Examples from Community Health Nursing Instructors
Ann, a nursing faculty member at a small Roman Catholic college, had a one-to-one postclinical conference with a student and relays this conversation. The student had made many visits to an African American teen mother of two thriving children. The young mother lived in a dangerous housing project, and, although she locked him out of her second-floor apartment, her abusive boyfriend had been known to climb up the drainage pipe and over the porch roof. Sometimes, he forced open a window and beat her. The mother worked every day at a fastfood establishment; her grandmother took care of the children. After a couple of months of weekly visits, the student exclaimed, “When I read her chart, I saw her as an immoral girl—a slut—and I expected her to be a loser. Now I can’t believe what I’ve learned about how strong she is. She just keeps fighting for herself and for her kids to survive! She’s a great mom and I told her so!” Another faculty member, Sharon, who taught community health nursing in a Midwestern school of nursing was having an informal discussion with a student who related her experience of trying to get comfortable making home visits with low-income young women. She was making brave attempts at home visits to a pregnant woman, about her age, living in the deteriorating outskirts of a major city. She thought she had established rapport and was making headway developing trust with the client. One day the client asked the student, with concern in her voice, if she had “broken off her engagement.” The flustered student then had difficulty explaining the absence of her engagement ring, which she had never mentioned but the client had obviously noticed. During the previous week, she had suddenly realized she was wearing this special ring in marginal neighborhoods and thought it best to leave it at home. Of course, she thought that she had to fabricate another reason to tell the client but felt badly for being so judgmental when the client was identifying with the student and noted they had something in common. Lynn, a new public health nursing faculty member from a large state university in the West was shocked and repulsed by the comment of one of her students during lecture one day. When discussing vulnerable populations in urban centers and rural areas, the point was made that poverty can be a generational phenomenon and that many of our clients may find it difficult to dig out of this circumstance. Social justice was discussed, along with the need for PHNs to become social activists in order to change political and socioeconomic factors that keep the status quo. One student, a Hispanic female from a middle-class family, spoke up stating “they should all get jobs at McDonalds.” This spurred further discussion about population-focused versus individual-focused interventions and approaches and the need for all of us to be aware of our prejudices and stereotypical viewpoints.