing in an underserved multiethnic Asian community: experiences and outcomes

Based on an Asian faculty's previous work, University of South Alabama College of Nursing conducted a project targeting the Asian population in Bayou La Batre, Alabama. The Helene Fuld Health Trust, HSBC, Trustee funded the project to demonstrate effective models for involving nursing students and faculty members in community-based practice. This project provided health services and developed educational programs for this underserved population. To facilitate entry into the Asian community, the College established clinical sites at 2 schools in Bayou La Batre that had the highest concentration of Asians in Mobile County's public school system. The purpose of the project was to develop a new curriculum, to involve nursing students in community-based practice, and to provide health care services in the community. The health services, educational programs, and community instructional activities generated substantial outcomes for the targeted population as well as nursing students. Nursing students learned to assess aggregates, plan, and evaluate interventions. The learning outcomes of the nursing students were evaluated using objectives developed in accordance with Bloom's (1956) Taxonomy. The project not only complemented and expanded existing school health services and programs but also filled the void in some health service and program areas. Preliminary evaluation of the project revealed overwhelmingly positive feedback from both the nursing students and Bayou La Batre school teachers. This article also explores the implications of the newly issued "National Standards for Culturally and Linguistically Appropriate Services in Health Care" for nursing education in the contexts of the Census 2000 and the megatrend of globalization.     

Service learning: a tuberculosis screening clinic in an adult residential care facility

Service learning is an educational experience that equally benefits the educational institution and the organization where the service is provided.A tuberculosis screening clinic was a mutually agreed upon service learning project that was conducted by baccalaureate nursing students for residents of an adult residential care facility. The college, the adult care facility, and a local public health agency participated in the clinic. Each organization contributed significant resources for the clinic, making it a unique project that was mutually agreed upon and implemented, as well as mutually beneficial.     

Community Analysis: A Collaborative Community Practice Project

Abstract Lack of access to health care is a concern in many communities. A group of representatives from health, social service, other community agencies and nursing education meet regularly to address issues in providing care to homeless, low-income, and uninsured persons in Spokane. Washington. This group's efforts has been hampered by lack of clearly identified factors that adversely affect access to care. One aspect of community analysis performed by this group used a collaborative community practice model. Community diagnoses were determined from information collected from service providers. Community health nursing faculty, as clinical specialists, can play a role in such a collaborative process.     

A qualitative exploration of nursing students’ perceptions of the homeless and their care experiences

The health care needs of the homeless are more complex than those of the population at large. The purpose of this qualitative study was to explore undergraduate nursing students’ perceptions of the homeless. Thematic content analysis of responses from 19 undergraduate nursing students yielded four themes describing student experiences with the homeless, their perceptions of homelessness and the health care of the homeless, and their suggestions for best teaching strategies. Students in this study had varying amounts of experience with and knowledge of the homeless. While our participants strongly believed that homeless people deserved compassionate, equitable nursing care, many of their statements suggested an implicit bias toward the homeless. This suggests that student nurses need more comprehensive education concerning the homeless and the health care needs of this vulnerable population. Few interventions aimed at educating student nurses about homelessness and changing their attitudes to mitigate bias are based on research, particularly research conducted from the perspective of the homeless, and few explore the impact of civil interactions on health outcomes. The findings of this study may assist nurse educators in developing education interventions to improve students’ knowledge of homelessness.     

Combining community health and psychosocial nursing: a clinical experience with the homeless for generic baccalaureate students

A report is made of a teaching approach which combined community health and psychosocial nursing clinical experiences for senior level, generic, baccalaureate nursing students over a period of two academic quarters. An urban community center and shelter for the homeless was the setting for this unique clinical approach. Areas on which the evaluation of the clinical experience focused included the clinical design, student activities, types of clients seen, and student and faculty views. Strengths and limitations of the experience were identified. The progression of the student group in adapting to the homeless population was described in detail. Faculty concluded that by sharing their clinical expertise in this combination clinical setting with the homeless, generic students were able to maximize and coordinate their academic and clinical activities. The homeless setting is demonstrated to be an excellent arena for student learning when faculty provide structure, support, and guidance.     

男性护士教育培养现状与对策

南丁格尔创立现代护理以来,护理一直以女性为主导,男性在护理队伍中所占比例很小。人们的健康需求需要男性护士提供护理服务,所以,教育培养一定数量的男性护士势在必行。在培养男性护士的过程中面临生源少且专业思想不端正、心理状况较差、角色适应难度大等问题。提出解决对策:教育者和学习者应该认清护理发展史上男性护士曾经扮演的重要角色,从社会需求和人类健康需要的角度认识男性护士在健康服务中的必须性,认清男性护士在护理职业中的优势,加强对男性护士的宣传,并针对男性护生的学习特点和社会需求开展教育培养。     

The New Paradigm: Concepts and Application in Community Health Nursing

Abstract The central role of community health nursing in future health care delivery systems is undisputed. The abilities and characteristics of nurses who will practice in those systems depends to a large extent on their learning experiences in basic nursing programs. Educators are being asked to prepare skilled, compassionate scholar-clinicians to provide care for the complex needs of clients, despite already packed curricula. The curricular changes cannot be additive; learning must be designed to empower students to become nurses who are both skilled and compassionate. Certain faculty attitudes and behaviors are essential to this new educational paradigm, and student activities and assignments must foster confident, effective practice.     

School Nursing Is Alive and Well in Kalamazoo,Thanks to Nazareth College Nursing Students

Kalamazoo, Michigan, public schools have not had nurses employed by the board of education for over a decade when nurses were cut from the school budget as an austerity measure. Approximately 26,000 school-age children live in Kalamazoo County, including a large inner-city, low-income population, many of whom have meager access to health care. Two part-time public health nurses provide consultation and limited direct services. Nazareth College's commitment to community service has resulted in the placement of nursing students in elementary school settings. The nursing faculty orients the students and takes responsibility for their experience. These students have planned and implemented health-promotion projects that have been well received. Suicide prevention, disaster response, nutrition, and personal hygiene are examples of topics. The challenge for school nursing is as great today as it was in 1902 when Lillian Wald first identified a need for school nurses. Through this program, the students are gaining rich experience, increased independence, and a sense of helping to meet a community need as they meet their own learning needs in community health nursing.     

Health and service utilization patterns among homeless men in transition: exploring the need for on-site, shelter-based nursing care.

Between September 1999 and May 2000, as part of a larger faculty/student teaching project, data describing the demographic, health problem and service utilization patterns of 183 newly sheltered homeless men (mean age = 42) seeking on-site nursing clinic services were collected and analyzed. Upon arrival to the transitional shelter, 46% of the study participants were medically uninsured or received state subsidized health benefits (49%). Almost all (99%) were in recovery from substance addiction. Despite numerous self-reported health problems, 44% had no primary care provider and 35% were seen only sporadically in local hospital clinics or in emergency departments. During the study period, nurse practitioner students and faculty managed most of the residents' episodic illnesses on-site, while assisting them to secure insurance coverage and medical appointments as a prelude to independent living. This was an attempt to curtail residents' previous pattern of waiting until medical problems became serious before seeking treatment. These findings mirrored those in studies of similar populations equating on-site delivery of health care to cost reduction. Unfortunately, many nurse-managed clinics, like our study site, fail to generate data supporting nurses' clinical efficiency and cost effectiveness in caring for homeless individuals. As such, nurses' work remains invisible and underappreciated. This article argues that future studies examining nurses' work and worth in caring for homeless individuals are necessary in determining future health care service planning with this vulnerable population.