GRADUATE NURSING STUDENTS FIND THE PATH TO COMMUNITY BEGINS WITH BUILDING TRUST
The aroma is fantastic, a heady blend of clove and pepper and cinnamon, punctuated with a hint of vinegar. It’s blessedly cool inside, in contrast to the blasting midday heat that bounces off parking lot asphalt. A burst of contagious laughter welcomes newcomers. The savory/sweet scent evokes a familiar hominess, crumpled napkins and empty plates provide evidence of a recently devoured meal. It smells like community.
Andrea Burger ‘18 beckons to an empty chair. “Don’t mind us! We’re in a food coma,” she calls out. “We eat insane amounts of food.”
This particular feast was courtesy of resident Abtesam Bedam. “I made kabobs, pickles and Iraqi samoon,” she says. Apparently, that heavenly fragrance emanates from the seven-spice blend that goes into the kabob meat, meant to be served tucked inside flatbread along with tomato and a slice of homemade pickle. Delicious.
Gatherings like this have become familiar. Every Friday, a small cadre of USD Master’s Entry Program in Nursing (MEPN) students, led by Clinical Instructor Jodi O’Brien, PhD, RN-BC, NE-BC, make the trip from Alcalá Park to El Cajon and get up close and personal with residents. The project is part of a class — Nursing Practice with Care of Diverse Families in Communities — that aims to “see how folks live and manage their health,” says O’Brien.
It’s part of the program requirement for MEPN students to put in clinical hours that include not just hospital experience, but community work.
“This low- and affordable-income apartment complex is a new site for us,” explains O’Brien. “There’s low turnover here, and many of the residents are refugees and immigrants. Naturally, the families have cultural preferences when it comes to diet.”
Quick to see a need and do the work to fill it, the dearth of options in this neighborhood “food desert” organically led to the idea of establishing a community garden. “There were lots of patio plants around doorways — mint, tomatoes, cilantro — so many that it could have been a fire hazard,” says O’Brien. But making the idea reality hasn’t been without challenges.
“It was quite an endeavor. We had no budget, so we got creative. We wanted to get the residents involved early on. We held a community meeting and asked them, ‘What would you like to see grown? Who does the cooking at your house?’ There was a lot of excitement right from the beginning.”
Linda Sue Beagle, the complex’s community coordinator, says the project has been a huge success.
“A garden is something that’s essential to everybody’s life. It’s a way we can come together.” She adds that the resident children have been a big part of their efforts.
“Three girls filled up a wheelbarrow about 10 times to fill up one of our garden boxes. These are fifth- and sixth-grade girls, using their muscle power for the common good.”
Mariam and Mohammed Ahmadi have become regulars in the garden, which is tucked out of sight around the back of the last building in the complex. A half-dozen large raised boxes — some painted in primary colors — are home to plants in various stages of growth: zucchinis, tomatoes, herbs, carrots, even a few stalks of corn. A pair of sturdy wooden benches beneath shade sails run between the two rows of boxes.
“Mariam and Mohammed come out here almost every evening and enjoy the coolness and the green space,” comments Beagle. “It’s really brought people together; the children, in particular, have been helping with pest control. They even kept caterpillars as pets to see how they change and grow.”
Morgan Colletta ’18 is ebullient when she talks about the how far this community-building project has come. “We did a lot of outreach, knocking on every single door and explaining who we are, what we’re doing, what are goals are.” Colletta has a quick smile and a rapid-fire delivery, eager to share stories of how they got here from there.
“We let parents know that if they had kids who needed help with homework, or if the parents needed to run to the store, they could go ahead and leave the kids with us. We wanted to make our faces known, to let them know that we’re nursing students from USD.”
And it worked. Week by week, residents started to get involved. “At one event, a lot of people came up and talked to us about personal health issues and struggles,” Colletta recalls. “Mohammed came in and we took his blood pressure. And we did a reconciliation of his meds with him, which was really important, because his blood pressure was sky-high, really dangerously high. Now that he’s getting his blood pressure checked here regularly, it’s doing much better.”
The human connection is what drew these students to pursue a career in nursing. “I’ve loved science my whole life, especially human sciences,” says Evan Gum ’18, who had fully intended to become a physician when he started his undergraduate work at UCLA as a psychobiology major.
“But about two years into it — after I’d done some shadowing of doctors and talked to professors who had gone that route — I felt that it wasn’t going to meet the needs of what I wanted to do in health care.”
Articulate and radiating a sense of optimistic thoughtfulness, Gum is one of the 10 percent of males in USD’s MEPN program. “I really enjoyed spending time with nurses at the hospital, and I saw how much time they spend with patients. Honestly, 95 percent of a patient’s time in the hospital is spent with nurses. So I changed my direction and started looking into nursing.”
His natural affinity for putting a human face on health care dovetails nicely with the group’s work to leave a lasting legacy with apartment complex residents.
“Many of them have trouble understanding what advice they’re being given, what advice they should take or seek,” says Gum. “The ones that come to us aren’t so much looking for straight nursing advice, but are seeking the tools they need to get answers. We want to show them things like, ‘This is how you get the advice you need. What did your provider say? Did you talk to them about this?’ A lot of times, it’s that kind of empowerment that people need. ‘This is what you should talk about, and this is what you should feel comfortable being able to say.’ We help them find the right questions to ask.”
Trust is key to getting residents to get to the point where they are not just seeking advice, but following it.
“We spent a lot of time with the kids this summer,” Colletta explains. “In the beginning, they wondered, ‘Who are these people?’ But we started to show up with food, and tailoring things for them, like, ‘We’ll take your blood pressure.’ Monitoring health issues that they might have, and tailoring things for the kids, then people really started coming around.”
Colletta has an authentic openness that makes her instantly likeable. She laughs, amused to find herself again returning to the subject of food. “Two weeks ago, Ruby, one of the girls that we love, her mom made us her special molé sauce. We’ve gotten a taste of all of these different cultures, and the truth is, we all eat insane amounts.”
She’s smiling, but the truth is that shared meals and conviviality have been a crucial part of building trust. “The relationships are slow and steady, but they’ve blossomed over time.”
When Ruby makes her entrance after school, it’s with a carton of candy bars, a fundraiser for an upcoming trip to a local water park. At $1 per bar, the price is right, and in truth, it has been 30 full minutes since lunch. Five minutes later, another $10 has been added to her cache. There’s clear affection for the fifth-grader, the oldest of five kids. She wants to be a doctor when she grows up. Her favorite plants growing in the garden? “Tomatoes, lettuce and carrots,” she says with a shy smile.
“One of the original goals with the garden was not only to create an area for the residents to have an area to come together, but also to talk about healthy eating,” explains Gum. “We want to have them think about long- term ways to maintain their own health, while instilling good habits in their lives.”
O’Brien is in the beginning stages of drafting the research protocol for a participatory action research study. “It’s a qualitative research method to investigate health outcomes of the garden, as identified by the residents living in this community setting,” she explains. She points out that what’s unique about this type of study is that it centers on health interests that matter most to residents, rather than more traditional research, which typically focuses on the investigator’s own research interests.
“It’s my hope that this will grow into a much larger community-focused research study in which subsequent MEPN cohorts may gain a better understanding of these community members,” O’Brien says. “Further, in the summer to follow this cohort’s graduation, a new cohort may see this project through a different lens and offer its own innovative ways to collaborate with the residents.”
As the afternoon begins its slow descent toward twilight, the temperature cools and the group splinters. A few head off to knock on doors to talk to
residents about the evening’s forthcoming event about disaster preparedness. Others head out back to assist in prepping a new garden container for planting. A pair stay behind in the community center to prep the room for the guest speaker, clearing away debris and putting together orange buckets filled with items that might be needed in an emergency.
While everyone is busy with various tasks at hand, all of the students have a poignant sense that the end is in sight regarding their own involvement with the center. Once coursework and other requirements for the 22-month MEPN program wrap up, the students will sit for their licensing exams and scatter to launch their new careers.
“Since we’ll ultimately be leaving here in December, one of our main concerns is, how can we keep this going?” says Briana Krenson. “The key is getting and keeping residents involved, since Dr. O’Brien won’t be bringing another group of students in until next summer.”
“At the end of the day, it’s not about the clinical aspect,” adds Colletta. “It’s about focusing on what matters and what people need in this particular community.”
But first, there is dinner to finish preparing. On the menu is homemade pumpkin soup with crème fraiche and pomegranate, alongside roasted pumpkin seeds and fresh fruit.
And once again, it smells utterly delicious.
Photography by Zachary Barron.