1 Running head: SERVICE LEARNING SYNTHESIS

Service Learning Synthesis Michelle M. Johnston Ferris State University

2 SERVICE LEARNING SYNTHESIS Abstract This paper leads its reader through the operations of a Service Learning project. The paper begins with a description of the agency, Oasis of Hope Center, where Service Learning took place. The volunteer role of this writer is then explained with specific description of activities that took place to fulfill the Service Learning requirement. This writers reflection of the Service Learning project is then presented in great detail with specific examples of thoughts, assumptions, insights, and ideas and their metamorphoses throughout the project from beginning to end. In finale, the synthesis of this writers experiences throughout the Service Learning project and how they are related to her RN to BSN program outcomes are reviewed. Specific examples of experiences are taken from the reflection portion of this paper and are used to highlight and drive home the main point of the paper that the overall purpose of the Service Learning project has been achieved.

3 SERVICE LEARNING SYNTHESIS Service Learning Synthesis Throughout my RN to BSN program at Ferris State University, I completed a Service Learning project that involved twenty hours of volunteer work. My Service Learning project took place in a small clinic in Grand Rapids, MI called Oasis of Hope Center. After completion of this project, I was able to reflect on my experiences and identify ways that the project has helped me to meet the program outcomes. This paper is a reflection and synthesis of my service learning experience at Oasis of Hope Center. Agency Oasis of Hope Center is a not-for-profit organization providing medical care and lifeskills education to the uninsured in the community since April 30, 2007 (Oasis of Hope Center, 2011). The clinic is free to persons who have no insurance coverage (including private insurance, or any government sponsored medical coverage) and who also make less than 200% above federal poverty guidelines (2011). Oasis of hope Center (2011) states that their mission is to provide hope through low cost/free medical care and basic life-skills education to the economically disadvantaged and uninsured of the west-side of Grand Rapids, Michigan, in Jesus name (para., 1). The center is run entirely on donation and volunteer efforts three days per week; Monday 9am-7pm, Wednesday 1pm-6pm and Saturday 8am-1pm (2011). The services provided are: urgent care, minor emergency care, wellness exams, ongoing disease monitoring, ongoing disease treatment, some cancer screening, assistance with medications prescribed, some immunizations, health education, and life-skills education classes (2011). Medical care is provided by licensed professionals including Physicians, physician assistants, nurse practitioners, certified nursing assistants, registered nurses, licensed practical nurses, and medical assistants. Receptionists, spiritual leaders (priests, preachers, etc.), and other members of the community

4 SERVICE LEARNING SYNTHESIS who want to help the cause also volunteer their efforts and time to the center. The center and its providers are insured against liability for medical malpractice through the federal government via the Federal Tort Act (2011). Role My role within Oasis of Hope Center as a registered nurse was to facilitate phone/walk-in triage, schedule appointments, provide patient education, file documents, and perform clerical tasks as needed. If the center was understaffed with medical assistants then I would take their place and collect vital signs on patients and bring them into rooms to be seen by the physicians. In my experience at Oasis of Hope, I never had to complete any task that was not in my role description. The twenty hours required for the Service Learning project went quickly. I would answer the phone and perform phone triage if necessary and make suggestions about home treatments or if the patient should be seen in an appointment. For those who were calling to schedule new patient appointments, I would inquire about health insurance and income before giving an approval over the phone to be seen at the center. I performed patient education on checking blood glucose/using a glucometer, signs and symptoms of hypoglycemia/hyperglycemia to newly diagnosed diabetics, and proper usage of insulin pens. On occasion I would have to call prescription drug companies such as Merck to re-order prescriptions for our patients who were on drug assistance programs. The majority of my time was spent answering the phones and scheduling appointments, but I was always on-hand and available to complete any other task that was asked of me. Reflection My initial thoughts about the Service Learning experience were that it was going to be easy to do but I would not have time for it. I also thought that I probably would not get

5 SERVICE LEARNING SYNTHESIS everything out of the experience that the rationale for the project suggested. I did not believe that the Service Learning project would contribute to my growth or self-development as the Service Learning Requirement Undergraduate (BSN) Programs Policy stated on page 40. After my experiences during my Service Learning project, my thoughts about Service Learning have changed. I now believe that Service Learning is a great way to grow professionally and develop self. The Service Learning project has given me opportunity to help a population in need and has made me feel more valuable to my community as a professional than I ever have before. I have taken my skill outside of my paying job and have put it to use to help others. Doing so has made me see that it is important to not only be a nurse while working for pay, but to be a nurse always and practice professionally with the highest standards of quality and safety in every instance that is necessary for my practice. At the start of my project, I had issues with the organization where I had proposed to volunteer my services. I was excited about volunteering my time with an organization that I had previously volunteered for, Wedgwood Christian Facility, but after the organization had agreed to my proposal, they failed to provide any volunteering opportunities. Because of this, I had to find an organization that would allow me to volunteer my time as well as exercise my nursing skill for those in the community who need the help. I have always had a passion for helping the underserved so I considered organizations that were dedicated to doing just that. After some searching, I found a new organization, rewrote my proposal, and managed to meet the requirements. I heard about Oasis of Hope Center, a free medical clinic, through a friend and decided to look into volunteering for the clinic. They were eager to have me volunteer with them, but I did have to wait for two months before starting because they already had enough staff through the

6 SERVICE LEARNING SYNTHESIS summer. Waiting for this volunteer opportunity made me a little nervous as it was the end of June and I would need to have the project requirements met by the fall for NURS 450. In writing my proposal for Oasis of Hope Center, I learned more about the center and what they offer the community they serve. Oasis of Hope Center sounded like a better fit to complete my Service Learning and it fit perfectly into the guidelines for the Service Learning project. The Service Learning Requirement Undergraduate (BSN) Programs Policy states that the project activity is expected to enhance the students professional development and should be related to health care (Ferris State University, n.d., p. 40). In hindsight, the organization that I had originally chosen would have had me performing duties that were not directly related to health care, so it would not have been fitting for the project. Oasis of Hope Centers clinical coordinator Rita Rodriguez was very polite and understanding of the program requirements for Service Learning. Once there was room for me to volunteer, I was able to go into the center to fill out the volunteer paperwork as well as have Rita sign required forms for the project. It was agreed that I would start on Monday, September 9th and every following Monday from 12pm-5pm through the month of September, then every fifth Monday from 12pm-5pm. My first day, I was taught how to log into the electronic charting system and create new patient charts as well as schedule patients for appointments. I was instructed to answer the phones, perform triage and schedule appointments as necessary for those who called the center. I was told that if I were needed for patient education, the physicians would find me, and that I was encouraged to use current scholarly literature to help find interventions to implement. As a volunteer for the underserved, I was told to get as much information as possible on patients in order to give them the best advice for triage, and offer the appropriate resources.

7 SERVICE LEARNING SYNTHESIS Out of the four days that I volunteered, I had three different occasions that I performed patient teaching with diabetic patients. My first time teaching made me nervous because things are different in a free clinic than that of a skilled nursing facility. For example, patients are taught that it is okay to reuse their lancets and pen needles because the center does not have enough to supply them with new each month. Two of the patients were newly diagnosed with diabetes that same day and needed teaching about diabetes management and how to check their blood sugar. The other diabetic patient needed teaching about how to use an insulin pen. After my first time teaching, I was no longer nervous. I had understanding of the limited resources available to the patients so I knew how to instruct the patients to care for themselves properly and safely using the resources that were available. Throughout my time volunteering for the center, I was able to provide health care assistance resources to patients calling into the center. I was amazed at how few resources are available to patients with no insurance and that many of them are unaware of the resources that are available. Over time, my ideas about the population with no health insurance changed. I went into volunteering for Oasis of Hope Center believing that many of the patients would not care about their health and would not follow their treatment plan, but after my experiences, I now know that many of these patients truly care about their health and simply lack all of the resources they need to properly care for themselves. Synthesis The Service Learning Requirement Undergraduate (BSN) Programs Policy states One of the primary objectives of the Ferris Professional Nursing Program is that students will demonstrate personal and professional accountability in nursing practice by identifying and planning activities that contribute to growth and self-development in relation to professional

8 SERVICE LEARNING SYNTHESIS goals and advancement of the profession of nursing (p. 40). The Service Learning project made an impact on my nursing practice and I am happy that it was a part of my BSN education. My experiences changed my ideas and assumptions about my practice and those I serve, they have created a sense of worth in my nursing skill that goes beyond my initial schooling. The project made such an impact, that I have decided to continue with my volunteer efforts for the center. The activities of my project have given me opportunity to collaborate with other members of the healthcare team to achieve the task of caring for those without insurance. I have always had a passion to care for the underserved and my collaborative efforts have made my passion a reality. I learned that being a nurse is more than caring for those I am being paid to care for. I take pride that I have volunteered my nursing skill to those who need it and that I have taken my professional accountability and high standards of quality and safety and put them to use outside of my working practice. I have been encouraged to seek information from scholarly literature to implement new learned knowledge and theory for my underserved patients. In these ways, what I have taken away from my Service Learning experience has helped me to fulfill the program outcomes of Collaborative Leadership, and Scholarship for Practice (Ferris State University, 2011). Service Learning has also helped me fulfill the program outcomes of Theoretical Base for Practice and Generalist Nursing Practice (Ferris State University, 2011). My work with the underserved population has allowed me to use nursing theory based on my knowledge of underserved populations. I used a holistic nursing approach while performing phone triage and teaching patients at the center. I knew to look at all aspects of the person and find ways to address all their concerns not simply their medical concern. Many of the patients at the center were very poor and had struggles with finding shelter and food. I was able to provide the resources and education necessary to give these patients the opportunity

9 SERVICE LEARNING SYNTHESIS to care for themselves wholly. Practicing in the free clinic setting was very fulfilling. It gave me, as a nurse, a greater sense of worth and professionalism. I have a new attitude about the underserved and my ideas about the way they care for themselves have changed. The Service Learning experience made me aware of bias against the underserved and has made me more of an advocate for the underserved in my community. The program outcomes of Professionalism and Health Care Environment have been partially achieved through my Service Learning project (Ferris State University, 2011). A nurses role in the community is greater than that of a caregiver. The nurse is a professional who remains a nurse and teacher outside of her working practice. The nurse uses the art of nursing to communicate and practice the science of nursing to those she serves from all populations in all environments.

10 SERVICE LEARNING SYNTHESIS References Ferris State University. (2011). RN to BSN Program Outcomes. Retrieved from http://www.ferris.edu/htmls/colleges/alliedhe/Nursing/BSN-program-outcomes.htm Ferris State University. (n.d.). Service Learning Requirement Undergraduate (BSN) Programs Policy. Retrieved from %2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_6542_1%26url%3d https://fsulearn.ferris.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2F webapps%2Fblackboard Oasis of Hope Center. (2011). Welcome to the oasis of hope. Retrieved from http://www.ohcgr.org/index.html

11 SERVICE LEARNING SYNTHESIS Appendix A