Volunteer nurses are making an impact in the community, here and abroad, through a wide range of initiatives—from supporting a school-based community clinic to delivering mobile mental health services in underserved areas to providing essential health care to remote populations in Belize, Kenya, and other places.
“We are filling a void of caring for people in the community,” said Nan Gaylord, professor and associate dean of practice and global affairs, who retired at the end of the spring semester after 38 years in the College of Nursing. During her time at the university, Gaylord said she witnessed an evolution in the way the college—and, in particular, student nurses—impact the Knoxville area and remote areas around the globe.
Dean Victoria Niederhauser agrees: “We’ve really expanded our outreach in the local community and globally over the last 10 years.
“In addition to experiencing caring for people of different communities and cultures, these experiences provide the opportunity for student nurses to see firsthand the impact of where someone lives, works, and plays on health outcomes,” she said.
“The College of Nursing produces compassionate nurses who provide exceptional care across the globe. But we do more than produce great nurses. We really help communities get healthy and stay healthy.”
Impact: Hands-on Care
The UP & UP Project, which began last year with a grant from the Health Resources and Services Administration of the US Department of Health and Human Services, provides free mental health services in rural areas via a mobile clinic. Faculty member Stacey Nelson, a psychiatric nurse practitioner, oversees the care with DNP students working alongside her.
The UP & UP van travels to five Tennessee counties: Sevier County on Mondays, Hamblen County on Tuesdays, McMinn County on Wednesdays, Morgan County on Thursdays, and Monroe County on Fridays. Patients can make appointments or walk in; no referrals are needed. After a diagnostic evaluation that includes an in-person health check, patients are prescribed medicines, if necessary, and get referrals for therapy, which they can attend via Zoom from their home or the van.
Project Manager David Jackson said the UP & UP Project has served about 100 patients ranging in age from eight to 72 for a wide range of psychiatric conditions, including bipolar disorder, depression, schizophrenia, and substance abuse. The project provides mental health care to people who might not otherwise have access to care, either because they’re uninsured or underinsured or because they can’t travel to appointments.
Jackson said patient surveys ask “Where would you have gone if this wasn’t available?”
“A lot of the patients say, ‘Nowhere,’” he said. “We’re helping a community that is in desperate need of mental health care by bringing the service to them.”
One of the longest-running community health outreach services provided by the college, the Vine School Health Center, provides holistic care to people from birth to age 21.
When it started nearly 30 years ago, the clinic providers were seeing about 1,200 patient visits a year; that number has grown to more than 7,000 a year.
Families in Knox County have access to pediatric health care and mental health services at the center or through telehealth services. Thanks to a partnership with Second Harvest, children and families also can receive much-needed food support, said Gaylord, who helped start the clinic in 1995.
The clinic is staffed by college faculty, two registered nurses, two licensed clinical social workers, and two office workers. Several nursing students are hired to work alongside the nursing staff and others rotate through, assisting with daily activities.
Here in Tennessee, the college is leading a project to identify the barriers preventing people from receiving routine immunizations.
With a $5.5 million grant from the Tennessee Department of Health, the college launched the Community Registered Nurse Navigator Project in January 2022. The initiative has deployed 16 registered nurses across the state to develop county-specific strategies aimed at improving and sustaining routine immunization rates.
Volunteer nurses impact an even wider swath of the community through academic service-learning.
Juniors and seniors are required to log at least 30 hours of volunteer work each semester at a community agency, which they arrange through UT’s Jones Center for Leadership and Service.
While students approach the work through the lens of a nurse, they’re encouraged to choose agencies that aren’t health related. The experiences are meant to help them hone their communication and interpersonal skills while providing much-needed staffing for local agencies.
“Through academic service-learning they’re learning how to interact and engage with the community at large,” said Virginia Fowler, the college’s academic affairs manager.
Student nurses touch a specific community—grieving parents—through the Precious Prints Project, a service project of the Student Nurses Association that provides families grieving the loss of a child with a pendant bearing the fingerprint of their child.
The Precious Prints Project began in 2012 and has grown to include 10 partner hospitals (East Tennessee Children’s Hospital, UT Medical Center, Fort Sanders Regional Medical Center, Parkwest Medical Center, and Tennova-North Knoxville Medical Center in Knoxville; Methodist Medical Center in Oak Ridge, Tennessee; LeConte Medical Center in Sevierville, Tennessee; Morristown-Hamblen Hospital in Morristown, Tennessee; Cumberland Medical Center in Crossville, Tennessee; and Blount Memorial Hospital in Maryville, Tennessee) and two university partners (Union University and the University of Las Vegas School of Nursing). The program has given away more than 2,400 pendants since 2012.
Lynne Miller, director of the Precious Prints Project, said the program is incredibly meaningful.
“By providing a tangible remembrance of the life of a child, the Precious Prints Project enables students to make a difference for families experiencing unthinkable loss,” she said. “Recipients have shared with us that it is one of the most precious gifts they could have ever received.”
Impact: Research
“UT is an R1 (very high research) institution,” Niederhauser said. “Our mission is not only educating, but also discovery and innovation.”
Research carried out in the College of Nursing seeks to improve health and health care for people of all ages across a wide spectrum of issues.
For example, Associate Professor Joel Anderson is currently co-leading two studies funded by the National Institute on Aging.
“We are working with national and community advisory boards and community partners across the US to engage with LGBTQIA+ people living with memory loss and LGBTQIA+ caregivers to understand their experiences and needs and to ensure they are included in aging-related research,” he said.
In another project, Niederhauser is part of a collaborative team that includes faculty from UT’s Tickle College of Engineering and College of Architecture and Design in addition to the College of Nursing. The team is developing SmartSHOTS, a mobile application to help reduce barriers to immunizations for children in their first 18 months of life. The work is being funded by a $1.3 million grant from the Tennessee Department of Health.
“Through the app, parents and caregivers can log their child’s immunizations, locate a provider, get directions, and also access immunization information,” said Penny Taylor, SmartSHOTS project manager.
Two other research projects led by Assistant Research Professor Andrew Ward involve using geographic information system data to improve cancer patient outcomes in the region.
The first project looks at 10 years (2010–2020) of pancreatic cancer data from UTMC.
“I can demonstrate that individuals with pancreatic cancer treated at UTMC have better outcomes in their disease compared to both state and national pancreatic cancer outcomes. These results are independent of other medical comorbidities, health insurance status, and socioeconomic status,” he said. “These results further underscore the value of an academic medical center for the community it provides care for.”
More recently, he began a project studying the Merkel cell carcinoma in south central Appalachia. He’s collaborating with Matthew Harris, Boyd Distinguished Professor of Health Economics in UT’s Haslam College of Business.
“We see a larger volume than expected at UT Medical Center, and my hypothesis for why this might be revolves around specific economic factors of East Tennessee,” said Ward.
Students in the Doctor of Nursing Practice program impact the community through their scholarly work.
During the first half of their three-year program, DNP students complete an evidence-based practice project. They identify an issue in a clinical setting, study literature related to the problem, and then propose and test sustainable interventions.
Assistant Dean of Graduate Programs Allyson Neal said one student working in pediatric intensive care wanted to help relieve patients’ skin irritation related to long-term use of medical devices such as breathing tubes and feeding tubes. His project resulted in patients being referred to wound care sooner.
Another student working in a hospital provided evidence that a specific heart procedure could be done as same-day surgery. Eliminating patients’ overnight stays not only saved costs but also lessened the risk of hospital-borne infection.
Impact: Simulated Learning
The college is a known leader in simulated learning, and nursing faculty have been teaching other colleges and health providers to effectively use manikins and other tools to teach lifesaving care.
“A lot of people buy equipment and renovate space, but they need to know what to do with it,” said Susan Hébert, assistant dean of simulation and a collaborator in the Health Innovation Technology in Simulation (HITS) lab. “Unless you know how to do it right, you can do a lot of harm with simulation.”
While colleges use simulated learning on a wide range of topics, hospitals and clinics often use simulation to teach new or improved techniques to better patient outcomes.
Hébert and her team have worked with East Tennessee Children’s Hospital, Roane State University, Tennessee Wesleyan University, and Walters State Community College. They’ve also provided asynchronous learning modules and conducted in-person training with nurses and students during trips to Kenya.
Impact: International Service Trips
For the past 17 years, undergraduate and graduate nursing students have had the opportunity to expand their personal and professional horizons through international service trips offered by the college. For the past six years, students have participated in a spring break trip to Belize.
Clinical Professor Karen Lasater helped establish the Belize trip, which enables nursing students to provide much-needed care at clinics in rural villages.
Collaborating with faculty and local health care workers, students conduct medical histories, physical exams, and basic tests including blood pressure screenings, urinalyses, pregnancy tests, and diabetes screenings. They distribute vitamins, prescribe medications like antibiotics, and refer patients for follow-up care.
Lasater recalls one patient who was crippled with arthritis and nearly blind. For him, navigating a trip to the larger city of St. Ignacio would have been difficult, if not impossible.
“Having these groups of students come through and provide primary care in the local communities is just huge,” she said.
Graduate students on the trip sometimes conduct evidence-based practice projects, such as mass screenings for diabetes, for their DNP scholarly projects.
During recent trips to Nyeri, Kenya, UT nursing students joined students and faculty from WAKA Medical Training Institute in for Helping Babies Breathe, a simulation training developed by the American Academy of Pediatrics.
“Historically in developing nations when babies would come out of the womb not breathing, they would mistakenly think the baby had expired,” Hébert said. “But often the babies just need a little help in the beginning.”
The training employed newborn-sized manikins to assist caregivers in learning to resuscitate babies using manual resuscitator Ambu bags and suction.
Hébert said 200 Kenyan nurses and midwives were trained during three visits.
In addition to annual trips to Belize and Kenya, College of Nursing students have also taken service trips to Peru, Panama, the Dominican Republic, and Costa Rica.
“Our number of students has grown tremendously, so we have increased the number of trips we take with students,” Niederhauser said.
While the trips allow faculty and students to impact international communities, participants also come home with a deeper understanding of the role nurses play in community health. Students gain insight into diverse cultures, refine their communication and interpersonal skills, and exercise resourcefulness through their experiences.
The ideal situation, she said, is to develop ongoing relationships with international health care providers as they have in Belize and Kenya.
“It’s a give-and-take relationship,” Niederhauser said. “We need to build the international partnership by returning year after year so that hopefully we can begin to help improve health and health care in underserved countries.”
Impact: Partnerships Help Boost Workforce
Strong partnerships with local clinics, hospitals, and other health care institutions are critical for student education. They also help ensure that those institutions maintain a healthy number of nurses on staff.
Last year, UT and UT Medical Center partnered to create the BSN/ABSN Scholars Programs, which provide new pathways for non-nursing students to complete a degree in nursing. Students receive scholarships in return for a commitment to practice at UT Medical Center for three years following graduation.
The BSN Scholars Program is a four-semester program for college juniors who have fulfilled required prerequisites and want to complete a degree in nursing. The Accelerated BSN Scholars Program is a 15-month program for students who have earned a bachelor’s degree in a field other than nursing and want to become a registered nurse.
Niederhauser said the programs, which will graduate their first classes in the fall, will allow the college to graduate an additional 102 nurses each year. They have also given the college more slots for transfer students.
For UTMC, the program means “a strong, steady pipeline of top-tier BSN prepared nurses,” said Sandy Leake, senior vice president and chief nursing officer at UTMC. “The BSN Scholars are a critical component of our innovative plan to meet the growing demand for nurses in East Tennessee.
“Nurses make up approximately one-third of all hospital employees, and COVID-19 created unprecedented disruption in the nursing workforce. UTMC fared better than most, but the hospital nursing shortage is very real and, if unaddressed, has the potential to impact both quality and access to care.
“At UTMC, we are determined to prevent that from happening,” Leake said. “Our partnerships with the UT College of Nursing, including the BSN and ABSN Scholars Programs, will mitigate this shortage by producing significantly more high-caliber BSN graduates to meet the needs of our community and region.”
Looking to the Future
While the number of Volunteer nurses is increasing, community needs are also rising and changing.
“As we continue to grow, our footprint will expand,” Niederhauser said. “And our growing number of students will be able to reach more people.”
Those students are growing their impact in significant ways:
By serving as a student workforce and filling voids in the health care community.
By providing health care and social interaction to those who might not otherwise have access to them.
By traveling to remote areas around the globe to work alongside local health care providers.
By sharing their research and expertise to improve patient care.
By emerging as the next generation of nurses.
Gaylord said the impact of the College of Nursing and its students has been—and will continue to be—both significant and appreciated.
“Every place our Volunteer nurses touch is better from the care they deliver, whether that’s direct clinical care or just connecting with people in conversation,” she said. “Everyone is better.”
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CONTACT:
Kara Clark (865-974-9498, [email protected])
