Calvin College

CALVIN - Minds in the Making

Strengthening Liberal Arts Education by Embracing Place and Particularity

Case Study

Transforming a nursing department by emphasizing place and partnership

Transformation of a Nursing Department

In 1997, two faculty members piloted a partnership with one underserved urban neighborhood, where service to the community was emphasized as much as the student learning.  As the experience and relationship grew, the partnership began to in turn impact student practice and the faculty member.  During this time, the department began to see the benefits of the experience and embrace the thought of a new approach to student practicum experiences.  All baccalaureate nursing programs have a community practicum component where students spend time outside of the acute care setting.  Traditionally these experiences have involved providing nursing care to a population already being cared for by other community nurses and health care agencies.  This approach occasionally resulted in community residents feeling like they were being used for student learning, agency staff displaying weariness in the extra time demanded on them to oversee a student, competition for community sites among local schools of nursing, and faculty feeling challenged to promote an ideal learning experience in the midst of the previous three.  In contrast, the piloted partnership led to community agencies viewing nursing students as an asset, residents feeling like they benefitted from nursing student activities and students who were excited about an educational experience that actually met a gap in health care rather than duplicating care.

 When faculty began writing the new curriculum, the department decided to replicate the piloted approach throughout the curriculum and apply it to all students in their community practicums rather than just a few in the pilot.  To accomplish this goal, the nursing department formed partnerships with two additional underserved, low income neighborhoods in the surrounding urban area.  Relationships were built with residents and service providers in the two new neighborhoods before initiation of the curriculum.  The neighborhood was assured that the nursing department was committed to a long-term relationship where effort would be made to match student learning experiences with the strengths and needs of each neighborhood.  The nursing department desired an even deeper partnership than in the pilot where community voice would drive student learning experiences across the curriculum.  During the first two years of the new curriculum, community based participatory research methods were used to listen to the voice of the neighborhood (Heffner, Zandee, & Schwander, 2002).  Some of the top neighborhood concerns voiced by residents were access to health care, hypertension, diabetes, asthma, depression, unintended pregnancies and lead poisoning.  Action plans were written in collaboration with residents and neighborhood providers to match specific strengths and needs identified by each neighborhood with strengths and learning needs of nursing students.  Through this process, place began to shape student practice across the curriculum.

The nursing curriculum has 4 semesters of coursework, consisting of theory, lab, and practicum experiences.  In the 1st semester, students have a 5 week practicum experience of 13 hours a week in their neighborhood, providing nursing care to individuals within the context of their family and community.  Some activities students participate in include:  providing nursing care at a neighborhood clinic, teaching health education at neighborhood schools, promoting health among children at risk for diabetes, and providing blood pressure and blood sugar screenings at various neighborhood sites.  During the 2nd semester a portion of the students return to their neighborhood for 15 hours of practicum time providing asthma education and care.  During the 4th and final semester of the nursing program, students return again to their neighborhood of origin to learn how to provide nursing care to the neighborhood as a whole.  For this practicum experience, students spend 13 hours a week for 6 weeks.  Some activities students participate in include: community health fairs, providing assessment and health education for diabetics, lead poisoning screening and education, and working with a community health worker (neighborhood resident) promoting health and access to care for the neighborhood.
 
By investing in a neighborhood as “place” and having students return to that neighborhood across the curriculum, not only do students learn about the role of the community health nurse, but students wrestle with deeper issues such as disparities in health, injustice, and how to apply the core virtues of the colleges curriculum (such as diligence, patience, courage, creativity, empathy, humility) to a specific neighborhood in which they are engaged.  Students see the value of long term commitment to their community by building on the work done previously by students and casting a vision of health in their neighborhood for the future.  They also feel a sense of pride that their educational experience was not solely for their benefit alone.  They graduate knowing that they have made a significant impact on the health of the most vulnerable in the city.

Because the department’s investment in place flowed so closely to the mission of the college, administration was very supportive of their efforts from the beginning.  One key to successful community partnerships was having the necessary staff to develop, maintain and sustain the partnerships.  The nursing department created a position for one part-time faculty to oversee the neighborhood partnerships as a whole and built in time for three neighborhood coordinator faculty (one per neighborhood) to oversee student activities along with strengthening relationships in each neighborhood (Feenstra, Gordon, Hansen, & Zandee, 2006).  These unique roles were affirmed and supported by administration.  An exciting, additional result of these new faculty roles was a level of engagement that not only allowed faculty to accomplish their curriculum responsibilities but to act as a living example of commitment to place.  Outside of their job, each neighborhood coordinator faculty volunteers at their neighborhood clinic, participates on neighborhood boards, or serves in various neighborhood functions.  This deepened investment by faculty infiltrates their teaching and models a true commitment to place to students.

Place and partnership has also made a significant impact on departmental scholarship.  Faculty have pursued grants, conducted research and disseminated results both locally and nationally in an effort to address concerns identified by each neighborhood, promote social change, and impact the future of how community practicums are taught in schools of nursing.  The interesting part of this impact was not only did place increase scholarship opportunities for faculty but it actually shaped what topics faculty were researching and grants they were pursuing.

Lastly, having a department committed to partnership and place has opened doors to collaborate with other departments on campus.  The nursing department has sought the help of other disciplines when nursing alone was unable to meet the needs identified in their neighborhood or felt that collaboration would allow the issue to be addressed more effectively.  In addition, other disciplines on campus have approached nursing when they were seeking to expand community learning opportunities for students.  New opportunities for collaboration have also expanded for the nursing department with those external to the college.  Over the past 5 years, nursing has had the opportunity to collaborate with community agencies and neighboring colleges and universities in areas of scholarship and practice within the partnering neighborhoods.

 

Next: Involving Community Leaders