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Nursing Student Summer Externship in Disaster Response

State: OK Type: Promising Practice Year: 2018

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Oklahoma Medical Reserve Corp:  OKMRC Nurses Unit
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Nursing Student Summer Externship in Disaster Response
The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the Oklahoma Medical Reserve Corps. This project entailed expanding a pilot program launched at the University of Oklahoma's College of Nursing to multiple nursing programs. This externship program allowed nursing students to develop and apply public health nursing skills focusing on emergency preparedness, response, recovery, and community resiliency. The primary target audience of this project was interested baccalaureate nursing students in Oklahoma. As a force multiplier, the proposed externship included outreach activities to other nursing students within each of their nursing programs and high school students with an interest in healthcare. The development of an Oklahoma public health nursing workforce with emergency preparedness, response, recovery and community resiliency knowledge and skills is crucial to advancing our state's health and responding to the disasters with which we are frequently faced in Oklahoma. For the students, it was a volunteer learning opportunity. Each extern signed a contract identifying their time and project commitment. The externship was typically over a 10-week period with approximately 8 - hours/week or approximately 100 hours of involvement. Nursing programs had the option to decide upon a different timetable. Nursing programs identified interested students and one or more faculty sponsors who were active MRC volunteers and who were interested in meeting regularly with the students. Students met weekly with faculty sponsors from each of the participating nursing programs (University of Central Oklahoma, Southwestern Oklahoma State University, and the University of Oklahoma). The Unit Coordinator of the OKMRC Nurses Unit coordinated the project, offered topics and provided resources. The externship was for a 10-week period from June 1st through the first week of August. Students joined the OKMRC and completed the required training for volunteers. Students met their time commitment on projects related to the four identified broad goals and strategies, including structured interactions with high school students. The externship culminated in the statewide 2016 Volunteer Workshop with training and exercise opportunities for medical, mental health, and animal response volunteers. Nursing student externs met weekly with nursing faculty to address the following broad goals: Explore the role of public health in emergency preparedness, response, and recovery Explore the role of disaster behavioral health in disaster response and recovery Discuss the National Health Security Strategy and Implementation Plan and describe the document's relevance for nursing Describe potential impacts of volunteering as an OKMRC nursing student on future professional choices and development Nursing programs at University of Central Oklahoma, Southwestern Oklahoma State University, and the University of Oklahoma participated in the student externship and each program had four students. Twelve students and six faculty members participated in the externship. The twelve students completed the Nursing Student Externship with over 1,283 hours of service and study. All of the goals were met through a variety of strategies. OKMRC nursing student extern activities included: staffing a community event First Aid station, teaching personal preparedness to 8th graders & High School Students, participating in inter-professional trainings, such as Psychological First Aid, and all externs participated in planning and implementing the annual Volunteer Training Workshop. One factor for the success of the program was the enthusiasm of the nursing faculty and the nursing students. The students saw the relevance of the training and were eager for the information and the collaborating partners at local health departments, OKMRC leadership and faculty were excited about the opportunity to share knowledge and skills with the students. The OKMRC Nursing Student Externship program is a creative solution to expand and enhance public health education strategies for nursing students and to provide valuable information and experience in public emergency preparedness and response. In addition, over time increased collaboration between the Oklahoma Medical Reserve and Oklahoma nursing programs may result in resulting in expanding community clinical experiences for nursing students and increased leadership and disaster response capacity within the Medical Reserve Corps.
Development of the public health nursing workforce is crucial to advancing our nation's health. Several organizations have identified this public health issue and developed strategies to address the issue. The National Health Security Strategy and Implementation Plan 2015-2018 identifies Strategic Objective 4: Enhance the integration and effectiveness of the public health, healthcare, and emergency management systems. Within this objective are two critical priorities addressed by this project: NHSS Priority 4.4 - Strengthen competency and capability-based health-security-related workforce education. NHSS Priority 4.5 - Expand outreach to increase the numbers of trained workers and volunteers with appropriate qualifications and competencies. The OKMRC nursing student externship addresses both of these priorities: to strengthen the knowledge and skills of nursing students regarding the Health Security Strategy and Implementation Plan and outreach to other nursing students and high school students. Additionally, the American Association of Colleges of Nursing (AACN), Centers for Disease Control and Prevention (CDC), and the U.S. Department of Health and Human Services have identified the need for strengthening academia's connection to public health and tailoring experiences to enhance workforce competency. The AACN has entered into a collaborative agreement with the CDC, Academic Partnerships to Improve Health, to help build capacity in the public health nursing workforce. This OKMRC nursing student externship mirrored strategies identified in AACN/CDC Academic Partnerships to Improve Health, including Increased hands-on experience for students working with communities and public health partners Fostering inter-professional collaboration and learning in health professional education. The need for a competent and capable public health nursing workforce is great in Oklahoma. With a population of less than four million, Oklahoma is often the state with the greatest number of federal disaster declarations per capita and has a wide variety of disasters. Nurses represent the largest group of healthcare professionals in the state and within the OKMRC. Because OKMRC provides crucial support for many during disaster relief, it offers an excellent opportunity for nursing students to develop an understanding of a nurse's role in the community and experience interdisciplinary collaboration. In the United States, a handful of nursing programs work closely with their local Medical Reserve Corps, but I am not aware of any formal nursing student externships within the Medical Reserve Corps network. Creating a partnership between the Oklahoma MRC and nursing programs is a creative solution to expand and enhance public health emergency preparedness and response education, create a pipeline for well-trained nurse employees and volunteers in the MRC, and reach out to high school students of diverse ethnic and social backgrounds to attract them to health professions and public health. This project could introduce an innovative and easily replicated program to communities across the United States.
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This project demonstrated broad-based involvement and participation of community partners. The project established an externship for nursing students with the Oklahoma Medical Reserve Corps in multiple nursing programs across Oklahoma through a Challenge Award with the Oklahoma MRC Nurses Unit housed in the Oklahoma Nurses Association. The Oklahoma MRC Nurses Unit is a state-wide unit for the Oklahoma Medical Reserve Corps and in Oklahoma the Medical Reserve Corps is administered out of the Oklahoma State Department of Health. Nursing programs at University of Central Oklahoma, Southwestern Oklahoma State University, and the University of Oklahoma participated in the student externship and each program had four students The Unit Coordinator of the OKMRC Nurses Unit coordinated the project. One or two faculty members at each nursing program (University of Central Oklahoma, Southwestern Oklahoma State University, and the University of Oklahoma who are OKMRC members supervised the OKMRC Nursing Student Externs. During the spring semester, faculty made nursing students aware of the possibility to participate as externs and investigated existing high school programs with which to interact. Each extern signed a contract identifying their time and project commitment. The externship was for a 10-week period from June 1st through the first week of August with approximately eight hours/week or approximately 100 hours. Once admitted to the Oklahoma Medical Reserve Corps 2016 Nursing Student Summer Externship, students met their time commitment on projects related to the four broad goals and identified strategies, including structured interactions with high school students. The externship culminated in the statewide 2016 Volunteer Workshop with training and exercise opportunities for medical, mental health, and animal response volunteers. Nursing student externs met weekly with nursing faculty who are trained OKMRC volunteers to work toward the following goals: Externship broad goals: Explore the role of public health in emergency preparedness, response, and recovery Explore the role of disaster behavioral health in disaster response and recovery Discuss the National Health Security Strategy and Implementation Plan and describe the document's relevance for nursing Describe potential impacts of volunteering as an OKMRC nursing student on future professional choices and development Strategies to meet goals: Participate in planning and implementation of the 2016 Volunteer Training Workshop, held in August in Oklahoma City Participate in MRC volunteer training as opportunities, including first aid protocols, disaster vaccination, and Psychological First Aid Develop a presentation for students within their nursing program on disaster preparedness, response & recovery to be presented during the school year. Interact with high school students interested in healthcare professions Develop strategies based on their community and interests Teach community members and MRC volunteers personal preparedness and/or disaster response. OKMRC Nursing Student Externship Timeline MARCH-APRIL 2016 Recruit nursing programs to participate in the OKMRC Externship Recruit nursing faculty to participate Recruit Stress Response Team members to participate MAY 2016 Provide Training for nursing faculty Develop evaluation tool to measure changes in knowledge, skills and attitudes toward public health, the health security strategies, and emergency preparedness and response JUNE, JULY, AUG 2016 Summer Externs meet weekly with faculty for the 10-week period from June 1st, 2016 to August 6, 2016. AUGUST 5 & 6 2016 OKMRC 2016 Volunteer Workshop – Externs participate Certificates awarded SEPTEMBER, OCTOBER 2016 Evaluation of program Collection and analysis of evaluation data Extern presentations to nursing students OKMRC nursing student extern activities included: staffing a community event First Aid station, teaching personal preparedness to 8th graders & High School Students, participating in inter-professional trainings, such as Psychological First Aid, and participating in planning and implementing the annual Volunteer Training Workshop. Within the Oklahoma Medical Reserve Corps leadership, there was great support for the nursing student externship. The State Coordinator for the Oklahoma Medical Reserve Corps, housed in the Oklahoma State Department of Health, met with the students and discussed the role of the Medical Reserve Corps in Oklahoma. OKMRC Unit Coordinators with the Oklahoma City/County Health department and the Tulsa Health Department also met with the students and shared the role of their local health departments. A NACCHO Challenge Award of $13,000 met the start-up costs for this project. The funds paid for professional service fees, uniforms for the OKMRC externs, the travel costs for out of town students, training materials and supplies.
The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the Oklahoma Medical Reserve Corps. Through the OKMRC Nursing Student Externship, partnerships were established with the Oklahoma Medical Reserve Corps, the University of Oklahoma College of Nursing, Southwestern Oklahoma State University (SWOSU), and University of Central Oklahoma (UCO). Both SWOSU and UCO allowed a limited number of externship hours to count towards academic community clinical hour requirements. In addition, partnerships developed between the nursing student externs at the University of Oklahoma and Exploring Math and Science Academy at OUHSC and an OU College-based summer program for high school seniors. Nursing programs at University of Central Oklahoma, Southwestern Oklahoma State University, and the University of Oklahoma participated in the student externship and each program had four students. Twelve students and six faculty members participated in the externship. The twelve students completed the Nursing Student Externship with over 1,283 hours of service and study. OKMRC nursing student extern activities included: staffing a community event First Aid station, teaching personal preparedness to 8th graders & High School Students, participating in inter-professional trainings, such as Psychological First Aid, and participating in planning and implementing the annual Volunteer Training Workshop. All of the nursing student externs participated in the annual OKMRC Volunteer Training Workshop held on August 5 & 6th in Oklahoma City. Students assisted with registration, were classroom-training proctors, and conducted video interviews with attendees. On Friday Aug. 5, 122 OKMRC volunteers attended and on Saturday, Aug. 6, 103 volunteers attended. This multi-track 2-day workshop offered animal response, mental health response, medical response and multiple volunteer leadership training opportunities to expand knowledge, skills and volunteer roles. The evaluation of the externship program included tracking participation hours (over 1,283) and student's reflective journal writings. In addition, a tool to measure knowledge, attitudes and beliefs was developed with 11 True/False knowledge questions, 14 attitude questions rated on a 4-point scale, and 6 beliefs statements rated from Strongly Agree to Strongly Disagree. The University of Oklahoma Health Science Center Institutional Review Board determined that the research met the criteria for exemption. Ten students completed the pre-survey and six completed the post-survey. Group comparisons were conducted using the Wilcoxon Signed-Rank Test. While the post-survey scores improved, the results were not statistically significant. Evaluation of the outreach showed OKMRC nursing student externs presented on personal preparedness and/or public health nursing in emergency response to 285 other nursing students or high school students. Qualitative data was collected via short journal entries that the externs were asked to complete mid-externship and at the completion of the externship. The use of reflection/journaling strived to capture the extern's goal of describing potential impacts of volunteering on future professional choices and development. This is a quote from a student's journal: This program showed me the importance of having nurses and medical personnel trained in how to respond. I've learned about the complexities of disaster relief and that preparation and prior training are necessary to help organize large groups of volunteers in the chaos. One of my favorite aspects was that it taught me to look beyond the obvious physical results of a disaster and to see the social, psychological and financial damage. I feel like I now have a more holistic view of how to help those affected by crisis and disaster.”
Because OKMRC provides crucial support for many during disaster relief, it offers an excellent opportunity for nursing students to develop an understanding of a nurse's role in the community and experience interdisciplinary collaboration. The OKMRC has the potential to provide very meaningful community clinical experiences for nursing programs. One means of sustaining the project is through the baccalaureate nursing programs providing school credit and faculty support for the externship. Other potential options for financial sustainability of the project include the high school programs, the MRC Nurses Unit, or the state OKMRC office depending upon funding and grant opportunities available This year's record number of large-scale disasters spotlights the acute need for additional training for healthcare professionals in the area of public health emergency preparedness and response. Nursing students are aware of the need and are excited about the opportunity to learn more. The interest in the OKMRC Nursing Student Externship has continued to grow. In 2017 the OKMRC offered a nursing student externship and twenty-two students participated, up from twelve in 2016. In 2018, we hope to see the number of nursing programs expand from three to five or six. In addition, pharmacy programs are asking about participating.
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