One by One
On one Tuesday in July, 10 Milwaukeeans received a COVID-19 vaccine at their homes.
That’s 10 people who may not have been vaccinated if nurses hadn’t knocked on their doors as part of a grassroots public health initiative to bring vaccines directly to people’s homes. That’s 10 more people who are now protected from getting severely ill with, or dying from, COVID-19.
And it was just one day’s work for a group of Alverno student nurses.
“This is grassroots community health nursing. We’re meeting the community where they’re at,” says Kirsten “Kiki” Lezama ’14, an Alverno nursing alumna and assistant professor of nursing in the JoAnn McGrath School of Nursing and Health Professions (pictured at left). “People have been saying: ‘I never would have been vaccinated if you hadn’t come to my door.’ This is what it’s all about.”
This year, Lezama and other Alverno nursing faculty partnered with the Milwaukee Area Health Education Center (AHEC) to work on a grant-funded project to promote vaccine confidence and provide COVID-19 education on a hyper-local basis. As a result, five sections of Alverno DEMSN courses were deployed this summer into high-need
Milwaukee neighborhoods to provide information about the coronavirus as well as to offer the vaccine.
Throughout the summer, the students learned how to engage residents in conversations that were respectful and productive.
“They started with closed questions: ‘Have you been vaccinated?’ They learned very quickly that people would answer ‘yes’ and shut the door,” Lezama recalls. “So it became: ‘We’re going around to help the community and answer questions about COVID and the vaccine. What questions can we help answer for you?’”
Lezama, who has worked in public health for her entire nursing career and earned a master’s degree in this discipline, says it is essential to be nonjudgmental.
“We want to promote healthy behaviors. ‘Promote’ is a different word than ‘force’ or ‘insist.’ We’re not forcing anybody to do anything. Our job as nurses is to give people the right information so they can make informed decisions about their health. We hope that sharing the most scientifically accurate information in a way that is easily understandable, digestible and relevant, resonates with peoples’ values and moves them to make a decision that will improve their health and the health of their friends and loved ones.”
Focus on the ‘movable middle’
For DEMSN student Porsha Brown (pictured below), one of the most profound lessons she learned this summer is best shared via the words of community health leader Lorraine Lathen.
“There’s such a thing as the ‘movable middle,’” Brown says Lathen taught her and her peers. “Some people aren’t budgable. You can’t get them to change their mind. But there are others who, with the proper education, can adopt a new perspective and see things differently. When I was out there canvassing, I kept that in mind.”
The students also learned how to establish their conversations with residents within a larger context.
“We’re working in historically underserved neighborhoods. We have to understand the mistrust that exists in communities that are vulnerable and have historically experienced poor exchanges with health care and other societal systems,” Lezama says. “I tell the students the biggest takeaway I want you to recognize at the end of the day is: Even if you don’t get somebody vaccinated, you were a positive experience with the system. That means more than you may understand. For you, it may be just another house, but for that person, it might be their first positive encounter that can help shape positive health outcomes for themselves, families and friends for years to come. And that is extremely powerful and profound.”
Brown, who is biracial and has lived in some of the predominantly African American communities that the nursing students visited, brought a strong sense of purpose to this summer’s work.
“If I have the education and the knowledge, there’s nothing more I would want to do than spread that knowledge to people I closely relate to and that my family closely relates to,” she says.
Ultimately, Lezama says, the students are discovering the many facets of what it means to be an Alverno nurse.
“They’re having all these epiphanies,” she says. “Everything that they’re doing is important. Everything they’re doing has meaning. Everything they’re doing is nursing.”
Ready for impact
This fall, undergraduate nursing students continued the community COVID-19 canvassing work. Assistant professor of nursing Kristin Wood and her eight students began by working on Milwaukee’s north side; as the work moved to the city’s south side, the students were able to leverage their fluency in Spanish and English to communicate with the predominantly Hispanic population.
“It was such an advantage to help the students connect with residents. The students have flourished. Their confidence levels have grown. They’re educating people appropriately, they’re registering the residents in the system and hopefully gaining consent and then giving the vaccine on site,” Wood says. “It’s been an honor for me to step back and watch the students take the lead.”
For both Wood and her students, it was their first community-based clinical experience. And it has made a deep impact.
“They are really taking this experience to heart. They’re noticing that nursing isn’t just skills-based, but it’s also how you communicate and connect with patients, clients and the community in general,” Wood says. “The fact that the residents have literally opened their doors to us speaks volumes to how the students have facilitated trust and a therapeutic relationship with the community.”
Student Isabel Colón, class of 2022, took the experience a step further by proposing her family’s restaurant as a site for a mobile vaccination clinic. And so on a chilly Tuesday in November, eight people received their COVID-19 vaccine at La Caribeña Restaurant, where Colón’s mother and sister — the head chefs — regularly prepare such staples of Dominican cuisine as La Bandera, the white rice, red beans, salad and meat a nod to the tri-color Dominican flag.
“I grew up on the south side of Milwaukee, so it really meant a lot to be able to advocate for the health of my community,” Colón says. “I always knew I wanted to give back to our community; I just didn’t know it would be this soon in my nursing career.”
Colón appreciates the opportunity to learn about the ins and outs of public health. And it has inspired a new career goal for her.
“I’ve always been firm on wanting to work in a critical care setting, but I grew a passion for policy making,” she says. “One of my future goals is to advise officials and government agencies on matters that affect the public. I think it’s important to have representatives who are like us and have a true understanding of the issues in our communities.”
Orgullosa de servir
Many of Wood’s nursing students in the community clinical class are bilingual, speaking both English and Spanish. They were proud to leverage these skills to serve the community.
“I believe that speaking someone’s native language helps people feel more comfortable. You can get their trust by listening and answering their questions accordingly.” — Myriam Hernandez, class of 2022
“The south side of Milwaukee is my home; therefore, having the opportunity to canvass and give back to the community was a phenomenal experience. Utilizing my bilingual skills… I truly felt like I made a difference as I could observe each individual’s sense of relief as we were able to comprehend one another.” — Angelica Torres, class of 2022
“I am glad I had the opportunity to partake in such a wonderful clinical experience! It was especially of great honor and joy to be able to communicate with the Hispanic population, especially during such stressful times. I was able to help break the language barrier and aid in keeping the community safe by providing education and addressing unanswered questions regarding the COVID-19 vaccination. I am a proud Puerto Rican!” — Ruby Perla Ortiz, class of 2022
“Being bilingual, this clinical provided the avenue to take my knowledge and experience developed in the classroom and clinical setting to the community and provide education in Spanish. This was so special because even if my Spanish wasn’t the best, I was using my skills to be a community advocate.” — Melissa Rogel, class of 2022
This article will appear in the fall/winter 2021 issue of Alverno Magazine, out soon!