New York – In the days after Hurricane Sandy hit New York and New Jersey, nurses from the New York State Nurses Association (NYSNA) hit the ground, providing health checks and aid to the hardest hit communities. Since then, NYSNA has deployed medical missions to the Philippines following Typhoon Haiyan, and to Florida, Puerto Rico, and the Virgin Islands following Hurricanes Harvey, Irma and Maria. Since 2012, more than 600 nurses and healthcare professionals have volunteered on a medical mission.
In 2021, the New York Relief Network (NYRN), a new 501(c)(3) organization, was launched to expand the program and the number of volunteers and medical and educational missions. Volunteers travel where healthcare is largely inaccessible — whether responding to natural or man-made disasters. In 2021, NYRN missions delivered care to migrants from Latin America and Haiti in Mexico, helped test and vaccinate people for COVID-19 in Puerto Rico, and trained nurses in a rural hospital in Egypt.
The medical mission program was suspended during the height of the COVID-19 pandemic, and many NYSNA nurses served people in need closer to home by volunteering at vaccination sites. International missions restarted in fall 2021.
NYSNA member and NYRN board member Karine Raymond, RN, said: “I am so excited to be part of launching NYRN and restarting international medical missions for our members and other volunteers. I think the experience helps communities around the world heal, and it also helps broaden healthcare professionals’ horizons by exposing them to different types of countries and different types of health care delivery systems.”
Shila Pandya, RN, a nurse from NYC Health+Hospitals/Bellevue recently returned from an NYRN mission to the U.S./Mexico border. She said, “It is such a good feeling to give for free and expect nothing. This is why I come, and I love it. It will help you reconnect to why you became a nurse in the first place.”
The NYRN has big plans in 2022. The organization plans to run missions to: Dominican Republic, Thailand, Mexico, Cuba, Ghana, Peru, El Salvador, Egypt, India, Nepal, Puerto Rico, and Brazil.
NYRN Coordinator Rony Curvelo is excited for what lies ahead. With decades of international experience as a global traveler journalist, Curvelo is now connecting NYRN volunteers and NYSNA members with nurses from many parts of the world and providing a unique educational experience.
Curvelo said: “Nurses have the opportunity during our medical and educational missions to learn and teach at the same time. The interchange of ideas with local nurses, the access to different healing methods, and cultural diversity, in addition to the free healthcare they provide to underserved communities, make those missions an extraordinary opportunity to grow as a human and as a professional.”
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The New York Relief Network (NYRN) partners NYSNA nurses with healthcare practitioners and trade unionists to deliver critical, timely, and compassionate care to those in need around the world. For more information, visit nysna.org/nyrn.
Latinos are the largest and youngest racial minority group in the U.S. – representing roughly a quarter of all people younger than 30 years old.
Duke University School of Nursing’s new Center for Latino Adolescent and Family Health (CLAFH) serves to engage in the health care of the Latino community by addressing the inequities facing it and by promoting the overall wellbeing of Latino youth and their families.
The Center was founded by its director Vincent Guilamo-Ramos, PhD, MPH, LCSW, RN, ANP-BC, PMHNP-BC, AAHIVS, FAAN, dean, Duke School of Nursing, and vice chancellor for nursing affairs, Duke University, with a mission to reduce health inequities and promote overall wellbeing among Latino adolescents and their families. CLAFH accomplishes that mission through its four key thematic areas:
Meaningfully engages the Latino community to identify, understand and collaboratively address the underlying drivers of health and social inequities.
Strengthening the role of families in supporting adolescent and young adult health and life opportunities through the development and evaluation of family-based interventions.
Developing and evaluating innovative, nurse-driven models of health care delivery that improve access to and utilization of prevention and treatment services in underserved communities.
Promoting the scale-up of evidence-based interventions in underserved communities to drive real-world impact, locally and nationally.
The Nurse Community-Family Partnership (NCFP) Program: Increasing COVID-19 Testing in Underserved Communities
As part of NIH’s Rapid Acceleration of Diagnostics in Underserved Communities (RADx-UP) initiative, CLAFH has been conducting this randomized controlled trial to see how effective NCFP is at increasing COVID-19 testing, vaccination and mitigation behaviors and reducing secondary sequelae among families in structurally disadvantaged communities.
Families Talking Together Plus (FTT+)
FTT+ is a remotely delivered, parent-based intervention that CLAFH has been analyzing to check the effectiveness of FTT+ at delaying sexual debut and informing correct and consistent condom use in youth who are sexually active.
Exploring Father-Son Relationships to Promote Adolescent Life Opportunities
The objective of this mixed-methods study is to learn more about how the father-son relationship can impact adolescent male academic/economic, social and behavioral resilience in the context of large-scale societal events.
Research Focused on Latino Sexual Health
Two central areas of CLAFH’s research are investigating Latino sexual health disparities and developing interventions to prevent STIs and unplanned pregnancies.
Latino-Focused Global Research
CLAFH’s work includes research, educational partnerships and service in Mexico and the Spanish-speaking Caribbean.
CLAFH offers research opportunities to Duke University students and welcomes collaborations with researchers and research institutions that are interested in projects related to Latino health and social welfare disparities.
Associates in Research Adam Benzekri and Marco Thimm-Kaiser join Ramos as members of CLAFH’s core team, in addition to María de Lourdes Rosas López, CLAFH’s primary collaborator in Mexico and an Universidad Popular Autónoma del Estado de Puebla professor.
For more information, visit the CLAFH website, or email the team.
Every workplace has its challenges. But, on the flip side, each has its advantages as well. We asked Beverly A. Ely, APRN, FNP-C, who works as a Family Nurse Practitioner in Harrogate, Tennessee, about what it’s like to see patients in a rural area.
Beverly A. Ely, APRN, FNP-C
What kind of work do you do?
I currently am a Family Nurse Practitioner and work with Lincoln Memorial University/DeBusk College of Osteopathic Medicine. We have 2 clinic locations that serve the University and the public. In the clinic, I see patients of all age groups from newborns to the elderly.
Working in a rural area is quite different from what most nurses do. Have you worked in a more urban or suburban area before this? If so, how does working in a rural area differ from those places?
My career spans over many decades and regions. I began a career in nursing in the late ‘80s. I graduated from Lincoln Memorial University with a degree as an Associate Nurse. I chose to begin my nursing career in Knoxville, TN and commute back and forth. Working in a suburban area, I encountered larger volumes of patients in which needs were very different than those in an urban location.
The urban area is different than the area where I first began my career. Coming back to it was a different experience, but one that has proven to be the most rewarding. I help them meet the simplest of everyday needs and assist them with coping skills to understand a diagnosis—this is rewarding. That is what I cherish about rural health and the people of the Appalachian area. I can now say that I can give back and serve the people that have given me so much.
Why did you choose to work in a rural setting? What kinds of patients do you tend to see? How are they different from those you saw in a more urban setting?
I chose to work and serve in the rural area of Appalachia because the needs are so great. I completed 29 years as a suburban nurse and saw many different classes for people. The common denominator for both is survival.
What have you learned from working as a nurse in a rural area?
I have learned to be patient and compassionate. I have learned that there is very little that we truly need in order to survive.
What are the biggest challenges of working in a rural setting?
The biggest challenge is compliance and understanding of their illness.
What are the greatest rewards?
Seeing people feel better and the smiles on their faces.
What would you say to someone considering moving to work in a rural area? What do they need to be willing to do or deal with?
I would voice that rural health is the most rewarding field that you can chose. It requires you to have compassion and patience.
Is there anything else about working in a rural area that is important for people to know?
Yes. Do I plan to continue here? The answer would be YES. It is the most rewarding of my 30 years as a nurse that I could have ever imagined. I’m compassionate and love the people of Appalachian and desire to see them live life to the fullest.
Many rural and urban communities face a shortage of qualified health professionals to meet the population’s needs. These underserved communities face unique challenges and nurses working in these areas need unique skills to meet those challenges.
What’s it like working as a nurse in an underserved community? What skills and qualities should nurses have in order to succeed in this area?
Amanda Buccina, BSN, is an RN for the Street Outreach Nurse Program for WellSpace Health in partnership with Sutter Health. She says that nurses should have a passion for working with underserved communities, possess strong coping skills, and understand the importance of self-care. She also notes that nurses working with underserved populations should be interested in and willing to make deep connections with people from all walks of life.
If you are thinking about pursuing a career as a nurse in an underserved area, these tips will help you succeed.
Understand the Culture
Erin G. Cruise, PhD, RN, NCSN, associate professor, Radford University School of Nursing, who has worked in public health and school nursing in rural areas and small hospitals for more than 10 years, says that nurses wishing to work in rural, underserved areas, and/or with vulnerable populations need to have a good foundation in clinical skills, organization, and communication. Cruise also emphasizes the importance of understanding the cultural dynamics of the community.
“Small hospitals and community agencies generally found in rural areas are often part of a close-knit community,” says Cruise. “People know each other and they want to know the nurse caring for them on a more personal level.”
Cruise says that new rural nurses can be taken aback by the expectation of openness. “Some nurses are not comfortable with having their personal lives become an open book,” she says. “It can be a thin line between patients just being friendly and curious and the nurse feeling that he/she lacks the privacy and anonymity found when working in larger agencies and big cities.”
People in rural or small town communities are also more likely to ask questions about private health information regarding their neighbors. “While neighborly concern and curiosity are usually quite innocent, nurses in these settings must be very careful and familiar with HIPAA and their own hospital or agency policies on confidentiality to avoid sharing that information inappropriately,” warns Cruise.
Build Strong Patient Relationships
A typical day for Buccina includes walking and driving around Sacramento, CA, meeting with patients on the streets, without the convenience of a full clinical facility. She works hard at building trust with her patients.
“A lot of my job is relationship building,” says Bucinna. “I work to build trust and rapport with my clients so even if they don’t need me in that exact moment, we have a relationship and familiarity with one another. I’m there when clients do want and need support, like medical advice, an advocate at a doctor’s appointment, help getting into an alcohol or drug rehab program, or just general wound care.”
Provide Judgment-Free Care
Cruise notes that many vulnerable people lack the resources that allow them to manage their health effectively, and nurses should be prepared to meet these patients right where they are, without judgment.
“They may have low literacy, live in poverty, live in environments that are polluted, run down, or crime-ridden; and work in jobs with low pay and dangerous conditions,” says Cruise. “People in these situations will pick up on a disapproving attitude by the nurse and shut down, shut the nurse out, and be less likely to follow his or her health care directions. Nurses should adopt a caring approach. While not condoning negative or criminal behaviors, accepting clients as they are and demonstrating concern for their health and well-being are more likely to motivate them to listen to the nurse’s advice and make positive changes.”
Jan Jones-Schenk, national director of Western Governors University’s (WGU) College of Health Professions and chief nursing officer for WGU, encourages nurses working with underserved populations to avoid making assumptions about their patients.
“Don’t label or assume individuals who don’t follow prescribed advice are non-compliant,” says Jones-Schenk. “There may be financial, social, physical, or cultural reasons why individuals do not follow the advice given. In such cases, the problem can easily be that it’s the wrong advice for that patient. Taking a patient-centered approach means the advice given has to be something the patient thinks makes sense too.”
Jones-Schenk advises nurses to remain open to listening carefully to understand the barriers and limitations individuals may be facing.
Gain Mental Health Experience
Buccina says that her best advice for nurses considering working in underserved communities is to gain some experience in mental health in order to understand human growth and development from a psychological perspective, and to become well-versed in social issues in order to avoid judgment and approach the population from a place of knowledge and compassion.
Practice Self-Care
Finally, Cruise advises nurses working with vulnerable populations and/or in rural areas to find the time and space to take care of themselves.
“Because these communities are close-knit and vulnerable populations, they may mistake the nurse’s caring approach for a desire to have a more personal relationship. The nurse will have to set boundaries in a way that is kind and not perceived as rejecting of the client, yet allows the nurse to be seen as a professional and not just a friend,” says Cruise.
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