Volunteers in Medicine Clinic
It’s 9:30 a.m. on women’s health day at the Volunteers in Medicine clinic in downtown Jacksonville and already there’s a lobby full of female patients of all ages waiting to be seen. These women are the working uninsured of Duval County — daycare workers, dental hygienists, waitresses and hair stylists — whose low income and lack of health insurance limit their options for health care.
Fortunately, this option is a good one. Not only does this not-for-profit clinic provide free medical services to families who qualify, it also provides unmatched, hands-on community experience to students in the UNF Brooks College of Health School of Nursing. On this particular day, students in the Primary Care Nurse Practitioner program interact with 40 patients, conducting annual pelvic exams and seeing them for primary-care medical issues like hypertension, diabetes and thyroid disease.
One of those students is Bridgitte Futch, who entered the master’s program after completing the RN-to-BSN Bridge program at UNF. Futch works on the weekends in the emergency room at Baptist Medical Center South while she attends classes at UNF and completes her clinical hours during the week. She spends many hours each week working with diverse populations in the community, developing and maintaining collaborative partnerships and providing health-care services to people in need.
“The community-involvement aspect is introduced at some point in other universities’ nursing programs, but at UNF it’s a constant focus throughout the entire program, from the first semester on,” Futch said. “It’s a more holistic approach.”
The Home-Base Concept
According to both Dr. Pam Chally, dean of the Brooks College of Health, and Dr. Li Loriz, director of the School of Nursing, it’s this approach —providing continuous community-based learning to students from the beginning of their nursing education — that sets UNF’s nursing program apart from all others.
“Our goal is really for comprehensive student learning. Community-engaged learning happens in an environment that benefits the student, because the student learns, but it also benefits the community or the population the student is working with,” Loriz said. “If our students didn’t go to the hospitals to do clinicals, there would always be nurses there to do the job, so that work would still get done. However, if our students were not out there in the community doing community-based learning, that work would not always be getting done.”
As Loriz explains, nursing students not only provide clinical hours in hospital settings as part of the nursing program curriculum; they also spend numerous hours each week immersed in the community — in nursing homes, community centers, homeless shelters and free clinics — providing essential care to diverse groups of people. While UNF students are out in the community learning about professional nursing roles and designing and managing culturally sensitive care, health-care needs for normally underserved populations are being met and the community as a whole benefits.
Putting it into perspective, every year about 450 students in the School of Nursing participate in more than 40,000 hours of community-engaged learning, which serves and benefits the uninsured, underinsured and underserved communities in Northeast Florida.
“The medically underserved are scattered across every walk of life,” said Dr. Michele Bednarzyk, senior nursing instructor at UNF. “Nearly 46 million people in the U.S. lack health insurance; 82 percent are adults 19-64 years of age, and more than 80 percent are from working families. At clinics like VIM [Volunteers in Medicine], students are able to see a variety of patients and learning is emphasized equally with service, enabling students to understand resources that are available and barriers patients face.”
Bednarzyk said one of the main ways for nursing students to really learn is to actively participate in helping to solve health-related problems encountered in the community.
From Day 1 in the School of Nursing’s three undergraduate programs, students are assigned to a community home base consisting of a core group of clinics, hospitals, shelters and community organizations where they work until completing the program of study. Students in the six graduate programs and one certificate program also participate in providing primary-care or acute-care services in clinics and shelters.
This home-base concept has become the dominant feature for all undergraduate programs in the School of Nursing since 2002, when its curriculum was refined to correspond to changes in health-care delivery trends. The changes included focusing on understanding community environments and how individual families with health challenges reintegrate into their home communities. This concept is also currently being implemented in the graduate programs.
Its commitment to relevance, collaboration and meeting community-defined needs, as well as its distinctive curriculum, is what earned the School of Nursing’s flagship designation in 2005. The goal was for the school to gain national attention and become a model for nursing programs around the country. The school is well on the way to achieving this goal, as evidenced by the presentation in 2008 of the Innovations in Professional Nursing Education Award by the American Association of Colleges of Nursing. With funding that accompanied its flagship status, the School of Nursing continues to focus on the mutually beneficial home-base concept.
“The students stay in the same community the whole time they’re in the School of Nursing, rather than moving from one community to the next,” Chally said. “I don’t think nursing students are able to fully understand the community and develop partnerships to meet its specific needs without spending an extended amount of time there.”
St. Vincent’s HealthCare’s Mobile Van
Even first-semester nursing students delve into working in the community from the get-go. In their first semester of the BSN (Bachelor of Science in Nursing) program, Megan Knight, Shae Raulerson and Kristin Sanders perform like seasoned nurses as they check in children for their school physicals at the Ed Stansel Clinic in Green Cove Springs. The clinic, indefinitely closed due to lack of funding, has opened for one day as part of St. Vincent’s HealthCare’s Mobile Health Outreach Ministry. Through a decade-long collaboration, UNF nursing students help deliver medical services provided via the St. Vincent’s mobile van, which employs a small staff and travels throughout Northeast Florida to provide free medical care to underserved populations.
Taking turns conducting vision tests and recording the weight, height and blood pressure of incoming patients, the new nursing students are glad to participate in the hands-on work.
“We’ve already done so much, including going into nursing homes and working with the elderly, going to Vistakon to help with employee checkups and going downtown to the Sulzbacher Center to work with the homeless,” Sanders said. “I’ve enjoyed all these experiences and I’ve learned so much.”
Several nurse practitioner students are also helping out at the clinic, including Kristi Hurt and Linette Jackson, both already registered nurses completing the master’s program part-time.
“UNF works with the St. Vincent’s mobile health team to utilize their equipment and work together with their doctors and nurses to make sure every child is seen and examined thoroughly,” said Hurt, who plans to eventually earn her Doctorate of Nursing Practice at UNF. “Most of the kids here today don’t have insurance or a primary care office, so we’re here to make sure they get school physicals and are up-to-date on their immunizations.”
Jackson has been a nurse for 11 years, but until she came to UNF, she hadn’t experienced public health firsthand.
“I really think UNF’s nursing program is awesome because it exposes students to the community aspects of nursing,” she said. “Once I entered the BSN program, I decided I’d like to focus on public health. Helping people who don’t have access to health care is just so important, so that’s the direction I’m heading.”
Healthy Start Coalition
On the Northside of Jacksonville, one group of last-semester BSN students head to City Rescue Mission to present one of two educational programs to residents of the homeless shelter as part of an ongoing collaborative project with the Healthy Start Coalition, an organization dedicated to reducing infant mortality in Florida. The students discuss topics like nutrition, exercise, prenatal care, women’s health and breastfeeding.
“Infant mortality is a big problem in Jacksonville. We lose 125 babies in Duval County each year, so our presentations cover ways women can get healthy before becoming pregnant or while they’re pregnant so they’ll have healthier babies and healthier families,” said student Erica Mitchell.
Sarah Holdstein, a UNF alum employed by Healthy Start, has worked with UNF nursing students for the past three years. “The students from UNF have been amazing,” she said. “The work we do here at Healthy Start couldn’t be done without them because we don’t have the manpower to do it alone. We’re so grateful UNF nursing students are so willing to collaborate with us as colleagues.”
The Mission House
In Jacksonville Beach, other students at the end of their BSN program are busy completing paperwork to secure free prescriptions for patients at The Mission House, a non-profit outreach center dedicated to helping those in need. Guided by associate professor Dr. Barbara Olinzock, nursing students Cheri Faurie and Ashley Foyt have perfected the Mission House Prescription Assistance Program.
Faurie said the most important thing she learned through the BSN program was how different each population is and how great their individual needs are.
“The community aspect exposed me to the varied populations that exist outside the hospital, because in the hospital, you treat patients only for the ailments they’re in for,” she said. “In the community, you get to actually see how some of these people live their daily lives and figure out what their health needs or concerns are, either as individuals or as part of specific populations.”
Olinzock believes having students work with diverse and vulnerable populations makes them more sensitive to patients’ needs in any setting.
“Prior to this [home-base] experience, students were very hesitant to work with populations like the homeless or in certain areas of the city,” she said. “Our students now speak of being better advocates for their patients and understanding the challenges for vulnerable persons that exist in our health-care system.”
Olinzock said through the home-base program, UNF faculty watch as their students mature and grow as nursing professionals, often having experiences that are life-changing.
“Students’ logs and journals are very profound as they describe what their experiences have meant to them,” she said. “Many students go on to commit to volunteer service as a result of their home-base experiences. In this way, they truly become a part of the community.”