Nursing students give back to the community

 by Karen Michell Sarver
 published on Wednesday, April 16, 2008

Photo courtesy of Terry Olbrysh

SAY AAAAH: Students of the clinical on site class at CASS provide primary care treatment such as blood pressure screenings, physicals, and exams in spring of 2007.

As part of ASU senior nursing students' community-health clinical rotation, the students spend half of their first semester volunteering in a homeless shelter.

Kay Jarrell, clinical assistant professor at the College of Nursing and Healthcare Innovation, said that the homeless are considered vulnerable because they have worse health outcomes than others. In theory, by helping the homeless, nursing students learn about vulnerable populations.

Ashley Skidmore, a nursing senior in the program, said, "Many of them [homeless people] are battling addiction and have lost everything — family, friends, possessions — and have hit rock bottom."

Skidmore did her rotation at the state's largest shelter, Central Arizona Shelter System, in downtown Phoenix during the fall 2007 semester.

Skidmore said working with the homeless was invaluable because "in the health care setting, homeless people get labeled as drug users, alcoholics, or losers, when, in fact, they are human."

"They have stories, lives, families, and each is unique as to how they came to that situation," she said.

Jarrell said that nursing students assess the shelter's residents' health and health risks, take vital signs and discuss medications.

Skidmore said some things she did while she was in the program was to check "blood glucose on the diabetic patients," and to take "health histories to see if they [the homeless] were up to date on their vaccinations."

"We did dressing changes, we gave out cough drops, creams, lotions and foot powders," she added.

But Skidmore said they did not administer medication because there wasn't any.

The most the nursing students could do in the way of treatment, Skidmore said, was to "listen to their lungs, look in their throat … give them some cough drops and say, 'Come back and see us next week.'"

Jarrell said the students also do a lot of educational presentations for the residents.
"Our focus is on health promotion since this population doesn't often get that type of care," she said.

"We see a number of people with blisters on their feet and many people with chronic disease such as diabetes and hypertension," she added.

Skidmore recalled a diabetic patient who asked her to check his blood glucose. A healthcare provider had given the patient a glucometer but didn't show him how to use it. The accompanying manual was also useless because the patient didn't know how to read.

Skidmore said sometimes it's the little things that cause the biggest problems, such as pill cutters.

Pharmacists won't cut pills, Skidmore said. The homeless whose prescriptions called for half a pill couldn't take their medication at all, or, in an attempt at compliance, they took a whole pill every other day.

"Sometimes they would try to bite the pill in half," she said. "We cut a lot of pills at Central Arizona Shelter System."

"The way we had to approach the situation was very different than any other health care setting," she added.

Skidmore said that approach often caused her to feel helpless, but that those feelings of helplessness didn't stop her from helping, even if help meant nothing more than sitting with someone while they cried.

Skidmore said the experience taught her that while knowledge of medications and disease processes is crucial to a health care provider, it's not necessary to make a difference in someone's life.

"You can do that [make a difference] by simply listening and being present for them," she said. "To be able to experience those emotions with others is why we choose to be nurses."

Reach the reporter at: ksarver@asu.edu.