You never know what skills you might need as a nurse. That’s an important lesson that nursing students Erin Graham and Augustina Delaney took away from their community immersion class this summer.
For two weeks in June, Graham and Delaney focused on gardening and nutrition at the City of Refuge, a relief organization and shelter that provides resources and life-building tools for Atlanta families living in poverty. The course is part of the curriculum in Emory University's accelerated bachelor of nursing program.
“The object of the immersion experience is for us go to a different community, try to understand it and identify a quality improvement project that will help them, and be sustainable after we leave,” said Delaney, who will soon begin Emory’s nursing Ph.D. program.
Initially, the students looked at ways to help in the organization’s clinic and the kitchen that serves meals to the homeless, but after they listened to staff, another opportunity emerged.
Staff member Gregg Sluder recently started an organic box garden on about an acre of land, with the goals of providing better nutrition for the community kitchen and creating a place of refuge and relationship building for the mothers and children of Eden Village, a homeless shelter.
“The area surrounding the City of Refuge is a food desert. The closest grocery store is four miles away and the local convenience store sells only onions and bananas,” said Graham, who will begin Emory’s master of nursing/nurse practitioner program this fall and plans to become a midwife.
Sluder knew that compost bins would help them grow more vegetables and would also be a good solution for kitchen waste. Bins might even reduce their garbage pickup costs, but he had no time to build them.
Four nursing students researched composting and built the bins from scratch, using lumber and chicken wire.
“It was more work than we thought it would be,” said Delaney, who wants to practice midwifery, and hopes to use research skills to help improve maternal mortality in developing countries.
Once in place, the nursing students saw a teaching opportunity for children attending the City of Refuge’s summer camp. They taught lessons on composting, the advantages of using kitchen scraps to grow things, and the importance of fresh fruits and vegetables in a healthy diet.
“The earlier you can expose kids to learning about diet and health, the better,” Graham said. “As a fun activity, we painted the kids’ hands and let them decorate the bins with their handprints.”
In the long term, the organization hopes residents will grow some food when they move to apartments of their own.
“Sluder also has a vision to start a farmer’s market that would [benefit] the entire neighborhood, so we helped him research the idea and left him with a business plan,” Graham said.
The experience taught her the importance of getting to know a community and its needs, so that she could give more appropriate and useful nursing advice.
“What good does it do to tell patients to eat a healthier diet if they can’t get or can’t afford fresh fruits and vegetables?” Graham asked.
But is building compost bins really a form of nursing?
“Absolutely,” said Hope Bussenius, the clinical assistant professor who teaches the community immersion course. She believes the composting project is a successful example of community nursing, one which contributes to better nutrition and public health.
“It was a good idea and I was really proud of our students,” said Bussenius, DNP, RN, FNP-BC.
Bussenius wants students to understand that public health nursing grew out of nurses going home-to-home and community-to-community to identify and meet needs.
“Because nurses now mostly work in clinical settings, when they do go out to serve in the community they tend to think in terms of blood pressure screenings,” she said. “We want them to see a much bigger picture.”
Bussenius asks students to put their beliefs behind and walk into a community with open eyes.
“I ask them to survey the people there, to open their minds to how they live, so that they can better identify needs without making judgments,” Bussenius said. “I want them to slip out of their comfort zone, to realize that it’s different when you’re on someone else’s turf. You have to play by their rules, but that’s when you figure a lot of things out and can make a difference.”
Bussenius, who has spent years volunteering in Haiti, has seen large nonprofits make mistakes by not assessing, listening and asking.
“It’s not that they don’t care or don’t have a passion to help, but they will spend millions of dollars implementing programs that the people don’t accept culturally, so they aren’t sustainable,” she said. “They don’t slow down enough to ask the community what it needs and wants. That’s what we need to learn as nurses.”
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