In a room near the entrance of the Preble Street Resource Center in Portland, USM nursing student Leah Roy pushes her folding chair closer to the man sitting across from her. They talk for a few minutes about his health.
“I think my blood pressure is high,” he says quietly.
The man is in his 60s. He’s homeless and has been struggling with a cough and other symptoms from decades of smoking.
Every Thursday morning, this small room is transformed into a makeshift health clinic. Roy checks the man’s blood pressure and lets him know it’s actually pretty good. From a nearby table, she grabs a pulse oximeter and checks the man’s blood oxygen level. It’s good, too.
“Just to make you feel better, are you able to come back in about 15 or 20 minutes so I can check your blood pressure again?” Roy offers.
The man smiles and nods, as two others enter the room to meet with Roy or one of the other student nurses on duty.
It’s one interaction, one snapshot among hundreds that take place every year within the Bayside Community Nursing Partnership, an innovative program that provides real-world training for USM nursing students, while addressing the health needs of high poverty/highly diverse neighborhoods.
Each semester, about a dozen nursing students are assigned to Bayside. Under the guidance of USM professors Su Sepples and Susan Clement, the students run weekly nursing clinics at Preble Street and at Franklin Towers, an apartment building that houses more than 200 people, many of whom are elderly.
Launched in 2001, the Bayside Partnership is all about making a positive impact on the vulnerable, homeless and the working poor. Beyond the two core clinics, the students also take part in projects with several other entities in Bayside, including the Oxford Street Shelter, a nearby family shelter and the Milestone Foundation.
Community partnerships serve a dual mission
Bayside is one of 11 community health partnerships overseen by the USM School of Nursing, including programs in Portland, South Portland, Lewiston the islands of Casco Bay and elsewhere. The partnerships are fundamental to the nursing track at USM. Every student in the nursing program participates in at least one community partnership for two consecutive semesters during his or her junior or senior years.
The mission of the partnerships is twofold:
- Disadvantaged communities receive much-needed health services; and
- Nursing students receive experiences in the field that cannot be replicated in a classroom.
“I’ll carry this with me for the rest of my career,” said Micaela Manganello, a senior from Connecticut. She was one of the Bayside students in the fall of 2016 and spring of 2017.
Her time in Bayside was a crash course in leadership, communication, decision-making and relationship building. Manganello also came away with an understanding of how intimidating the health care system can be for poor and homeless clients, the elderly and people who speak little or no English.
“Many people are afraid of nurses, doctors, health practitioners in general,” she said. “Our goal is to provide a positive interaction for them, to give a basic screening where we can look for any red flags, and to refer them to the appropriate providers if they need follow-up.”
“For people who come into the clinic, sometimes you’re the only person all day who has taken the time to really hear them and listen to their concerns.”
As population ages, nurses are in high demand
This valuable community health training will help Manganello and her classmates contribute as professionals in a wide range of settings.
The USM nursing students will enter a job market where employers desperately need their skills. Driven primarily by an aging population, Maine is one of many states facing a nursing shortage.
Recent estimates from the Maine Department of Health and Human Services, along with the University of Maine System, project a shortage of more than 3,000 nurses by 2025. The number of people in Maine over the age of 65 is expected to grow more than 30 percent by then, and many of them will face chronic health problems.
Sepples, the nurse and professor who has been the one constant at the Bayside Partnership since it began, said future nurses will need to be as resilient and creative as their predecessors, if not more so. Community partnerships are perfect environments to spark creativity, she said.
“Students get out and meet with the community, they hear what the needs are, and they have the freedom to find creative ways to respond to those needs,” Sepples said.
Students must develop “interventions,” which are individual projects that respond to specific needs they identify in the community. For example, students have developed interventions for stress management, a lice clinic to help families keep their children lice-free and attending school, and educational workshops on heart health.
Students are placed in a variety of leadership roles, and second-semester students are responsible for mentoring first-semester students. A seminar led by students is held every Thursday from 8 to 9:30 a.m., then the students head to either Franklin Towers or Preble Street, where they run the health clinics from 9:30 to 11 a.m.
Although students don’t participate in the Bayside Partnership during summer break, Sepples and Clement routinely check in at the clinic sites throughout the summer, maintaining the relationships that represent the backbone of the program.
'Peace of mind and a positive interaction’
On a Thursday morning in the spring semester, nursing students set up their weekly clinic in a community room at Franklin Towers. They made popcorn and iced tea, and welcomed residents for health checks.
In the past, Franklin Towers primarily housed poor, elderly residents. More recently, the apartment building has seen an influx of immigrants and younger tenants who are making the transition out of homelessness. The Bayside nursing students provide assistance with medication, education, general support and referrals.
“Our relationships start with something simple, like a blood pressure check. But it often turns into so much more,” said Mariah Sanders, a Scarborough High School graduate in her final year of nursing school. “They come to trust you and that can lead to deep conversations about their health and their lives.”
“Even though this is a big place, some of the residents don’t have a lot of day-to-day interaction with other people,” Sanders said.
“It can be very isolating here, so it feels good to provide that connection for them week to week. It can give them some peace of mind and a positive interaction.”
While most people are familiar with the type of acute nursing that happens in hospitals, fewer are aware of community nursing, which depends on trusting bonds between community members and nurses, Sepples said. The impact of community nursing can be just as profound as acute care, she said. That’s why the Bayside student nurses can often be found reading to children, listening to the life stories of the elderly or celebrating birthdays.
“People in the community get a sense of nurses as caring people who understand them,” Sepples said. “Plus, every positive experience they have with one of our students sets them up to seek healthcare when they need it in the future.”
By Trevor Maxwell for USM Connects