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Nursing education model to change as greater emphasis put on community care

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Nursing students assess patient

Bachelor of Science in Nursing students Marianne Semeaton and Sophie Stanley assess patient Lorne Primrose just prior to his return home after three weeks in Ponderosa.

The following story originally appeared in the spring 2012 edition of Bridges, the magazine published by the TRU Alumni & Friends Association. —> Download the pdf.

By Diana Skoglund
TRU Marketing and Communications

Health care is changing. Patients with chronic and acute diseases or injuries are doing more of their recovery at home.

This change has increased the emphasis on community rather than acute care nursing, and requires a more holistic focus to make sure transitions from hospital to home maintain the level of care throughout the process. In many cases, patients are better served by being cared for at home, and moving their care out of the hospital is also proving cost effective for an overburdened health care system.

But as the delivery system changes, so must the educational model for nursing.
Dr. Barbara Paterson, Dean of Nursing at TRU, and Susan Rolph, the Residential Manager of Ponderosa Lodge and Overlander Extended Care Hospital
in Kamloops, recently developed a plan for TRU and Interior Health (IH) to adapt student nurse education to address the changing delivery system. Their research proposal, “Innovation in Clinical Nursing Education to Foster Competencies Required by Emerging Changes in HealthCare”, was recently awarded $113,151 in funding by the Michael Smith Foundation for Health Research through its BC Nursing Research Initiative.

The two-year research project now underway at Ponderosa Lodge, established the Dedicated Learning Unit and Community of Practice, involving approximately 36 nursing students, 30–50 practitioners, and 90–120 clients and their families.

At Ponderosa, TRU’s Bachelor of Nursing students complete a practicum that involves residential care, respite, and services for patients convalescing before moving to home care services. For students, it’s much more than a rotation in geriatrics.

The project will focus on developing student nurses’ leadership and collaboration skills, and a seamless continuum of care that spans care settings over time.

The research team, co-led by Paterson (research) and Rolph (practitioner) will examine how nursing students, who do their training mainly in acute care
settings, can adapt and manage their approach to fit different types of care settings.

The project will also study the best way for nurses to fully understand the complexities of managing chronic illness, and identify the potential gaps in transition services as health care delivery continues to move from acute care facilities to home care situations.

When Sophie Stanley compares her experience at Ponderosa to other clinical rotations in maternity, surgery, and acute care, the second-year TRU nursing student says she has come to know the patients better. Being assigned to individual patients or clients, not to wards, gives nursing students a more complete understanding of their patients and the wide range of issues they face as they transition from hospital to home.

The student nurses are included in health care teams along with doctors, nurses, social workers and physiotherapists.

“When I do a home assessment, I understand that healthcare is more than hospitals, nurses and healthcare providers. It’s family and home too,” Stanley adds. Aided by iPads and smart phones, students can check the name of a drug or take a photo to better handle wound care or illustrate the situation in a patient’s home.

“Sometimes the patients don’t know what they need, or the resources that may be available to them. We are learning the resources that will support the clients when they move home,” says nursing student Marianne Semeaton, who was part of the class at Ponderosa in the winter semester. “When I thought about going into nursing, I thought about hospitals, medications and IVs,” Semeaton said.

“I am learning there is so much more to nursing than what I had imagined.” Sitting across the table in Ponderosa’s kitchen, Stanley agreed.

For Michelle Funk, the TRU clinical nursing instructor at Ponderosa, it’s been a privilege to see her students think beyond the walls of traditional learning settings normally offered in schools of nursing.

“They are seeking care for patients beyond the ailment they originally presented with in acute care,” she said. “These students are able to consider the health and care of this person in the real world, in their homes, their communities. Students have become masterful in providing resources well past (patients’) initial contact with the hospital.”


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