Promoting Self-Efficacy in Senior BSN Students in the Community Setting

Fact: Clinical sites are becoming harder to secure for our baccalaureate prepared nursing students (BSN) challenging colleges and faculty to look for creative solutions to meet this challenge, while providing sound clinical learning.

Fact:  Patients are discharged early from the hospital to their homes with little or no health supports in place.

Fact:  The general population is ageing; healthcare issues that one once viewed as acute events are now viewed as chronic illness; congestive heart failure, DM type II, atrial fib, and HIV/AIDS.

Fact:  Education and follow-up are needed for these clients in the environment where the healthcare system expects them to function and live.

Solution: As a creative solution our baccalaureate nursing program looked to the community in which we are located and partnered with a group of senior buildings.  These senior buildings, a total of 8 buildings, had in place a registered nurse, who over sees the general health of the community and a social worker assigned to each building.  We assigned 8 senior BSN nursing students to 4 of the buildings along with one clinical instructor. The students completed a needs assessment on their assigned buildings and created a schedule specific to their building and its population. Schedules were created for each building and a typical schedule was as follows: 8am: Senior BSN students arrived to set up the office space in which they would conduct interviews, B/P’s, BGM’s, weights, and client specific education.

 8:30am: BSN students met with the Social Worker to review and follow-up on any clients and changes that occurred since the last time the students were in the building.

9:00am to 11:00am:  Building residents began to arrive and be seen by the BSN students. Records were kept in locked cabinets in the Social Workers office. Collaboration and communication was constant and consistent among the Students, the instructor, the RN, and the social workers.

11:00am to 11:30am:  Education Sessions were done in a group setting in the community rooms, based on the needs assessment of the building population.

11:30 am to 12pm:  Questions and answer periods were held.

12pm to 1pm:  Students, in pairs, did apartments visits (checking B/P’s, medication & diet education, dressing changes) for those residents identified by either Registered Nurse or the social worker.

1pm to 2pm:  Students met with the Clinical Instructor, the Registered Nurse, and the Social Workers.  Care Plans were updated, referrals made, and needed follow-ups were identified.

It needs to be noted that the area which these buildings are located is low income and the buildings were home to not just seniors, but to individuals who had physical and mental disabilities.  The age range for this population was from 48 to 88 years, providing the BSN students with a rich lifespan experience of a population successively living in the community. In addition, the experience provided the students with a first-hand experience of working as leaders in a collaborative setting: Client – Registered Nurse – Social Worker, increasing their self-efficacy as future professional registered nurses. This experience also provided the BSN students and the college of nursing to give back to the community in which it is located: fulfilling their mission statement through service to the community.