Nursing Value: Connectedness
Carol Petrozella, RN EdD
Director, Miami Dade College
Institute for Ethics in Health Care
Through the Community Health Nursing Course students begin to appreciate how nursing as a profession and nurses as individuals are connected to the community in which they serve. They begin to understand the values of nursing as stated in the Code of Ethics for Nurses and how these values direct their service. According to Boyer (1989) one of the priorities of nursing education is “how we live and how we work—the challenge to bring moral and ethical perspective to our profession.” (104). “Boyer states that in the Carnegie Report College that the “values professionals bring to their work are every bit as crucial as the work itself.” (105).
Incorporation of nursing values is achieved by providing guided opportunities for the students to interact within the community setting using their nursing skills in partnership with community agencies. Healthy People 2010 serves as a framework for planning experiences for the students.
Unique to this course is the focus on families within the childbearing years and children. The experiences for this course are not “add on” experiences but are alternative experiences designed to enhance the learner’s appreciation of the values of nursing and commitment to health care needs of all clients in a multi-cultural environment.
Students learn the art of communication fostering trusting relationships by giving of themselves and their nursing expertise. They develop health care projects based on the individual needs of the neighborhoods they serve. The students bring the nursing care to the people. Ernest Boyer (1989) states…”I believe that, especially in the healing professions, the capacity not only to communicate carefully and with integrity, but to listen, brings us to the heart of the quality of patient/professional interaction---a relationship of trust. (103). He believes that students are empowered and connected who have skills in language.
Code of Ethics
The focus of the Community Health Nursing Course at Miami Dade College is tied to the Code of Ethics Standard #8. “The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.”(Pg 23, 2001 Code for Nurses with Interpretive Statements)
8.1 Health needs and concerns
The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of the specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels.
8.2 Nurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. Through support of and participation in community organizations and groups, the nurse assist in efforts to educate the public, facilitates informed choice, identifies conditions and circumstances that contribute to illness, injury and disease, fosters healthy life styles, and participates in institutional and legislative efforts to promote health and meet national health objectives. In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services.
The nurse also recognized that health care is provided to culturally diverse populations in this country and in all parts of the world. In providing, care, the nurse should avoid imposition of the nurse’s own cultural values upon others. The nurse should affirm human dignity and show respect for the values and practices associated with different cultures and use approaches to care that reflect awareness and sensitivity. (23-24 Code of Ethics, 2001)
Mueller and Norton (1998) state … “Service Learning offers a way in which students can develop their own sense of democratic citizenship and help to create a better world by contributing to national renewal.” (171). These authors state that service learning provides experiences that foster the development of “moral judgment, civic responsibility, cultural competence and, global awareness, in addition to the basic professional skills set forth in the curriculum.” (171). The author’s caution: Academic credit is given for “the learning and its relation to the course, not for the service alone. The service activity must match course content and enhance learning by allowing application of the theoretical principles taught in the classroom setting.” (172). They further state “Service learning in the curriculum provides opportunities for students to attain personal, professional, and curriculum goals. Service learning also contributes to the overall educational experience of the college or university and thus provides benefits to the institution as well.” (173).
Bartels (1998) states “it is in the experience of providing service that they [students of nursing] gain the personal insights required for them to act on behalf of those experiencing social injustice and learn their role as guardians and servants of the community.” (10).
Service learning is one of the teaching strategies, which is incorporated into the Community Health Nursing Course curriculum. Service learning and Provision # 8 in the Code of Ethics for Nurses are integrated throughout the course. Reflective activities include small group seminars facilitated by a faculty member and journaling throughout the course. The course emphasizes civic responsibility and professional nursing values.
Mentoring and Student Involvement
Boyer (1989) explains that there is a “need to create a climate not only in which there are teachers who mentor, but in which students are teachers, too. Students, as they continue to learn, must accept an obligation to be increasingly engaged. We also need cooperative learning as a part of this process.” (106).
The students work collaboratively with the faculty to plan appropriate projects for their service learning activities based on community needs. The students actively engage in health care teaching. The faculty serve as role models for the students and have developed community partnerships with organizations within the community. Students are encouraged to be creative and take on leadership roles.
The Miami Dade College Center for Community Involvement has been instrumental in helping the faculty by providing grant opportunities and College support for activities. Faculty and students in partnership with community organizations have written grants. The School of Nursing also works closely with AHEC(Area Health -- Consortium) to provide health care services to the community.
Students who are members of the National Student Nursing Association have the opportunity to participate in the National Student Nursing Association Leadership U. There is an additional syllabus that outlines the requirements for a community project in collaboration with a community health agency. The students must collaborate with each other to develop a project and implement it. In addition, a formal paper is required. This requirement reflects Boyer’s emphasis on the essential need for nursing students to have command of the written language. The Syllabus can be accessed through faculty resources at NSNA@nsna.org.
In conclusion, this quote from Ernest Boyer (1989)captures the essence of nursing education and the value of connectedness. He states:
|I believe that nursing is the noblest of callings. Nursing education requires a rare combination of knowledge, skills, and values. And at its core, it would call for an understanding of the connectedness of things. Connectedness through a careful, sacred use of language. Connectedness through the interdependent world in which we live. Connectedness through a vision of great teachers. Connectedness between theory and the values of our lives. And finally, connectedness between the classroom and the imperative of service.” (107).
The School of Nursing, Community Health Nursing Course incorporates many of the essentials of undergraduate nursing education as defined by Boyer in his article Connectedness Through Liberal Education. Nurse connectedness to the community and society is a value found in the Code of Ethics for Nursing especially in Provision # 8. This value is interwoven within the course. Faculty and students collaborate to develop community health projects designed to meet the needs of individual groups within the community. Trust within the community is fostered. Students learn to communicate with accuracy and integrity as they provide services to the community. Reflective thinking and critical analysis is fostered through small group reflections and journaling. Additional opportunities for collaborative learning and leadership are afforded the students through Leadership U.
ANA (2001). Code of Ethics for Nurses with Interpretive Statements. ANA.
Bartels, J.E. (1998). Humanistic learning in the context of service: The Liberal Arts in Nursing Education In: J.S.Norbeck, . C. Connolly, C., & J. Koerner (Eds),. Caring and Communnity Concepts and Models for Service-Learning in Nursing. Washington, D.C: American Association for Higher Education. 1998.
Boyer, E. Connectedness Through Liberal Education (1989). Journal of Professional Nursing, 5(2),102-107.
Mueller, C. & Norton, B. (1998). Service learning developing values and social responsibility In: D.M. Billings,. & J.A. Halstead, Teaching In Nursing A Guide for Faculty. Philadelphia: W.B. Saunders Co.