Future Nurses Develop Public Health Strategies

May 11, 2017

Aspiring nurses are researching vulnerable populations and brainstorming strategies to improve lives. University of Sioux Falls students examine vulnerable populations. Some teams consider solutions for children who are hearing impaired. Others develop a plan to deter college students from abusing alcohol. Hear from a nursing instructor about comprehensive patient care and learn about the vision these 20-somethings have for making the world a better place.

Three University of Sioux Falls juniors stand at least six feet tall, and these men major in nursing. Their latest task examines vulnerable populations.

"We looked at the homeless population and thought it would be something that we could easily go down and kind of see and do like kind of hands-on," Austin Shaffer says.

Shaffer says pinpointing people without homes is more difficult than he assumed. He says some people who need free health services don’t fit homeless stereotypes. Shaffer says examining areas where poorer people live, though, reveals more.

"If you really looked at and focused on the buildings, the infrastructure, their lawns and everything like that," Schaffer says. "If you don’t really pay attention, you kind of miss how rundown and unkept it kind of is in that area."

Branden Boyd says people congregate in the core of the city.

"You know, you’ve got all your businesses in your nice Downtown Sioux Falls area, and then almost instantly you’ve reached where it’s like Union Gospel Mission, The Banquet, and it’s more rundown and you don’t have all those businesses working together to keep it nice and maintain the area," Boyd says.

Some people who don’t have homes sleep in their cars, and they can move around town. He says homeless people rely on public buses.

"Transportation has the potential to be a positive in Sioux Falls, but with the schedules and the routes? For instance, the routes don’t go out to the food pantry right now," Boyd says. "So there’s people working to get a petition to make that happen, but who knows how long that’ll take."

First of all, from a human stance, we should care about other individuals.

Boyd says his group discerns Sioux Falls boasts multiple agencies to meet the needs of disadvantaged populations. He says the problem is that some people can’t access the services. He discovers this while performing free blood pressure checks.

"I encountered this gentleman who came from overseas, living homeless with his wife, had uncontrolled diabetes but didn’t have the means of doing it – maintaining his illness, I should say," Boyd says. "So that was kind of a huge thing that stood out to me, because he knew everything and he knew what he needed, but he couldn’t get it."

Team members craft a strategy to shed light on options for underserved populations. Nick Stanke says the best way to do that is a sort-of party.

"If we could figure out some way to collaborate all the resources in one location in kind of like a convention-type deal in a local park for these resources to gather, and people could come," Stanke says. "We’d have incentives for them like food that could bring them in, and then they could learn about these resources all in one location so that they can realize that these resources could work together for their benefit if they knew what was actually out there."

Stanke says he now knows no one kind of person becomes homeless. He says some people fall to addiction and others get sick. He says some are college graduates or spent years working full time before they lost a place to live.

"One thing just to remember is that every person you see has a different story," Stanke says. "I remember at Center of Hope, we were talking with Maddie, and someone would walk in and she would tell us about his story, and it’s crazy to realize that all these people have different stories."

Stanke says he and his group members want to be nurses to serve, and part of that is taking the initiative to solve community problems.

"First of all, from a human stance, we should care about other individuals," nursing student Simone Rernleitner says.

Rernleitner's team examines what happens to people with mental illness behind bars.

"We chose that because of the decision of Rapid City recently to automatically incarcerate mentally ill when their hospital is full, so we wanted to evaluate if the treatment and everything of that within the prison is actually sufficient for that kind of decision," Rernleitner says.

Credit Kealey Bultena / SDPB

Group members interview a nurse who previously worked in prison. They also access information from two pastors involved with corrections. Andrew Ruiz now understands what life is like for some prisoners with mental health problems.

"The mentally ill are actually separated to their own separate unit. The reason for that we found out from our key informant, the one that was a pastor, was that the general population like to prey on the weak, and they prey on the mentally ill," Ruiz says. "So that was one of the things that surprised me: that they separate them for that reason – not because they need more care, not because they need more attention. It’s so that they’re not a target to the rest of the population."*

Ruiz says he also learns that some prisoners suffering from mental illness receive too much medication, whether inadvertently or intentionally.**

"Just kind of like, here, toss some meds at them and try to fix the problem that way rather than looking at the holistic approach of it and try to take care of the whole person itself, rather than just medicate them up and you’re no longer my problem," Ruiz says.

Ruiz says prisoners are human beings who made grave mistakes. Marianna Brawand says people don’t need to know someone in prison or with mental illness to feel the effect of treating mental health in lockup.

"It impacts you financially, because you are paying your tax dollars that go towards prisons," Brawand says. "And if they don’t get the healthy treatment they need and they are continuously being re-incarcerated, your money is going towards that."

Group members grapple with the concept that prison is punishment. They first construct plans that offer more opportunity than programs available to people not convicted of wrongdoing. Brawand says they settle on a strategy that prepares inmates for life beyond the razorwire.

"We’re going to have a mandatory social skills class where they learn conflict resolution, so if they have conflicts with other inmates they know how to properly manage that without just lashing out and being violent or doing the opposite and being isolated, which can actually exacerbate mental illness," Brawand says.

These college juniors argue education can lower recidivism. Rernleitner says treating mental illness helps break the cycle of health crisis and crime.

"Like teaching about medication adherence and the reasons behind their illness and the importance of all the different interventions, so that they don’t get released from prison and just end up back in prison, because nothing really fixed the problem in the first place," Rernleitner says.
 
Rernleitner says teaching life skills moves former prisoners from the label of vulnerable population to a new category: productive members of society.

*An authority with the SD Department of Corrections says the SD State Penitentiary includes a mental health unit for inmates with serious challenges for the purpose of providing additional care. He says other inmates can manage their mental illness within general population.
**The SD DOC says licensed medical professionals handle care for patients with mental illness and do not practice abuses such as overmedicating inmates.