Clinical experience … In nursing, it is learning the skills you will need in your career, but it is so much more! It is learning about life through the people you serve. According to two Senior I students doing their Community Health NUR 481 clinical rotation at the Central Arizona Shelter System (CASS) adult shelter in central Phoenix, they are learning a lot about both and being unexpectedly changed by the experience.
The students are not taking their clinicals at just any shelter. The CASS shelter downtown is the largest in Arizona and serves 6,000 clients annually — 400 women and men on a given night. Community Health Faculty Kay Jarrell and Judy Hightower arranged for the clinical site in 2002. Jarrell takes her students there in fall and spring while Hightower brings her ASU West nursing students in the summer. Few leave without being moved by the experience.
Students enter the rotation with varying experiences and expectations. Judy Sirkis was familiar with the homeless and poor from growing up in metropolitan Phoenix. Aaron Dorcy, on the other hand, grew up in a small town in rural Washington State and had never encountered homeless people.
“Several in our group of 10 viewed our future clients as ‘unhelpable’ when we started the rotation,” Dorcy, a native of Shelton, Washington, said. “I have to admit I was one of them. However, it did not take long to see how resilient these people are and that there is not any one type of person who ends up in a homeless shelter.”
expectations based on life experiences
Judy Sirkis started her rotation with different expectations based on life experiences. “I was a child of the 60s and early 70s and had a natural affinity to helping people in need,” she explained. “When I first graduated from school, I worked as a VISTA volunteer in southern Georgia, giving impoverished people legal services advice.” Working with the homeless at the shelter, Judy said she rediscovered her comfort zone and the excitement she has in serving a population for which she has a great empathy.
The shelter is a setting that is open to developing personal styles in caring for clients. Aaron encourages clients to take part in the healthcare screenings he conducts. “I ask the clients to hold the blood pressure gauge as I take their pressures,” he said. “It helps them to see that good health is their responsibility, too. It is the experience that you do not often get in clinical rotations in hospitals.”
The students follow a set routine during their six-week rotation. Working from 2 to 7 p.m., they start with a conference session with Kay Jarrell, who advises them of the chronic illnesses and social problems faced by the homeless and the need to listen and respect their views. Following the hour conference meeting, the students spend the rest of the time conducting blood-pressure and diabetes screenings, treating wounds, or giving vaccine shots.
When you deal with the clients on a weekly basis, you get to know them and form a bond, Dorcy said. “When you learn the problems the homeless face, it makes you feel badly about complaining and appreciate what you have,” the student noted.
The students themselves bring their own stories and life experiences to the clinical setting. Judy Sirkis, for example, was an attorney with a large Phoenix law firm. When her husband died at a young age, she experienced a sense of vulnerability from not knowing enough about his condition to help to the extent she desired.
“My husband’s long terminal illness drove me to learn about medical knowledge and bring my legal advocacy skills and experience to nursing,” Sirkis said. “The change process took several years because I had a child at home when my husband died, but now I am nearing the start of an exciting new career of helping more people.”
impact on students and community
Both students have been impacted by their experience in the community. Dorcy notes the insights his clinical rotation at the shelter have given him in the realities of life. Sirkis puts it more strongly. Despite the enormous, endless need Sirkis has seen, she takes heart in something from the Talmud. “He who saves one life … It is as if he saves the whole world.”
Chief Executive Officer Mark Holleran said CASS measures the impact of all service program collaborations against the question, “Is this good for those we serve?” Holleran explained, “Our partnership with the ASU College of Nursing & Healthcare Innovation has assisted us in addressing many unmet needs of our homeless men and women clients. Most importantly though, the ASU nurses, however briefly, have been able to positively impact our clients’ physical and emotional well-being through their professional, caring, and compassionate efforts. We believe this not only helps our clients but will ultimately provide our community with better caregivers.”
Perhaps the best long-term measure of the impact of the clinical rotation comes from the faculty who observe the results over time. Kay Jarrell feels the commitment of the students to vulnerable populations continues long after their rotation is completed. “The students become advocates for people who are vulnerable and often ask to be assigned to their care in hospitals in their careers,” Jarrell observed. “They also educate others about the unique needs of the homeless. After working with the shelter residents, I often them hear them say, ‘This is why I became a nurse.’” More on Community Involvement
