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March 18, 2015
Public health nursing is as old as modern nursing itself — Florence Nightingale championed concepts like health promotion and disease prevention in communities as far back as the mid-1800s. Now a new East Carolina University blog is drawing attention to this seminal approach to nursing, which is the focus of a required class for all graduating nursing majors.
“Public health nurses work with whole communities to serve and educate populations and specific groups,” said Clinical Associate Professor of Nursing Jane Miles. “They create plans and initiatives that help people manage their health and avoid illness in the first place.”
Miles is one of two College of nursing faculty members who teach the didactic course, NURS 4210, “Nursing Care of Populations and Communities,” to about 130 students each semester. The course addresses a long list of topics from the standpoint of community health, from adolescents and sexual health to hospice care.
The course also has a clinical component, NURS 4211, and that’s where the blog comes in. Each student is assigned to work with a preceptor who is a registered nurse in one of many types of clinical sites: schools, health departments, home health or hospice agencies, occupational health settings, cardiac rehabilitation programs, community early childhood programs, or chronic disease case management programs.
“Small group clinical conferences among the students help them connect their didactic learning with the clinical experiences,” explained Clinical Assistant Professor of Nursing Karen Krupa, who is one of seven community health faculty members who teach a total of 13 clinical sections of the course each semester.
The future nurses also team up to take on community service-learning projects based on their clinical placements. The projects are conducted within the clinical settings or within the larger associated community. Students are responsible for everything from performing a community assessment to implementing and evaluating the effectiveness of an intervention. They spend the entire length of the course working on the assignment.
“The projects are based on a community needs assessment with on-site clinical nurse preceptor and faculty input,” said Associate Professor of Nursing Kim Larson, who teaches didactic and clinical sections of the course.
The result is a wide range of initiatives — 30 in total this semester — that impact a number of different populations in the region. The new blog showcases all of them, from encouraging proper needle disposal in diabetic home health patients, to evaluating the need for car seat safety information in Craven County schools and daycares, to encouraging dental hygiene in the Wake County homeless population. The projects are guided by the seven community health faculty members, including Tara Leeder, Sharon Mallette, Sandra Morris, and Monica Parker, along with Krupa, Larson and Miles.
In the past, students in this course created posters describing their projects and presented them in the College of Nursing lobby, but faculty members wanted students to be aware of other ways of disseminating information and to reach a potentially broader audience. Readers can make comments on blog entries after logging in.
Undertaking the projects seems to have the intended effect on student thinking.
“I think it’s going to help me look at a patient in a bigger picture,” said senior Rebekah Carbone. “I’m going to think about how they got to this point versus just treating them right now and getting them out the door. How they got here is important too so we can help try and prevent them coming back, and that’s all about community health.”
The blog, created in partnership with College of Nursing IT Director Karl Faser, is called Upstream Thinking in Action. Its title is based on a story that students discuss during their first days of the NURS 4210 class in which a man is standing by the lower part of a river where an increasing number of people drift by, struggling in the water. He continues to rescue them but quickly becomes exhausted.
“The point of the story is, if the man were upstream, he could prevent people from falling into the river,” Miles said. “It’s all about doing something on the front end to prevent the problems.”