Nebraska Methodist College (NMC) and Catholic Charities of the Archdiocese of Omaha, Inc. (CC) formed a faith-based service-learning partnership in 1999. The partnership provides collaborative, community-based education for nursing students enrolled in associate, baccalaureate, and graduate degree programs. Currently in its fourth year, the partnership has focused its attention on social justice and issues identified in Healthy People 2010 (U.S. Department of Health and Human Services, 2000). The partnership is known as DARING to Reach the Heartland (i.e., diversity, advocacy, respect, innovation, nursing education, growth).
Community faith-based service-learning is a strategy by which students learn and develop through participation in thoughtfully organized and supervised professional activities. As a pedagogy, service-learning is incorporated into academic coursework and allows students to address community-identified needs, as well as understand and appreciate the public purposes of the nursing profession (Seifer, 1998).
The goals of this partnership were developed and implemented after intense training with the Partners in Caring and Community: Service-Learning in Nursing Education program. The partners developed the following goals (Herman, Wallace, Sassatelli, & Tutor, 2000):
* To enhance students' critical thinking and leadership capabilities.
* To create change in health care delivery and education systems whereby knowledge, technology, and compassion are integrated, brought to, and shared with consumers in the community.
* To serve as the impetus to effect wide-reaching growth toward a community that serves its own members.
* Develop an expanded view of students as citizens of a larger, global community.
Connors, Seifer, Sebastian, CoraBramble, and Hart (1996) referred to the changing health care arena as a basis for service-learning. Oakley (1999) identified fundamental assumptions of the American Association of Colleges of Nursing, Pew Health Professions Commission, and National League for Nursing recommendations, which include community-based health care is here; community-based health care is necessary, and communitybased health care is just.
Nebraska Methodist College and Catholic Charities of the Archdiocese of Omaha, Inc., view community-based education as responding to needs identified by the community. Community-based education joins participants from NMC, community members, and health care partners. The learning process enables students to provide nursing care to people wherever they may be. Bellack (1998) addressed the rationale for community-based nursing practice and described experiences that allow for risk and innovation, which help develop broad professional competencies.
Critical to the long-term success of this collaboration has been a solid foundation for the partnership. Principles developed by the Community-Campus Partnerships for Health (1998) provided the framework on which to build the collaboration. The first of these principles is the development of mutual mission, vision, and goals. Currently, the common mission of DARING to Reach the Heartland is to build just and compassionate communities. Cruz and Giles (2000) encouraged examination of the partnership's and community's assets, which can be developed and implemented further. In this vein, NMC and CC actively engaged in communitybased service, which supports and helps clients with the long-term goal of empowerment and self-sufficiency.
The mission of NMC, a health professions educational institution, is to provide education for the development of individuals so they may positively influence the health and well-being of the community. Commitment to education has been a long-standing tradition of this institution. Nursing education began in 1891, and the institution evolved into the Methodist School of Nursing. It remained the School of Nursing until 1985, when it received its charter from the Nebraska Commission for Posteecondary Education as a degreegranting institution of higher education. Nebraska Methodist College offers programe of study at the certificate, associate, baccalaureate, and graduate levels. The core values of caring, excellence, learning, holism, and respect actively reflect the mission and vision of NMC.
Catholic Charities is a multifaceted organization providing a wide range of services to more than 65,000 people each year at nine program sites. It is a Catholic-sponsored agency but serves all people in need regardless of religion, race, age, or income. Areas of service include addiction, counseling and mental health treatment, domestic violence, adoption, and community services (e.g., food pantries, support groups, mentoring, social justice/advocacy forums). Reaching out to people who are poor and underserved, helping individuals and families achieve self-sufficiency, and acting as a voice for social justice are at the core of CCs mission.
Together, NMC and CC have more than 175 years of history and expertise in serving Omaha, as well as urban and rural communities in the northern and southern plain states. Through their complementary missions of "building just and compassionate communities" and "positively influencing communities," these two institutions are committed to serving, educating, and enhancing the lives of people in the community. Nursing education, health prevention, community education, and an array of direct services are critical components of both partners' purposes. Both partners focus on the needs of individuals and families who are less fortunate and less able to access such community resources. This partnership brings the heart of education and service to a real-life, community, and civic level.
After a common mission, vision and goals were agreed on, a model and focus for the community-based service-learning partnership was designed. DARING to Reach the Heartland is grounded in the principles of social justice and its interrelationship with nursing education, trends, the goals of Healthy People 2010 (U.S. Department of Health and Human Services, 2000), and leadership development.
Faith-based community service-learning offers an opportunity to affect and shape the lives and experiences of future community members. Seifer (1998) supported this when she reported on servicelearning as a means by which students come to understand their social responsibility and the public purposes of their chosen professions. A basic premise of servicelearning is to learn while and through serving. Through serving the community, students can embrace a broader perspective than that afforded them by direct patient contact in a hospital setting.
To build just and compassionate communities, we, as members of the community, are called to join with individuals who are poor, needy, and often on the fringes of the community. We must listen to them, hear what they say they need, and through service, advocacy, and support, help them meet those needs. This process is about social justice and self-sufficiency and can be achieved through service-learning.
A community "in need" includes people who are in need and may be oppressed by a combination of poverty, powerlessness, and exclusion from the community. These people are vulnerable, lack power, and often are alone with no protectors or advocates (Kammer 1991). Using Rammer's (1991) philosophy, several CC programs that serve these individuals were identified. These programs included an emergency shelter for battered women and their children, an addiction recovery treatment center for poor and indigent individuals, community service sites and food pantries, and an inner-city school counseling service.
Initially the focus was on the nursing students' ability to apply theoretical knowledge while providing agreed-on services for poor and needy individuals. As the program evolved, it has embraced the challenge Brackley (1988) articulated when he wrote, "...what is most fundamental is the courage not to turn away from the eyes of the poor, but to allow them to break our hearts and shatter our world" (p. 38). In support of this view, Dorr (1993) stressed the importance of not only feeling for poor individuals but discovering what it means to be with them. This companionship encourages understanding of what it means to be humanly weak and powerless.
Currently, DARING to Reach the Heartland is committed to communitybased, experiential opportunities, in which etudents may have eye-opening and life-changing experiences. Faculty, students, and staff of both institutions are challenged to stand with the poor and needy individuals in the community. According to Kammer (1991):
[Sltanding with the poor carries a sense of an active stance, a definite choice, and a decision to croes over the lines drawn between most of us and the marginalized pushed to society's periphery (p. 144).
Combining the experiential process with the theoretical components has been significant. Service-learning at NMC is a course-based, credit-bearing educational experience in which students participate in an organized service activity to gain further understanding of course content, a broader appreciation of the discipline, and an enhanced sense of civic responsibility. Further integration of the project's purposes into the existing nursing curriculum at NMC is facilitated through the expansion of service-learning experiences to the second and fourth levels of the curriculum.
Reflection is a required, critical component of the pedagogy. Through guided and shared reflection, the team, which consists of students, faculty, and program directors, realizes the effect of increased critical thinking and expanded aense of self and community. Such deep personal awareness frequently is identified as the "aha experience" and may significantly shape a team member's value system.
DARING to Reach the Heartland will continue to use a team approach for student supervision in the form of a facultyagency dyad implemented in each program site. Faculty provide direct clinical supervision, while program personnel oversee the specific service-learning project/experience. In thi6 way, students benefit from contextual role modeling, onsite mentoring, and a direct connection to the community. In addition, many NMC and CC staff facilitate ongoing focused reflection to guarantee diverse perspectives.
Implications: Social Justice
Throughout the United States, nursing schools are acknowledging the changing environment of health care and the movement toward community-based nursing. This movement demands a new level of knowledge about the community. As nurses transition from the medically built environment to the neighborhoods of the communities, they face challenges. Nurse are no longer in the somewhat sterile and sheltered setting of the hospital. Hurst and Osban (2000) indicated that teaching students in hospitals and then sending them into patients' homes with discharge instructions is not enough. Instead, nurses support illness prevention, health promotion, and lifestyle modification. Nurses recognize that homelessness, violence, poverty, and discrimination have a direct influence on the health status of individuals and families.
According to Hageborn (1997), social justice is:
a nursing practice competency characterized by awareness of multifactorial dimensions influencing the health of individuals, communities and societies and commitment to accessible, and socioculturally acceptable quality health care for all (Social Justice and Responsibility section).
Such awareness is essential to achieve long-term positive outcomes for clients.
The NMC-CC partnership brings together students, educators, community service workers, and the most vulnerable citizens within the community. This joining of such diverse individuals has created a new level of awareness, trust, and respect. All involved in this collaboration have been both learners and teachers.
It is important to ensure that nursing leaders have the ability to positively affect the community as a whole. Service-learning is a beginning for the development of this ability. Bringing nursing students into their community to see, feel, and touch individuals who may be forgotten. as well as their needs, develops and strengthens students' ability and desire to address health in a holistic manner, thereby linking health care and civic responsibility.
Mockelstrom (personal communication, June 5, 2000) stated:
To touch the hearts and spirita of our students and staff, we believe that lived experiences are primary and essential. We must each challenge ourselves to seek opportunities to serve those in need if we are to truly build communities. Teaching the leaders of tomorrow is an honor which is filled with great responsibilities-to assure that we provide the best possible learning experiences and modalities to enrich body, mind, spirit and stimulate thought and action.
The nursing profession is in an extraordinary position. It can significantly affect the health and hope of the community. Faith-based community service-learning is only a starting point, yet without a beginning, even the most basic needs of our fellow citizens will not be met. It is the desire of all involved in DARING to Reach the Heartland to help the civic community, academic community, faith-based community, and students view health and health care differently and apply their knowledge and gifts in new ways. This vision and application, which are the heart of servicelearning, are the building blocks for compassion, justice, and healing.
- Bellack, J.P. (1998). Community-based nursing practice: Necessary but not sufficient. Journal of Nursing Education, 37, 99-100.
- Brackley, D.S.J. (1988). Downward mobility: Social implications of St. Ignatius's two standards in studies in spirituality of Jesuits. Studies in Spirituality of Jesuits, 2CKl), 38.
- Community-Campus Partnerships for Health. (1998). What makes partnerships successful? Retrieved January 5, 2001 from http://futurehealth.ucsf.edu/pdf_files/ partnerships.pdf.
- Connors, K., Seifer, S., Sebastian, J., CoraBramble, D., & Hart, R. (1996). Interdisciplinary collaboration in servicelearning: Lessons from the health professions. Michigan Journal of Community Service-Learning, FaIl(S), 113-127.
- Cruz, N.I., & Giles, D.E. (2000). Where's the community in service learning research? [Special issue]. Michigan Journal of Community Service Learning, 28-33.
- Dorr, D (1993). Option for the poor: A hundred years of Vatican social teaching. Maryknoll, NY: Orbis Books.
- Hageborn, S. (1997). What is social justice? In Service learning and social justice: A capstone experience. Retrieved March 22, 2001 from University of Colorado Health Sciences Center School of Nursing Web site: http://freenet.uchsc.edu/capstone
- Herman, C, Wallace, C, Sassatelli, J., & Tutor, M. (2000). DARING to reach the heartland: A service-learning approach for psychiatric/mental health nursing. Academic Exchange, Spring, 64-68.
- Hurst, CR, & Osban, L.B. (2000). Service learning on wheels: The Nightingale mobile clinic. Nursing and Health Care Perspectives, 21, 184-187.
- Kammer, F.S.J. (1991). Doing faith justice. Mahwah, NJ: Paulist Press.
- Oakley, L.D. (1999. June). Why community-based education? Implementing community-based education in the undergraduate nursing curriculum. Paper presented at the American Association of Colleges of Nursing/Fuld Community-Based Workshop, Orlando, FL.
- Seifer, S. (1998). Serrice-learning: Community - campus partnerships for health professional education. Academic Medicine, 73, 273-277.
- U.S. Department of Health and Human Services. (2000). Healthy people 2010: What is healthy people? Retrieved March 4. 2001 from http://www.health.gov/healthypeople/ About/whatis.htm