Service Learning: Story of Engagement

Service Learning with the Cone Health Congregational Health Nursing Program

A vital component of the Regis University DNP program is focused on service learning as described in my Service Learning Reflection Blog.  According to Ash and Clayton (2004) “reflection pushes the student beyond a superficial interpretation of complex issues and facilitates academic mastery, personal growth, civic engagement, critical-thinking, and the meaningful demonstration of learning” (p. 137).     

My experiences with the Cone Health Congregational Nurse Program have enriched my DNP learning activities in multiple ways and I’d like to enumerate these experiences by utilizing the DEAL Model described by Ash and Clayton as follows:

• Description – (objectively) of an experience.
• Examine / Analysis – in accordance with relevant categories of learning.
• Articulation of Learning outcomes - including goals for the future (2004, p. 140).

Academic Dimension:

Description:  The NUR 725C Application to Practice course gave specific guidelines for the completion of our service learning activities.  The Regis University DNP Advanced Leadership in Health Care Specialization degree overview (website) spoke to the focus on service to vulnerable, underserved, and diverse populations in both rural and urban settings.  The Ignatian Pedagogy Conceptual Model reinforced the DNP course content with four Guided Reflection steps that included context, experience, action, and evaluation.  

My Service Learning Project entails working with the Cone Health Congregational Health Nursing Program as they serve clients that include the uninsured working, poor/homeless, immigrants, elderly, and members of congregations participating in the health ministry program in my community.   Congregational Nurses provide health screenings, referrals to medical clinics and social service agencies, educational programs, and individual counseling as needed for these underserved / vulnerable populations.  I have had the opportunity to work with diverse populations including Hispanic parishioners, immigrants from Asia and Africa, Vietnamese members of St. Mary’s Catholic Church, the homeless and poor (NC Missions of Mercy Dental Program) and most recently the Rockingham County Veterans Stand Down event. 

 Analysis:   Working with the Congregational Nurses has given me a broader understanding of the needs of the vulnerable populations in my community.  Many of the Hispanic parishioners shared stories of his or her “first” experience receiving health care screenings in our county.  An interpreter was available to help participants as they received referrals to the Free Clinic in Rockingham County for follow-up care and counseling.  I discovered how important it is to refer to Hispanic participants as “undocumented” rather than “illegal”  immigrants in conversations with other health care workers.  What a difference a few words can make in the lives of these people.  I sensed God’s presence in each of these encounters;  in the grateful eyes of the adults and the shining light of joy and optimism in the faces of the children.

Articulation of Learning Outcomes:  It was such a humbling experience to hear stories, such as the young man who started walking before dawn to receive dental care with the NC Missions of Mercy program, as we arrived on-site to see lines of people wrapped around the college gymnasium waiting for dental care.  And…stories of the two Vietnam veterans (brothers) who entered the military together to serve our country.  The “older” brother smiled and proudly stated he was responsible for looking out for the “younger” brother as they stood in line together at the Veterans Stand Down event.

What we gave in services during each of these events could not compare with what the participants gave each of us.  Most importantly we received clarity for our purpose described by the Ignatian ideal for each person to be very sensitive to the emotional movements that shape them as we examine “how ought we to live?” (Ignatian Pedagogy:  A Practical Approach).

Personal Dimension:

As we go forward, it is very important that we continue to examine how we can help these vulnerable populations in Rockingham County.  My future plans include staying with service learning activities on a regular basis following my DNP graduation.  Some of the personal questions that come to mind include:

·      How can we find additional resources to support these groups?

·      How can we promote “awareness” of the critical needs for vulnerable populations in our community?

·      How can I “weave” service into my weekly/monthly routines to avoid “dropping the ball” following our educational experiences.

One of the most important things needed by all of these groups is the ability to find employment in a county that is already designated as a Tier 1 – most distressed counties in NC (NC Department of Commerce).  As a department chair at Rockingham Community College, I will have the opportunity to raise these issues on a continual basis as we look for avenues to increase workforce development in our county.

Civic Dimension:
The Cone Health Congregational Nurse Program partners with groups and agencies throughout Guilford and Rockingham Counties.  Along with individual faith communities, I have had the honor of working with the NC Dental Society’s Missions of Mercy and the Rockingham County Veterans Coalition.  Civic groups in Rockingham County (examples - Lions Association, Rotary International, Kiwanis, Habitat for Humanity) strongly support these events by providing vendors, medical personnel (physicians, dentists, nurses, technicians) and other resources as needed.

According to Ash and Clayton, examination from the civic perspective requires an exploration of decisions made and actions taken in light of consequences for the common good, consideration of the elements of power and privilege, and options for short versus long-term changes (2004, p. 141-142).  As I reflect on the service learning experiences supported by these civic groups, I can see commitments for the greater good as evidenced by physician / dental practices as they volunteered time and resources to provide much needed services to these vulnerable populations.  Short-term goals have certainly been met while plans for additional services are already in progress.  The Cone Congregational Nurses are instruments of change as they continue to provide and improve health care services in our community.  It is an honor to work alongside this health ministry group as they collaborate with physicians and others to provide personal health counseling, health education, and referral assistance to enhance the health status of people  in Rockingham County.

Ash, S. L., & Clayton, P. H. (2004).  The articulated learning:  An approach to guided

            reflection and assessment.  Innovative Higher Education, 29(2), 137-154.

American Association of Colleges of Nursing (2009). The essentials of doctoral

education for advanced nursing practice.  Retrieved from

 http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

Ignatian Pedagogy:  A Practical Approach. Retrieved from

http://www.rockhurst.edu/media/filer_private/uploads/ignatian_pedagogy_a_practical_approach.pdf

North Carolina Department of Commerce.  2014 NC County Tier Designations. 

Retrieved from http://www.nccommerce.com/research-publications/incentive-reports/county-tier-designations

Regis University.  Doctor of Nursing Practice – Advanced Leadership in Health Care

           Specialization.  Degree Overview. Retrieved from  http://www.regis.edu/       

Veterans Stand Down: October 31, 2014

The Rockingham County Veterans Coalition held their 4^th Annual Needy Veterans Stand Down on October 31, 2014 at the National Guard Armory in Wentworth, NC.

There were a number of free services provided that included:

• Dental Van and Vision Services
• Haircuts
• Legal services – NC Legal Aid for Veterans
• Help for the Homeless;  Red Cross;  VA Medical Center
• Blood pressure checks, blood glucose monitoring, flu vaccines
• Clothing, blankets, and sleeping bags
• Breakfast and Hot lunches
• Transportation to the Stand Down from cities within Rockingham County

The Cone Health Congregational Nurse Program provided services including blood pressure checks, flu shots, blood glucose monitoring, and health counseling advice.  We arrived at the Armory before 8 am to set up tables and prepare for the arrival of the veterans.  There were “staff” personnel wearing blue T-Shirts with STAFF in large letters across the front of the shirt with the Rockingham County Veterans Coalition logo.  Volunteers wore cream-colored T-Shirts with VOLUNTEER across the front with the same logo.

The event opened with the JROTC students from a local high school presenting the colors followed by the Pledge of Allegiance and National Anthem.  Immediately following the opening, the volunteers walked to the entrance of the Armory and escorted a veteran into the auditorium for services.  One volunteer was assigned for each veteran and remained with that specific veteran throughout the event.  The volunteer walked with the veteran to each of the tables lined up against the walls for health services, haircuts, vision checks, etc. and  outside to the dental van as needed.  The volunteer stayed with his or her veteran during the meal provided for lunch.  They shared food, stories about the veteran’s experiences, and gathered information for future needs. 

My role in this service learning experience:

During this Veterans Stand Down event, my role included registration and documentation for the Congregational Health Nurse as she provided blood glucose screenings.  Ms. Rakestraw is a Certified Diabetes Educator as well as a Congregational Health Nurse.  She gave each participant counseling on healthy food choices, follow-up referrals as needed, and encouragement with individual health care needs.  One veteran had a blood glucose screening of over 400 mg/dl.  Ms. Rakestraw made an immediate referral to a local physician for the afternoon following the Stand Down event.

This program was such a humbling event and I have a new appreciation for the struggles of our older veterans as they face poor living conditions and a lack of resources we take for granted each day such as haircuts and hot meals. Each veteran received a sleeping bag, box of food, new clothes, blanket, and backpacks along with informational materials from the agencies participating in the event.  All of the congregational nurses took special care to say “thank you for your service” as veterans visited our tables.  Their smiles, stories of service, and gratitude made this event the highlight of my week and I am looking forward to the 5^th Annual Needy Veterans Stand Down – 2015! 

Ark of Salvation Evangelical Church: October 26, 2014

Iglesia Evangelica Arca De Salvacion provides one of the congregational homes for Hispanic Ministries in Eden, NC.

The Cone Health Congregational Nurse Program provided flu vaccines for the members of this Hispanic church on Sunday, October 26.  Congregational Health Nurses provide personal counseling, health screenings, health promotion activities, educational programs, and advocacy for clients within the area’s faith community.   

There were 15 vaccines administered during this event.  An interpreter was available to translate information and health counseling advice as needed for the participants.

My role in this service learning experience:

My role in this activity included assisting the congregational nurses with registration, supplies, and documentation as needed. 

This is a very rewarding service project.  There are two additional Hispanic congregations scheduled to receive flu vaccines in November.  These vaccines are available for adults only; children may be taken to the public health department to receive flu vaccines. 

To be continued…