How to Champion Individuals With Disabilities Through Nursing Care

AREA OF FOCUS: disabilities

A single sentence from a 2009 article in the Journal of the American Medical Association made an indelible impression on Suzanne C. Smeltzer, EdD, RN, ANEF, FAAN. “It may have been a throwaway line, but it was profound for me: ‘Disability is a universal experience that will affect every single one of us without exception at some time in our lives,’” she recalls.

Dr. Smeltzer, the Richard and Marianne Kreider Endowed Professor in Nursing for Vulnerable Populations and evaluation coordinator, now dedicates her career to ensuring nurses will be able to care for the 60 million people living with disabilities in the US, as well as those who follow.

Dr. Smeltzer was inducted into Sigma’s 2019 International Nurse Researcher Hall of Fame in recognition of the impact of her research and advocacy for health care access and quality care for people with disabilities.

Toward that end, she was instrumental in the development of the Advancing Care Excellence series on disability (ACE.D). Created in collaboration with Villanova colleagues and the National League for Nursing, it provides vital information for nurses, nursing faculty and students, nationally and internationally, about caring for persons with disabilities. “The materials have been accessed from NLN’s website over 70,000 times in less than a year,” says Dr. Smeltzer.

She also partnered with Elizabeth Blunt, PhD, RN, FNP-BC, the College’s clinical professor and coordinator of Nurse Practitioner Programs, to create an indispensable resource in the form of an informational toolkit for Villanova faculty, as well as nursing programs and faculty across the nation. Available online, it identifies a set of competencies necessary for working with persons with disabilities for both undergraduate students and nurse practitioners.

Such standardized competencies had not been established prior to this effort. Funded by a grant from the Health Resources and Services Administration, Dr. Smeltzer and Dr. Blunt worked with national experts and people with disabilities to put this toolkit together. Concise and precise, the toolkit offers curricular content that nursing faculty can integrate into existing curriculum and provides a detailed practice guide for NPs and RNs serving patients with disabilities.

In the course of her research, Dr. Smeltzer interviewed health care providers for pregnant women with disabilities. "I asked, ’Did you have any training to care for people with disabilities anywhere in your education?" she recalls. "Not a single person said ’yes.’" For Dr. Smeltzer, this experience further validated the need for the kind of resource they were creating.

That won’t be the case for Villanova Nursing graduates. Dr. Smeltzer and colleagues are seamlessly weaving education about people with disabilities into existing coursework. “We recruit people with disabilities and train them to be standardized patients in our simulation lab,” she says. “Students come into the lab for the usual simulation, but they have patients with real disabilities.” Students have reported that the experience was incredibly valuable.

Villanovans Team Up With Pantry Clients to Teach and Learn

AREA OF FOCUS: nutrition

Food is a vital part of every culture, building community and solidifying identity. Nursing faculty, staff and students are helping women who frequent a local food pantry to capitalize on that natural connection, and they mentor others in making nutritious choices for themselves and their families.

The Community Cooks program, launched by the Fitzpatrick College of Nursing’s MacDonald Center for Obesity Prevention and Education, engaged 10 clients at Martha’s Choice Marketplace, a food choice market at a Catholic Social Services location in Norristown, Pa. The women learned the basics of nutrition and cooking during six months of classes and workshops, with the goal of becoming peer mentors to other food market clients.

“The underlying premise of our project was that individuals who face food insecurity would be more receptive to learning from community peers who share similar cultural beliefs and experiential knowledge, and who are going through similar budgetary and healthy food access struggles,” says COPE Director Rebecca Shenkman, MPH, RDN, LDN.

When developing the program, Shenkman and her colleagues found little research had been done in this area. They designed Community Cooks as an innovative nutrition education pilot program to address this gap in the research and the need in the community.

The Villanova team led discussions on such topics as protein in healthy eating, vegetables’ role in a diet, the benefits of fruit, and more. “Then the peer mentors presented demonstrations on whatever food category we discussed. We guided them, but they led the classes,” Shenkman says.

The workshops have been well-received, and now are being integrated into CSS parenting classes. They have expanded a years-long partnership between CSS and Villanova Nursing students, who have collaborated with the agency on health fairs, education and parenting groups.

Given increasing rates of food insecurity in American communities, the sustainable evidence-based Community Cooks program demonstrates that nutrition education delivered by peer mentors can reach individuals with simple healthy-eating messages and skills for cooking on a budget otherwise unavailable to them.

“This educational program provides relevant and empowering information to patrons—and to the peer mentors themselves—empowering them to take charge of their health and food choices in ways that are realistic, culturally relevant and mindful of food choices and budget,” says Shenkman. “The peer mentor model may be a key component to engage harder-to-reach community members.”

The next phase of the Community Cooks project aims at making an even greater impact by accessing the food pantry itself and improving the quality of foods offered. “Peer mentors will encourage and nudge clients to select healthier choices as they walk through the pantry,” Shenkman explains.

An Opportunity to Learn and Serve at the Monastery

AREA OF FOCUS: geriatrics

Frail older adults are among the most vulnerable populations for poor health outcomes. They have unique needs that are critical to their ability to continue living healthy and independent lives.

“But ask sophomore Nursing students, ‘Where do you expect to end up in nursing?’ and few, if any, will say, ‘Working with older adults,’” says Melissa O’Connor, PhD, MBA, RN, FGSA, associate professor of Nursing, who started Villanova’s Gerontology Interest Group, in early 2019. “We wanted to expose students to the idea of working with and for older adults.”

Traditionally, in their sophomore year, Nursing students gain hands-on practice through four days of in-hospital clinical exposure. But now, through a pilot program launched by GiG, sophomores have a fifth day devoted specifically to older adults.

In the program’s first iteration, senior Augustinian friars living in the St. Thomas of Villanova Monastery on campus were beneficiaries of that targeted nursing care.

It was during a discussion about health care at the monastery with the Very Rev. Michael DiGregorio, OSA, Prior Provincial of the Augustinian Province of St. Thomas of Villanova, that it occurred to Dr. O’Connor that Nursing students might be a perfect fit.

“The monastery has different levels of care; we were on a skilled nursing unit where nursing and ancillary staff support health care needs for the oldest friars in their 80s and 90s,” says Christine Pariseault ’95 FCN, ’19 PhD, RN, CEN, clinical instructor for the program. Students provided full care—including personal safety plans to cut risk of falls—to friars living in that unit.

The program will be expanding to include all sophomores going into other senior resident programs in the area. “I’ve had four students say, ‘I think I want to go into geriatric nursing,’” says Dr. Pariseault. One student wrote of her experience: “This opened my eyes to older adults. They have so much wisdom to share. I enjoyed learning about each person, their lives, who they are, and what they’ve done.”

Nursing Students Focus on Improving Global Health

AREA OF FOCUS: global health, HIV, pediatrics, medication

In an ever-more-connected world, global health is paramount. As people find their way around the globe, so do superbugs, infectious diseases and the imperative to stop them. The Fitzpatrick College of Nursing has grown its educational options for its students to explore the ripple effect of health issues around the globe, and to consider the diverse needs of the populations they will care for throughout their careers.

Since 1996, various Villanova Nursing courses have allowed students to apply theoretical nursing knowledge in other countries, including the Dominican Republic, Peru, Ghana and South Africa. Elective courses also educate students about health systems in selected countries—Poland, Ireland, Japan and China, among others—within the context of their culture, politics and history, and then send students to that country to see the system in action.

Travel to developing countries can be challenging, especially when amenities like drinkable water are scarce. “But sacrificing modern amenities places us in solidarity with those we hope to serve,” says Ruth McDermott-Levy ’96 MSN, ’08 PhD, MPH, RN, FAAN, director of the College’s Center for Global and Public Health.

In South Africa, Villanova Nursing students are working at an orphanage for children who are HIV-positive and at a school for children with disabilities. Jennifer Yost, PhD, RN, FAAN, has collaborated with the orphanage staff to develop health assessment tools that she and her students use to meet the needs of the agency.

Additionally, students have begun making assessments at host sites to determine what is needed and how to meet those needs. In the Dominican Republic, for example, over-the-counter medications were needed, but international laws prohibited students from bringing them there. Instead, students of Sherry Burrell ’15 PhD, MSN, RN, CNE, ACNS-BC, started fundraising to purchase medications in the host country.

“That resulted in three things: respecting international laws, using Dominican formulary with instructions in the native language, and infusing money into the local economy. This is how students learn best practices for global health,” says Dr. McDermott-Levy.