Caring Where It Counts

Community health nursing provides real-world experience

From left: Kimberly Thomas, Sarah Iverson, Elaine Kauschinger, and Kathleen Fitzgerald work in underserved areas of Miami-Dade to expand access to care and advance community health.

Before moving to South Florida, nursing instructor and doctoral candidate Elaine Kauschinger, A.R.N.P., lived in Mexico for ten years where she learned firsthand about inequities in health care and imbalances in social justice. Her personal and professional experiences there had a profound impact on how she views culturally sensitive nursing, community building, and the care of underserved populations. At the School of Nursing and Health Studies, Kauschinger oversees undergraduate students in their community health clinical rotation, specifically those who are involved with MUJER, a health clinic for immigrant and migrant families in the rural farm areas of southern Miami-Dade County.

MUJER, which stands for Mujeres Unidas en Justicia, Educación, y Reforma (Women United in Justice, Education, and Reform), offers comprehensive care to victims of domestic violence and sexual assault. The center also provides health assessments, counseling, group therapy, and legal assistance. A majority of MUJER's clients are Hispanic women, children, and undocumented workers.

"Through the partnership, students gain hands-on experience, faculty can observe students in action, and the school provides critical services to at-risk populations," says Kauschinger. "Students need the opportunity to see how dynamic-and challenging-nursing can be. There's no better place to do this than the real world."

Kauschinger says there are many "teachable moments" in community health nursing. Students who have previously spent time in the supportive environment of a hospital-where physicians, fellow nurses, technology, and medications are readily accessible- feel vulnerable when doing home visits in poor, underserved communities. Notes Kauschinger, "I am asking them to rely on their nursing skills and the nursing process to provide care, show concern, listen to clients, and identify solutions." An exercise in building confidence and competence, community health nursing helps students learn to take initiative and handle situations directly.

"For the first time, I felt like I was able to do something for a client on my own," says Roberta Cutter, a senior nursing student. "You don't realize how many obstacles people face in trying to get basic health care until you visit them in their own environment and understand what they go through."

"Our students learn that nursing goes far beyond the walls of a hospital or clinic," says Kauschinger. "When discharging patients, they'll know to ask about prescriptions, health insurance, and other issues that could impede the continued care and recovery of the individual."

Adds Kauschinger, "Florence Nightingale believed that nurses should provide care to clients in their community, in their homes, and at the bedside. By putting that into practice, we can truly make a difference."