Taking the Nursing Process into the Community

Students Work with Low-Income Elderly to Encourage Healthy Lifestyles

DePaul students and residents from Jugan Terrace join together in Go4Life walk to end Alzheimer’s.
For the past two years, DePaul nursing students have been volunteering their time to create programs that enhance the health and well-being of the residents of Jugan Terrace, a housing facility for low-income, elderly persons not in need of medical care. According to Sister Maria de la Luz, a Little Sister of the Poor (a Catholic order established to care for the elderly) and the Director of Jugan Terrace, the residents “need somewhere to live that is safe, where they can feel supported, and where they can be independent and yet have recourse to someone who can assist them.”

In the autumn of 2015, when Sister Maria was an incoming student in the Master’s Entry to Nursing Practice (MENP) program at DePaul, the directorship role at Jugan Terrace was only responsible for making sure that the facility was running properly. “That changed when I met Dr. Larimer during the partner fair,” says Sister Maria, referring to the event where incoming MENP students meet with local community organizations to find a site that they will partner with for their Community-based Service Learning (CbSL) requirement. 

“CbSL is a pedagogical strategy where you teach students by embedding them in organizations,” says Dr. Karen Larimer, Assistant Professor and Coordinator of Community Engagement for DePaul Nursing. Community-based Service Learning is embedded into at least one course in every quarter of the MENP program, and students partner with the same organization for two years. “Working with the organization and the people that the organization services often challenges their assumptions and broadens their world view. It gives the students real-life, hands-on experience of what it means to work in service organizations.”

For Sister Maria, a light went on. She knew that the residents at Jugan Terrace needed more than just an apartment, and here was a group of first-quarter nursing students, herself included, who were eager to make a positive impact on the community. DePaul’s relationship with Jugan Terrace began that quarter, with Sister Maria and fellow students Sarah Bieber and Jeanne Burdette tasked with starting a program from the ground up.

They began by performing an assessment to find out the goals and interests of the residents. Sister Maria recalls this first step being a major learning experience. “As a Little Sister, I came in thinking that I knew what was best for older persons. I knew that I wanted to do something for Jugan Terrace, but what I learned is that we have to ask the residents what they want. That’s how the nursing process starts. You don’t start out saying ‘this person looks this way and must have this.’”

Sarah Bieber had a similar revelation. “Nurses must demonstrate a certain knowledge base and skill set required to do the job; however, unless we are able to go beyond that and achieve an understanding of who our patients are on a deeper level (their values, concerns, challenges, desires), we cannot truly fulfill the bigger picture of the nursing role.”

While the DePaul students were learning the importance of the nursing process and its application to a real-world situation, they were also learning how they could best make an impact at Jugan Terrace. Overwhelmingly, they discovered that the residents valued their lifestyle and independence and were worried about having to move to a nursing home in the future. With this information in hand, Sister Maria and the other DePaul students began researching ways to help the residents at Jugan Terrace meet their goals, coming up with five pillars to maintain an independent and healthy lifestyle: physical activity, nutrition, socialization, safety, and local resources.

The DePaul students tackled one pillar each, and they quickly developed an exercise program with the help of volunteers. Jugan Terrace lacked any exercise equipment, though, which limited the effectiveness of the program. According to Assistant Professor Dr. Liz Aquino, it is situations like this that force CbSL students to think outside the box. “They are going to areas where there is a lot of need and where there are limited resources. So the students have to learn how to handle that. There are times when students say, ‘there’s no money, how are we going to do the project?’ Well, they have to find a way to get those resources for the organization, just like the organization would have to do if the students weren’t there.”

The students submitted a request for grant funding, and they received a Vincentian Endowment from DePaul University for their efforts. With this funding, Jugan Terrace was able to purchase exercise equipment for the residents, still in use today.

Progress was also being made on the other pillars: students began performing regular safety checks to ensure, for example, that there were no tripping hazards within residents’ apartments. Students also started nutrition classes and organized potluck dinners and movie nights to help the residents socialize, an aspect that could have been easy to overlook. At all stages, students were careful to include the ideas of the residents themselves. Jugan Terrace is represented by a very diverse population, and so the theme of the potluck dinners began to be organized around particular residents’ backgrounds. 

“It has been a very collaborative program that continues to be shaped by input from the residents as well as the passions and talents of student volunteers,” says Bieber. “The duration of the partnership also fostered resident trust in our efforts and allowed for deeper, more meaningful relationships to be developed.”

Students also started a quarterly newsletter for the residents that provides news, healthy recipes, exercise and safety tips, notices of local events, and even light-hearted jokes and anecdotes. The newsletter, written by CbSL students and one resident-writer, has been continuously produced for two years now.
 
In March of 2017, Sister Maria, Sarah Bieber, Dr. Aquino, and Jon Handrup, Academic and Community Coordinator at DePaul’s Steans Center, gathered at New York University to present their work with Jugan Terrace at the Eastern Region Campus Compact Conference, which promotes civic education and community development in higher education. 

“Our presentation focused on sharing the goals of DePaul’s CbSL program, how and why the School of Nursing has used CbSL to positively impact and enhance its curriculum, and best practices that could benefit other universities when integrating similar models,” says Bieber.

For Sister Maria, “It was a great honor to be able to share what we’ve done at Jugan Terrace with other schools who are trying to introduce service learning in the academic arena.” But, as Sister Maria notes, there is still much work to be done, with one of their current goals being to raise funds for the establishment of an internet café. “A lot of residents are immigrants – they are asking about being able to email their families but don’t have internet access. We also have residents that love to read, but they can’t get to the library.” An internet café can resolve some of these issues, while also providing an additional means of socialization. 

Although the original three students to partner with Jugan Terrace graduated in August, new DePaul students have taken up the reigns, each assuming responsibility for one of the five pillars. According to Sister Maria, who still works closely with Jugan Terrace, the graduated students continue to reach out and maintain their relationships, and that is what Sister Maria remains most proud of. “More than the practical things, it’s those relationships that have been established. The students who have graduated still inquire about coming back because they have established relationships, and the residents ask about the students too.”

That’s the kind of long-lasting benefit that Dr. Aquino hopes for. “It’s my hope that CbSL is a good experience for the students so that once they graduate they continue to be active in the community, whether it’s volunteering or starting their own non-profit. It’s not just about being a nurse and going to your job – there’s more that you can do.”