The Oklahoma State Department of Health has oversight on the Oklahoma Medical Reserve Corps (OKMRC) Nurses Unit . The OKMRC Nurses Unit is a statewide unit serving the state of Oklahoma. The public health issue two-fold. Oklahoma is the state with the greatest number of federal disaster declarations per capita with a wide variety of disasters. One issue is to developi a healthcare workforce with the knowledge and skills to respond to disasters and work well with other emergency response professionals. The second public health issue is public education of personal/family preparedness. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the OKMRC. The 2017 Nursing Student Externship focused on strengthening the knowledge and skills of nursing students in emergency preparedness, response, recovery, and community resiliency. In addition, the curriculum emphasized developing, maintaining, and leading a multidisciplinary disaster task force team. In Oklahoma, MRC Stress Response Team (mental health) members and nurses are often deployed as a healthcare/ mental health care team. This leadership training will prepare students to function as both members and leaders in a deployable unit.
The second focus of the externship was outreach to other nursing students and local high school students in order to increase high school student's personal/family preparedness and awareness level about public health nursing. This interaction will enhance relationships between nursing programs and high school programs.
The objectives for the project were met. Five faculty and twenty-one nursing students from three Oklahoma nursing programs along with the OKMRC Stress Response Unit leaders met weekly for a ten week period over the summer. The summer externship culminated with the annual Oklahoma Medical Reserve Corps Volunteer Workshop, a two-day training event. The total volunteer training hours for the project came to 1,324 hours. The Nursing Student Externs presented on personal preparedness for over 165 middle and high school students. The OKMRC Nurses Unit was honored with the MRC Youth Engagement Award as a result of the engagement of nursing student externs and the outreach to college and high school students.
Developing a healthcare workforce with the knowledge and skills to respond to disasters is a national goal and a goal for Oklahoma. As a state with approximately 3.5 million people, Oklahoma is the state with the greatest number of federal disaster declarations per capita with a wide variety of disasters. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the Oklahoma Medical Reserve Corps. In addition to increasing the number of healthcare workers, there must be those with knowledge and experiences to develop into leaders. The challenge is to find resources and clinical experiences for students to develop the knowledge and skills to become leaders in the field of emergency preparedness and response. Oklahoma is in a unique position to provide a model for public health emergency and response nursing education.
In the United States, there are a handful of nursing programs that work closely with their local Medical Reserve Corps, but the Oklahoma Medical Reserve Corps has the only nursing student externships within the Medical Reserve Corps network. Creating a partnership between the Oklahoma MRC nursing and OKMRC mental health teams, baccalaureate nursing programs, and high school programs is a creative solution to expand and enhance public health and mental health experiences for nursing students in order to develop a trained workforce. The externship also provides nursing students eager to share personal/family preparedness to middle and high school students. The externship provides an opportunity for multi-disciplinary team building and team leadership skills growth. The nursing student externship creates a pipeline for well-prepared volunteer or employed leaders within the MRC or local health departments. In addition, the externship reaches out to high school students of diverse ethnic and social backgrounds to attract them to health professions and public health. MRC nursing student externships is an innovative program that could be easily replicated to communities across the United States. The acceptance of two poster presentations and a written article shows the national interest in this project. The externship addresses several of the National Health Security Strategy priorities, including NHSS Priority 4.4, Priority 4.5, & Priority 4.6.
We developed a Leadership training for the nursing students. However from my perspective, the most interesting resource we developed was the training on Leadership: Building effective teams & leaders. This training was targeted to an interprofessional group of medical and mental health volunteers and the goal was to practice multidisciplinary team development and leadership in simulations involving rapid medical and mental health assessment of survivors in the immediate aftermath of a disaster. The training took place during the annual Volunteer Workshop in a hands on shelter scenario with volunteers playing the roles of shelter residents. The evaluations and feedback from experienced professionals and students alike was very positive.
The goal of the project was to expand the OKMRC nursing student externship to include training and participation in healthcare and mental health multidisciplinary teams. To meet this goal, one objective was to recruit 3-6 baccalaureate nursing programs to participate in a 100 hour nursing student externship program with 3 – 8 students in each program. Preference will be given to those programs that participated in 2016, including the University of Oklahoma College of Nursing, University of Central Oklahoma, and Southwestern Oklahoma State University. Another objective was to recruit nursing faculty who are interested in community health, are MRC members, and interested in overseeing the externship at their nursing program.
Nursing student externs would meet regularly with nursing faculty, Stress Response Team leaders, and MRC volunteers to work toward the following externship goals:
Externship broad goals:
- Discuss the role of public health in emergency preparedness, response, and recovery
- Examine the role of disaster behavioral health in disaster response and recovery
- Describe and demonstrate effective multidisciplinary teamwork
- Describe potential impacts of volunteering as an OKMRC nursing student on future professional choices and development
The time frame was that all faculty and students were identified by June 1, 2017.
There were no start up costs.
Quantitative data: Hours The project tracked the hours that externs, Stress Response Team volunteers, and MRC nursing faculty spent on the externship. Outreach hours included the hours of the high school students interacting with the externs and the hours of non-extern nursing students who received instruction from the externs.
Surveys: 1) The knowledge, attitudes, and beliefs (KAB) survey developed and deemed IRB exempt in 2016 was used to measure changes in KAB. Externs completed a pre-externship survey and a post-externship survey to measure success and impact of the externship.
2) Faculty and externs completed an end of externship satisfaction survey.
Qualitative data: Qualitative data were collected via short journal entries that the externs were asked to complete mid-externship and at the completion of the externship. The use of reflection/journaling tried to capture the extern's goal of describing potential impacts of volunteering on future professional choices and development.
Because OKMRC provides crucial support for many during disaster relief, it offers an excellent opportunity for nursing students to develop an understanding of a nurse's role in the community and experience interdisciplinary collaboration. The OKMRC has the potential to provide very meaningful community clinical experiences for nursing programs. One means of sustaining the project is through the baccalaureate nursing programs providing school credit and faculty support for the externship.
Other potential options for financial sustainability of the project include the high school programs, the MRC Nurses Unit, or the state OKMRC office depending upon funding and grant opportunities available. Oklahoma is in a unique position to develop and sustain a model for public health emergency and response nursing education. Oklahoma is the state with the greatest number of federal disaster declarations per capita with a wide variety of disasters. Nurses represent the largest group of healthcare professionals in the state and within the OKMRC.
The emotional sustainability of the plan will be based upon the excitement generated by the faculty and students who participate. The past two summer's experience assures me that students and faculty are eager for this type of learning opportunity.
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