In a dining room full of people waiting for an early Thanksgiving meal, seven students from the Kirkhof College of Nursing were easy to spot.

Several handed out soup in plastic bowls while others staffed a table filled with bread, lunch meats and cheeses and served sandwiches. They roamed the room taking blood pressure readings while one student called off raffle numbers and directed people to the table of donated food.

Meridell Gracias, affiliate faculty of nursing, supervised those students on a November afternoon at Adams Park Apartments in southeast Grand Rapids and called the scene unstructured but said it was the epitome of community nursing. Adams Park is a 188-unit building managed by the Grand Rapids Housing Commission (GRHC) and is home to disabled adults and low-income senior citizens.

Since 2014, nursing faculty members and students have partnered with GRHC to provide health screenings, health interventions and education events for residents of Adams Park and other GRHC properties. Cynthia McCurren, dean of KCON, said community health rotations such as these are high-impact learning opportunities for undergraduate and graduate students that focus on the social determinants of health care.

Both partners benefit. Hattie Tinney, deputy executive director of GRHC, calculated 500 students have provided 15,000 hours of care for residents since the collaboration was established; it was recognized with an award of merit for resident and client services by the National Association of Housing and Redevelopment Officials at its 2018 conference.

“I’ve worked here for nearly 40 years, and to me, this is the most important collaboration we have,” Tinney said.

“The students change but the program remains consistent.”

Consistent care on the ‘front porch’

Consistency is key, Tinney said. At Adams Park, for example, residents know a team of nursing students will be in the community room each Tuesday afternoon, leading games of nutrition bingo, providing health information or teaching a cooking lesson. Last year, KCON students helped residents establish a vegetable garden outside their building.

Groups of students also lead activities at other GRHC properties. At Mount Mercy Apartments, a 180-unit building on Grand Rapids’ northwest side, an interdisciplinary team of GVSU nursing and movement science students spent a semester leading senior citizens through an exercise research study complete with Fitbits to track steps.

“If students are new to nursing, they’re learning how to talk with someone from a different background or different socioeconomic class. More experienced students are helping to care for our residents who have diabetes,” Tinney said.

For some vulnerable residents, it’s often the only health care they receive outside of emergency room visits, she said.

“I think of the community room at Adams Park as a front porch, people talk to other people on their front porches. The social stimulation the students provide makes a huge difference for some of our residents,” she said.

One resident said she enjoys talking with students. Melissa was referred to GRHC by Network 180, Kent County’s community mental health agency. Before moving to Adams Park in early 2018, she said she was homeless for three months after being forced from her Holland area apartment when the landlord died. “My blood pressure is good but I enjoy coming here for the bingo and social activities. It’s nice to know that the students are here,” she said.

Gracias started taking students from her community nursing class to Adams Park six years ago but her involvement began as a volunteer 20 years ago.

She began providing blood pressure checks then expanded her volunteer role by helping the building’s staff members establish a healthy living program with support from Michigan State University Extension.

“A lot of the residents are in really fragile health,” Gracias said. “They won’t tell you that, they think their health is good, but two problems are very prevalent: hypertension and diabetes.”

Johnny Boyd suffers from both; he is 62 and has lived at Adams Park for nearly two years. Boyd, who is trying to quit smoking, regularly undergoes blood pressure checks during Tuesday clinics.

“These students do great work and give service to a lot of people who can’t go out and get care,” Boyd said.

Building trust

During one of her visits to Adams Park, Kelsey Morgan, a junior from Rockford who is majoring in nursing, learned her mother and a resident were acquaintances.

“One of the ladies told me she went to the same high school as my mom. Each time we come here as a class, we’re building relationships,” Morgan said. “We’re not going to come in here each week and tell someone, ‘You should eat this and not that.’ You have to build trust before talking to someone about their health or eating habits.”

Nursing student Austin Johnson admitted standing at a food line serving sandwiches does not look like traditional nursing, but said he understands the theory behind performing these kinds of activities in the community.

“I like seeing the positivity that all these people get to experience even from the short time we’re here,” Johnson said.

He said helping others is important to him also; Johnson worked as a machinist for four years before switching to what will be a nursing career.

“I knew I needed to do something different, something that wove social skills into my passion for science. This is a good taste of what community nursing is,” he said.

For Gracias, community nursing centers around recognizing and empowering the dignity in people. She said serving soup, sandwiches and pie to the residents who attended the pre-Thanksgiving meal was important. “These are people who don’t get to go to a restaurant, so nobody says to them, ‘I’m happy to serve you.’ You’re doing a lot more than handing out a turkey sandwich,” she said.

That was the reasoning behind arranging the table full of pantry items like canned peas, stuffing mix and peanut butter as a raffle rather than a give-away. “It’s a game then and not a handout,” Gracias said. The items were collected and donated by Delta Zeta, one of Grand Valley’s sororities.

During a debriefing session with students after their Thanksgiving week visit, Gracias reminded students of a hallmark of community nursing.

“When you work in community nursing, you need to be comfortable with uncertainty. It’s not like working in a hospital. Community nursing is about building relationships and making people feel welcome,” she said.

Grant establishes onsite primary care

Through a $493,690 grant from the Michigan Health Endowment Fund, teams of Grand Valley faculty, staff and students are providing onsite care to older adults and senior citizens who are served by GRHC and the Dwelling Place, a nonprofit organization in Grand Rapids.

The project began in January at Mount Mercy Apartments and Reflections, a senior housing community managed by Dwelling Place in southeast Grand Rapids. The GVSU Family Health Center, a nurse-managed center operated by KCON, is the collaborating partner and deploys primary care teams.

McCurren said interdisciplinary teams are providing care to patients with a focus on improving mental, physical and functional health, which will help decrease emergency room and hospital visits, delay nursing home placements and support aging in place.

The grant from the Health Fund was among $14 million in awards to Michigan organizations. Della Hughes Carter, assistant professor of nursing, is overseeing the grant and said anticipated outcomes include decreased number of falls, improved medication tracking, and reduced financial costs.