The Nurse is In
Carroll’s nursing students have an ongoing presence at the United Community Center. “Throughout our curriculum, we thread different opportunities for our students there,” said Dr. Teri Kaul, chair of the nursing department. Nursing students spend time visiting classrooms in the Bruce Guadalupe Elementary School and delivering lessons in health literacy to the students. Nursing students also rotate through the student health center to gain experience in pediatrics. And students in their final year may spend a full semester at the school health clinic, alongside the school nurse, gaining direct experience in dealing with children and their families.
Then, in fall, armed with that knowledge, the teams were introduced to their clients. Through the semester, the teams met regularly with them, developing a case history of that person. Their task, according to Vega, was to examine three determinants of their client’s physical health—physical, social and emotional—and propose some interventions they could undertake to improve it.
That process, of getting to know a person, of drawing out their story and developing a rapport, can be daunting, even more so when the person speaks another language. Enter Carroll’s Spanish program, which provides students to serve as interpreters. The program has launched a course in medical terminology designed to prepare students to act as interpreters and conduct medical interviews. A student is assigned to each team that requires interpretation.
“We couldn’t function without him,” said Makenzie Kirk, a PA student, of their team’s interpreter, Sam Rodriguez, a Spanish and pre-PT major. Their client, an elderly male, was initially apprehensive about the program. “Until we played dominoes,” recalled Rodriguez with a laugh. Games were just one of the tactics students used to get to know their clients and develop trust.
Faith in Each Other
Of course, the barriers students have to surmount weren’t just between students and clients, but between students from different disciplines as well. “We must teach that collaboration,” said Brandes. “When they go out into practice, it will be expected that they do that. Through this experience they learn what the other practitioners can offer.”
That’s one of the goals of the fall semester for each team. “We each know what we know, but it’s important to realize what all the others know as well,” said Andrew Johnson, a PT student. “Having the members of my team share their wealth of knowledge—their expertise—has just been so beneficial.”
And practical. After all, said Kaul, “We will all work together in the workforce. So, let’s learn about each other and how we each complement the team and build on those strengths as we work together. We want the best for the patient, however that looks. And every patient will be different. At the bottom line, we are all there for the same reason...better patient outcomes.”
Such awareness is key to the model of integrative care Carroll faculty hope to inspire. It has an added bonus. As they learn what other disciplines can offer and how each practitioner views the patient, the students begin to develop a picture of the patient as a whole, complicated, multifaceted human being.
“It’s enlightening to learn and understand that each student is a part of the team,” said Erin May, an OT student. Samantha Osterberger, a PA student and teammate of May’s, noted how they began to trust one another during this process. “It made me realize I need to rely on the others to manage our client’s whole being. And that we’re treating the whole person.”
The whole person. If you’ve ever gone to seek healthcare and felt reduced to a set of symptoms, you’ll understand how obvious, yet profound, that can be. For the students, who until now have been learning anatomy, science and symptoms, it’s a paradigm shift of sorts.
“At first, the students are just so overwhelmed by all the details of it,” said Dr. Wendie Leveille, a clinical assistant professor of occupational therapy. “Our job is just to help them with the next step and then the next step. First, get to know your client and who they are on the personal level. You have to put that person in the middle.”
Johnson said the students had to overcome that challenge first. “How do we find a way into their life so that we can make an impact? How do we motivate them to make changes?”
Hector Hernandez is UCC’s director of programs for the elderly. He has observed the Carroll teams working with their clients for two years. “To build that rapport and that trust with their clients is very important,” he added. He noted that there was some initial hesitation among the seniors, but that now, partly through word of mouth, they have seniors lined up to participate. “This is a win-win collaboration for us,” he said.
It’s wins all around, really. The students get an immersive education in cutting-edge healthcare practices and experiences dealing with another community. And the clients of the senior center get help.
As part of the grant, teams have money they can spend on health-related items to assist with their proposed interventions. Those might include fitness trackers, water bottles, braces, fitness club memberships or Spanish-language cookbooks, for example. Once the students have spent the fall semester getting to know their clients and conducting their assessments, they’ll work with those clients to come up with some goals for the spring semester.