In hopes of gaining a breadth of experience, many nursing students immediately look for a job in a hospital setting upon graduation. But Judy Liesveld, associate professor at the University of New Mexico’s College of Nursing, encourages students to look past the typical offerings.
Working on a “Nurse Education, Practice, Quality and Retention-Bachelor of Science in Nursing Practicum” grant from the U.S. Department of Health and Human Services, Liesveld runs a program in which selected nursing students from the University of New Mexico and San Juan College in Farmington, New Mexico, work twice a year (once in fall and once in early spring) in the Chinle Indian Health Service Unit on very rural Navajo Nation Reservation located in Arizona, three hours outside of Albuquerque.
In their two-week stay on the reservation, the students are immersed in an unfamiliar culture and with medically underserved people who need healthcare that runs the gamut from minor to serious. Students who want to return are able to complete a senior capstone in the following term.
“When they are in this setting, they are in a very rural setting where it’s a totally different culture with a vulnerable population,” she says. “This totally helps to expand their world view. This is a robust, rich experience for them.”
And the experience the nursing students get in a short time rivals intense clinical experience in a larger healthcare setting, she says. Liesveld should know—her first job out of nursing school was working in Chinle Health Services.
The Chinle clinicals, as they are called, bring students through things like the emergency department, obstetrics, urgent care, and pediatrics. There are primary care clinics that the students participate in as well as home visits where many residents live without running water or heat in extremely remote areas where dirt roads are common. Even in living conditions that aren’t what they are used to, students see the human bonds that make the community what it is, Liesveld says. They see an incredibly close family structure and a culture that is powerful and strong.
The nursing students give presentations on health topics to different populations increasing both their presentation capabilities and their understanding of the different needs throughout a community.
“They presented at a senior center on smokeless tobacco and at a middle school on self esteem,” she says. Through the presentations, the nursing students interacted with people and felt like they were making a difference.
“The hope is students will love the experience and will work in rural settings,” says Liesveld. But if they never work in a rural setting again, she says the experience they gain on the reservation is one they will never forget and one that will offer them skills they will use throughout their careers.
“They learn they have to be resourceful and they learn how to think on their feet,” says Liesveld. Students quickly develop authentic rapport with the residents and they use nursing skills they might not have a chance to use in other places. “It changes their world,” she says.
If they stay in the region, they are likely to work with a Native American population, so the exposure to their culture will give them a cultural competency that can only be gained by such an immersive experience.
And the ripple effect of what they have learned can lead to advocacy as well. Students begin to think about health policy on a national level and what that means for the country as a whole and these rural pockets of communities that exist across the nation.
When there is that kind of meshing of skills, understanding, and cultural exposure, nursing students, wherever they land after graduation, will have a broad view that will benefit them and their patients.