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In sickness and in health

blood pressure screening

Imagine that you are the parent of a toddler who is ill and exhibiting symptoms such as a fever and sore throat. You live in Steelton, and your child’s doctor’s appointment is in downtown Harrisburg. You must use the bus system to get to the office. The doctor examines your child and orders more tests at a separate facility, so you have to take the bus to yet another location. After more waiting in another medical office, you and your exhausted and ill child still have the bus ride home, complete with several connections, ahead of you.

Such is a sample scenario that a senior student in associate nursing professor Wanda Thuma-McDermond’s community health clinical rotation might receive, along with a bus pass so that they can maneuver the city under conditions similar to what their community health clients might face.

Learning opportunities
Thuma-McDermond believes that it’s important for students to understand as entirely as possible the myriad challenges that the economically-disadvantaged clients that they encounter at any of Messiah College’s three community health centers face on a regular basis.

For 12 years, Messiah College has operated a community wellness center on the second floor of Hoy Towers, a 10-story apartment building in nearby Steelton, in partnership with the Dauphin County Housing Authority.  Kay Huber, retired associate professor of nursing, began the program in 1998. There students encounter primarily older residents who are sometimes socially isolated and often have little economic means. Recently the College also partnered with Silver Spring Gardens and Courtyard in Cumberland County and Green Meadow Apartments in northern York County to open two additional centers.

In 2009, 517 contacts were made through Hoy Towers, and an additional 25 at the Silver Springs and Dillsburg locations.  Besides working from these three established centers, Messiah students and staff occasionally travel to other areas of need in central Pennsylvania to provide needed services such as blood pressure screenings, weight and foot checks, and pulse and respirations assessments.

blood pressure screening

Under the supervision of Center directors, nursing students provide a number of services, including chronic health problem monitoring, medication assessment, education, and management; health and safety assessment; health promotion and education programs; blood pressure and weight monitoring; and nutrition counseling.

In keeping with the nursing program’s goals for these centers, students learn to refine their assessment and intervention skill, expand their definition of nursing, have a cross-cultural health care experience; learn about community resources, encounter the world of insurance and reimbursement, engage in collaborative practice, learn to explain a huge number of medications while having the privilege of serving an economically disadvantaged population of primarily older adults. And, though not a defined responsibility or goal for the program, many students also find themselves in impromptu learning situations in which they are using a screwdriver to fix a broken walker, arranging transportation for a non-English speaker, or politely listening to a crocheting lesson taught by a socially isolated resident.

According to Thuma-McDermond, students are often as impacted by the experience of helping someone in need with the details of day-to-day life—things like coordinating transportation and making improvements to living spaces to provide for greater mobility—as actually utilizing their nursing skills to do more predictable things like take blood pressure or review medicine plans. Thuma-McDermond adds, “These centers are about providing and promoting wellness at the point where they [the residents] are.”

Results
As a result of their community health rotation, some students opt to refine their senior year research and focus on developing and promoting programs for populations of older adults most in need of additional attention.

One such project that emerged was “Walk and Win,” a program utilized by more than 170 senior citizens at six participating centers that taught older adults how to use a pedometer while better understanding the benefits and strategies for safe walking. The program’s success as well as outcomes from the study were published in “Geriatric Nursing” magazine.

About the nursing program at Messiah College
Messiah College’s nursing program is 25 years old and has graduated 975 nurses. Nursing is currently the largest major on campus.

A hallmark of the program is the diversity of experience available to nursing students; the nursing program has clinical agreements with hospitals, rehab centers, hospices, and primary care settings throughout central Pennsylvania.

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