Category Archives: Community outreach
Roseanna H. Means, MD, is the founder of Women of Means, which provides free medical care to homeless women in the Boston area, a clinical associate professor at Harvard Medical School, and an internist on the attending staff at Brigham and Women’s Hospital in Boston. She is a 2010 Robert Wood Johnson Foundation Community Health Leader.
The prolonged recession of the last four years has hit many people hard. My work is taking care of homeless women, which I have done for the past 20 years. I lead a team of volunteer physicians and part-time paid nurses who provide free walk-in care to women and children in Boston’s shelters. We fill in the gaps left by larger, more bureaucratically rigid systems that put unrealistic and unattainable expectations on those who are disabled by extreme poverty, mental illness, trauma, and cognitive dysfunction.
I designed a program of “gap” care that brings health care to them. We act as the communication and advocacy bridge between the shelter/street world and the hospitals and health centers. Gap care is part of a continuum that I feel has an important role to play in health care access for vulnerable populations.
Here is a glimpse of our work.
Walking into one of the women’s shelters on a recent morning, I see a woman standing glumly in line for coffee, her hands chapped and shaky, her face pale and dry, a blanket heaped around her shoulder, pouring hot liquid into her body before staking out a cot where she can sleep for a few hours, let her guard down, away from the doorway where she was prey to drunk men who jumped her, raped her and stole her stuff.
She is hungover. She drank to escape the horror of having been attacked. She has been on and off the wagon so many times we have all lost count. She’s also been raped and stabbed more times than any of us can remember. She doesn’t go to the police any more. She’s just one more homeless woman who has been raped, a “nobody”; just more paperwork. I give her a hug and remind her that I love her no matter what. I know that she has a library of negative and self-loathing messages in her head. Mine is the one that can break through that chatter and give her a shred of self-respect.
By Eric A. Hodges, PhD, FNP-BC, Robert Wood Johnson Foundation Nurse Faculty Scholar (2009 – 2012)
In each of the last two years, I have grown a mustache for the month of February to support teachers and their students in low-income school districts across North Carolina through the organization, DonorsChoose. With funds raised from my generous donors, 16 projects to promote health and environmental education have been supported, touching the lives of 4,943 students.
This year, for a change of pace (and honoring my family’s humorous pleas for no more mustaches!), I volunteered to shave my head on April 21st with the St. Baldrick’s Foundation. I'm doing it to stand in solidarity with kids fighting cancer, but more importantly, to raise money to find cures. I do this in honor of the children I've cared for in the past at St. Jude's and in honor of my other formerly-bald hero, my Mom... now many years cancer free.
I set a goal to raise $1,000, and donations from family, friends, colleagues and students began to come in steadily. What happened next was unexpected and thrilling.
On April 12th, with $10 to go to reach my goal, I sent a message to the students, faculty and staff at the University of North Carolina-Chapel Hill School of Nursing to ask who would be the one to give the last $10 so I would reach my goal. Within seven minutes, I met my goal! Within 10 minutes, I surpassed it. Before long, I had surpassed it by more than $250 dollars.
I felt the pressure build as I began the one-year accelerated nursing program at Fairleigh Dickinson University (FDU). I was fearful and thought, “How could I make it through this program in one piece?” As a recipient of an NCIN scholarship, this honor also brought a responsibility to positively represent the Robert Wood Johnson Foundation through my volunteer work in the community. I wondered, “How would I be able to add this responsibility to my academic commitments?”
That fear is now a thing of the past. Over the last seven months, my community service involvement has increased from only one activity per month to two or three. It has brought me closer to my classmates, enabling me to use team synergy to make a difference in the community while growing in my academic performance.
I feel helping the community and becoming a unit with my fellow classmates is an experience I will always take with me. In the nursing profession, it is so important to work together and help others who are in need. I consider one of the lessons learned was how to work together most effectively to find a volunteer option we were all interested in accomplishing, and ensuring the group effort makes the biggest impact.
By Sharon Stanley, PhD, RN, Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow, and chief nurse for the American Red Cross
March is Red Cross Month. And at the American Red Cross, it’s a time to celebrate our work in communities across the country and around the globe, and to recognize how we depend on public support to help people in need. Every meal we serve to a family displaced by disaster, every emergency message we send to a member of the military and every unit of Red Cross blood we collect is made possible by the generosity of a donor.
People support the Red Cross by making a financial contribution, becoming a volunteer, taking a class or giving blood. The level of service the Red Cross provides with these generous gifts is staggering. The organization responds to nearly 70,000 disasters a year, for example, and educates more than 9 million people in first aid, water safety and other lifesaving skills.
March is also a time to celebrate the contributions thousands of nurses and other health care professionals make to this organization. Nurses are a part of everything that happens at the American Red Cross.
Nurse volunteers help the Red Cross support veterans, members of the military and their families; they volunteer at blood drives. They provide health screenings and information at Red Cross booths during countless community events. They serve on the Nursing and Caregiving Sub-Council of the Scientific Advisory Council, which advises the American Red Cross on the development and dissemination of critical information and training related to CPR, first aid, caregiving and safety.
Are you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the latest nursing news, research and trends. Here’s a review of what’s in the January issue:
Read about the remarkable journey of RWJF Community Health Leader Jamie Kamailani Boyd, who made a long and arduous climb out of poverty and is now helping others do the same. She has created an academic program called Pathway Out of Poverty, which helps disadvantaged Hawaiians become nurse’s aides and registered nurses.
Several alumni of the RWJF Executive Nurse Fellows program are using the leadership and risk-taking skills they gained in the program to support Partners Investing in Nursing's Future projects in their home states.
This piece examines some of the early work that laid the foundation for even more innovative and ambitious RWJF programs to build nursing leadership, improve nurse education, strengthen the nursing workforce and, ultimately, improve health and health care. Read about former RWJF staff member Terrance Keenan, who influenced the Foundation’s early investments in nursing programs and initiatives.
As the economic downturn made hunger and food insecurity more common last year, RWJF Scholars and alumni stepped up to help in their communities. Read about their work, individually and through their nursing schools.
February is National Children’s Dental Health Month, so the Human Capital Blog reached out to John Gusha, DMD, PC, a 2003 Robert Wood Johnson Foundation (RWJF) Community Health Leader, to learn more about children’s oral health. As project director of the Central Massachusetts Oral Health Initiative, Gusha mobilized dozens of dental societies and non-profit groups to provide dental care for low-income residents of Worcester County. Although funding for the Oral Health Initiative has ended, many of the programs Gusha helped create are still in place.
Human Capital Blog: What spurred the Central Massachusetts Oral Health Initiative? What made you aware of this need for oral health care in your community?
John Gusha: There was a special legislative report in 2000 that described disparities in access to oral health care for low-income populations. It raised a lot of questions about what we could be doing in the community and in the dental society to address these gaps. We got funding from the Health Foundation of Central Massachusetts, which also saw this as a critical need for our area, to launch the initiative.
HCB: Tell us about the school-based programs you put in place.
Gusha: The decay rate in Worcester County schools was very high—more than one-third of the students had active decay in their mouths. It was especially prominent in schools with high numbers of free and reduced price lunches, where students came from low-income families that are more likely to be using Medicaid. These students didn’t have access to care and weren’t getting the preventive services they needed.
We started a school-based program that is now in place in more than 30 Worcester County schools. Dental hygiene students from a local community college provide fluoride varnishes, cleanings and other preventive services to students, and the University of Massachusetts’ Ronald McDonald “Care Mobile” visits schools to offer the same services. Community health centers also participate in these programs by adding dental to their school-based health centers. In the past you could go to schools and provide services, but Medicaid rules didn’t allow you to get reimbursed. We were able to help get those rules changed so the program could become sustainable.
HCB: You also had a role in creating a dental residency program and training primary care providers to screen for oral health needs.
Gusha: We wanted to better integrate dentistry into medicine. The University of Massachusetts was the administrator of our program, and the team there developed a dental residency program at the medical school. The University had no classes in oral health before this. The local hospitals were in desperate need of professionals with this kind of training, particularly in emergency rooms. The Medicaid population was presenting there frequently for treatment because they had nowhere else to go, and people with other issues like cardiac problems or cancer needed clearance on their oral health in order to proceed with treatment.
The residency program is still in place at our two local community health centers, and it’s grown now to include education for other disciplines.
By Laura Larsson, PhD, MPH, RN, is an assistant professor at the College of Nursing, Montana State University and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2010 – 2013)
What started as a place for nursing students to earn supplemental clinical hours toward their public health course has evolved into a wonderful community-academic partnership that has just celebrated its 5th anniversary.
As a nurse educator, my first thought when I decided to offer students the chance to gain extra hours at the food bank was how beneficial such a partnership would be for my students. They would get to work with families experiencing food scarcity, see a wider variety of community members than they did in the hospital setting, and gain first-hand experience with where the strengths and weaknesses are in the “safety net.”
I imagined projects where concepts from the community would converge with concepts from individual-level care, and the students would better understand that nursing cannot operate in a silo.
In the past five years, this project has been all of that and even more.
During the spring of 2008, two students started the Nurse’s Desk at our local food bank in Bozeman, Mont., holding hours every Friday afternoon. Sponsored by the local federally qualified health center, they offered blood pressure and casual blood glucose testing, and referral services to clients as they waited for their supply of food.
Throughout that spring, the students grew markedly in their appreciation for the diverse and challenging circumstances their clients faced. They did perform blood pressure and blood glucose checks, but mostly they listened. They heard stories that strained their catalogue of experience and met people whose willpower and resilience humbled them. The clients, the volunteers, and the students insisted the Nurse’s Desk continue.
In May, the U.S. Department of Housing and Urban Development (HUD) awarded a multi-year grant to an asthma prevention and treatment program run by 2008 Robert Wood Johnson Foundation Community Health Leader Ray Lopez of New York City. Lopez is the director of environmental health services at the Little Sisters of the Assumption Family Health Service in New York’s East Harlem. The grant award is shared with the New York Academy of Medicine.
Ray Lopez: Our mission is to serve children in East Harlem by helping their families treat and prevent asthma incidents. Asthma rates are unusually high in New York City in general, and the problem’s even more acute in Harlem, the South Bronx and Central Brooklyn where there are all kinds of environmental factors in children’s homes. We’re focused on children in public housing, where there are a number of problems. A lot of the apartments have mold that has grown as a result of leaks, and they’ve also got a lot of cockroaches, and mice, which all contribute as well. What we do, and what this grant will help us do a lot more broadly, is to get treatment for the kids, but also to go into their apartments and get to work on reducing the environmental factors. Sometimes that means identifying moisture sources and safely cleaning the mold. Sometimes it means pressing the city’s housing authority to do major work. Sometimes it involves teaching the adults in the family about the safe use of pesticides and cleaning products. For each family we visit, we work with them to create an individualized service plan, and then we focus on remediating the asthma triggers.
Teaching is a major part of this, too, and the plan is to teach by showing and doing. Families are enrolled with us for a year, and by end of year, we hope they will have accumulated skills to manage these problems on their own in the long-term. It’s a three-year project, in all: two-plus years working with the families, and then a final phase that consists of data analysis and policy initiatives led by the New York Academy of Medicine.
HCB: And then what’s the plan with the data and the analysis?
Lopez: The plan is to build the business case for this kind of intervention, and then to persuade insurance companies and providers that it’s worth the investment to them to spend a little money up front to prevent asthma incidents, rather than paying for them in the emergency room.
The Times of Trenton is reporting on the extraordinary work of Susan Hassmiller, Ph.D., R.N., F.A.A.N., the Robert Wood Johnson Foundation’s senior adviser for nursing, who is in Alabama helping victims of the recent tornadoes. An American Red Cross volunteer for decades, Hassmiller is working with a team that includes caseworkers and mental health experts providing medical care and other support to some of those who were hardest hit.
Hassmiller has a long history of helping those affected by disasters, including victims of Hurricane Katrina, the Indian Ocean tsunami, and the 9/11 attacks in New York City. In 2009, the International Red Cross awarded her its Florence Nightingale Medal, nursing’s highest international honor.
Read Hassmiller’s blog on her work helping victims of the disaster.