By Ranjit Kaur Dhari (1), Joanne Ricci (2) & Alysha McFadden (3)
(1) Lecturer, N336 Course Leader
(2) Senior Instructor, N427 Course Leader
(3) Clinical Associate, Evergreen Community Health Center.
UBC nursing students spend part of a day twice in a 6 week rotation at the Union Gospel Mission (UGM) where they provide foot assessments and build rapport with residents in the downtown Eastside. The students also get a tour of the UGM and learn about the unique programs the UGM provides as well as the history of the downtown Eastside. This experience highlights to students the importance of understanding how history impacts the social determinants of health for individuals, families, and populations who live in the downtown Eastside, while also allowing clients themselves to tell their own unique stories.
Prior to them being in this clinical setting student are prepared with classroom lecture with content on outreach nursing and in particular working in the DTES. They are shown the film “Bevel Up” filmed in Vancouver Downtown eastside where it follows nurses working with vulnerable populations on the streets. Their knowledge from Relational practice thread courses is further reinforced with discussions on collaborative relationships with clients, communication with challenging clients and setting boundaries and keeping oneself safe.
All nursing practice is grounded theory, hence learning about Outreach from the Minnesota Wheel of intervention as a model for practice in Public Health in our baccalaureate program is used in this unique setting. Follow-up from the foot soak in often brought back into the classroom in the way of discussion as various other interventions of the wheel are used to analyze the often complex clients that the students work with at the UGM foot soak clinic.
For many students, who are not from the Vancouver area or have not ever experienced this kind of marginalized population with many determinants of health affecting this population group- the experience is powerful to say the least. These students have the opportunity to debrief not only after the foot soaks session with the clinical nursing instructor but the following week in the classroom and via their personal journal if they wish which is required at various times throughout the 6 week rotation.
The experience and partnership have proven to be a win -win situation for all. The students are learning about living with adversity and engaging in many ways with this populations lived experience as the clients are receiving an ear to listen, health promotion counseling on a variety of topics such as nutrition, medication compliance and are receiving a warming foot soak, massage and a clean dry pair of socks.