UpDate - Vol. 11, No. 34, Page 1
June 11, 1992
Community experience reflects expanding care

     The profession of nursing is undergoing change. Because of the
high cost of hospital stays, health care is becoming more home and
community centered. Premature babies on ventilators with tracheal
tubes are cared for at home; a patient with a catheter in the heart
for medication is no longer kept in the hospital.
     As nursing care moves out of the hospital, many nurses are
expanding the focus of their profession, not only in helping and
supporting family caregivers, but in promoting and teaching wellness
to the community- at-large.
     To familiarize nursing students with working in a neighborhood
setting, Evelyn Hayes and Linda Matocha, both associate professors of
nursing, have facilitated the use of community centers in meeting
clinical criteria in a course, "Determinants of Wellness," offered to
first-semester juniors.
     The students are assigned to neighborhood centers in the area,
mostly in Wilmington , such as the Latin American Community Center,
the West Side Neighborhood House, Peoples Settlement and Edgemoor
Community Center.
     "It is a learning and growing experience for students, and it is
beneficial to the people the centers serve, " Matocha said.
     The students, in groups of about 10 for each location, tour the
center and get acquainted with different groups of residents who use
the facility, from children to seniors.
     They also get a feeling of the neighborhood, by walking around
the area, assessing police and fire protection, the condition of
streets, sidewalks and lighting, looking at schools and libraries.
They visit the local ethnic and neighborhood stores, and then make
maps and reports of what they discover.
     "Many of our students have never been in city neighborhoods or
been involved with different ethnic groups. The course provides an
introduction to the variety of clients they will be serving and to the
many cultures in a city setting. As they become involved with people
in the community centers, what they learn is that we all share common
concerns and are more alike than we are different,"Matocha said.
     An important part of the course is working with residents on
wellness programs. With a faculty member, students select an age group
to work with on health issues and then develop a program.
     "They don't just give a program off the top of their heads that
they think is a neat idea. They learn about the age group with whom
they are dealing, find out what topics are appropriate and then
research and organize a program.
     "The program helps educate people about health issues. The
process also helps students with communication and teaching skills,
which are important during their careers when working with staff,
patients and the public. The programs are critiqued by fellow
students. This also helps them to learn how to give constructive
criticism," Hayes said.
     As examples of programs for pre-teens and teenagers, the students
may present programs on sex, smoking, drugs and alcohol. For seniors,
nutrition, exercise and hygiene are addressed. Stress reduction is a
topic for those in their middle years.
     For children from ages 6 to 8, Hayes said a Halloween safety
program, where the children made safe masks, was successful.
     Wellness training involves hands-on practice as well. As an
example, students in succeeding semesters monitor blood pressure for
older adults or help assess school-aged childrens' hearing and vision.
In day care centers, students work with preschoolers to assess
developmental levels. They also provide nursing care in clinics or
nursing homes.
     Another clinical experience includes home care where nursing
students accompany a nurse on his or her rounds, and they may help
change dressings, weigh a new infant or talk to a new mother who may
have a drug problem.
     "It's exciting to watch the students change, gain confidence and
develop independent judgment," Matocha said.
     "The second semester for juniors is intense training in clinical
centers and hospitals, but we would like to see this community
component extended for a longer period of time, so that students
maintain contact with the neighborhood centers and there is more
continuity," Hayes said.
     The test of the program is in its acceptance. "When the directors
of the neighborhood centers were first approached, they were somewhat
leery. But now they are calling up and are eager to have the program
return," Matocha said.
                                        -Sue Swyers Moncure