Learning from the Community

At first, Hana Conlon,’14, questioned whether she was helping people at her community service project at Narco Freedom, an outpatient drug and alcohol treatment facility in the South Bronx. It seemed like many patients only came there to get medication refills, typically synthetic opiates used to treat addiction.

But after a few weeks, she tried something different during patient intakes. She asked them ‘how’s it going?’

Many of them immediately opened up to her about their health concerns and the daily struggles to stay clean and sober.

One patient told Conlon she was terrified of having a heart attack during an upcoming vacation to her native Puerto Rico. The last time she her husband made the trip, he had a heart attack.

“I explained to her that the risk was unrelated to location, and many factors went into having a heart attack,” said Conlon. Conlon and the clinic’s Nurse Practitioner spent a half hour going over the patient’s lab results with her, as well as her other risk factors and explained that since her cholesterol levels were low and she was generally healthy, she was not at an increased risk for having a heart attack.

The woman left the clinic relieved, unafraid to travel.

Conlon is one of 169 ETP students who are winding down their 60 hours of required community service.

Last June, they were given a list of more than 60 programs to choose from by Assistant Professor Norma Hannigan, DNP, who scouts potential agencies throughout the year, monitors the sites, and advises students on their issues and concerns once they are placed. Placements included elder care centers, Head Start programs, Hurricane Sandy relief efforts in The Rockaways, a lead poisoning prevention center, literacy agencies, and a harm reduction/needle exchange site.

“Community service is really important to nursing because it allows you to gain a much better understanding of your patients, and if you understand their lives and stressors, you can serve them better," said Hannigan, who served as a Peace Corps volunteer in Chile in the 1980s.

“Every student would say that aspects of the project were frustrating,” said Hannigan. “But I think most of them enjoyed it, and it gave them an insiders’ view of what community health is all about.“

Although a lot of the work the students did in their placements wasn’t clinical, it’s still relevant to their nursing education, according to Hannigan, because it makes them aware of the social determinants of health:

“If you are poor and unemployed or never finished school, those factors affect your health,” said Hannigan.

Darcy Izard, ’14, spent most of her placement planning a health fair and writing brochures about mental health topics including panic disorder at The Institute for Human Identity, an agency that provides counseling services for the LGBT community. Writing a brochure about Body Dysmorphic Disorder, she learned about a condition prevalent among gay males. The disorder involves a severe preoccupation with a physical feature thought of as flawed that can impair daily function and cause severe depression. Izard plans to specialize in psychiatric-mental health and said she felt this experience would make her more knowledgeable and empathetic about her future patients’ concerns.

Another non-clinical program with health implications were the weekly weight loss groups for seniors ran by Kerry Nieman, ’14 along with two ETP students at the YM & YWHA of Washington Heights and Inwood. 

Among the challenges Nieman faced during her placement were  that many clients left right after getting weighed and didn’t stay for the health lectures she had prepared. Other clients arrived late, interrupting the flow of the group. Many clients struggled to lose weight because of their diabetes and side effects of their medications. Few were interested in exercise, and most of the people did not cook for themselves.

So Nieman, who plans to specialize in women’s health, along with two other ETP students and her supervisor at the Y, came up with a solution to keep people coming to the class: in-class workshops where participants learned to make easy, healthy snacks like ants on a log — celery sticks with peanut butter and raisins — and a salad made with canned corn, tomato and onion.

The revised class also served as a lesson in cultural competency: One day Nieman and the other students brought in frozen edamame to share with the group and the majority of the Dominican-American clients stared quizzically at the soybeans: They had never seen this food before.

To better serve her clients, Nieman started taking suggestions from them for what foods to make and came up with ideas for snacks that were more culturally relevant— like guacamole.

“They learned a lot from me and I learned a lot from them,” said Nieman, who admits she didn’t know what an empanada was before she started working there.

“I’ve always been interested in nutrition and healthy eating, and I took for granted  that not everyone else is,” she said. “When I started the project, I assumed everyone would come to lose weight and get healthier. That wasn’t the case. But once we tailored the experience to their needs, they came regularly. It’s like what we learned in class; don’t assume you know what a population or community needs until they tell you.”