Since 2009, students from the Samuel Merritt University (SMU) family nurse practitioner and physician assistant programs have been providing free health screening checks to an underserved community in South Hayward, Calif.
For the past year SMU students have been volunteering their weekends to work at the Hayward Day Labor Center (HDLC), where crowds of immigrant day workers gather each morning and afternoon looking for hourly jobs. The majority of people who are seen at the multiuse center are undocumented immigrants and low-income families with no insurance.
"Samuel Merritt University is committed to improving the well-being of the communities we serve, regardless of an individual's ability to pay," said Dr. Suzanne August-Schwartz, DNP, APRN-BC, FNP, assistant professor at the SMU school of nursing. "In collaboration with community partners like the Hayward Day Labor Center, we take healthcare education, screenings and support services out to its primary and secondary community."
For just a short wait, uninsured individuals, family and day laborers are able to speak with supervised NP and PA students about symptoms, pains and general health concerns. SMU students offer basic health screenings for blood pressure, vision and depression; they also strive to educate uninsured workers about preventing injuries and chronic conditions such as heart and skin diseases. The students also administer referrals for specialized medical appointments, pass out health education materials and counsel about substance abuse, depression and anxiety.
And SMU students offer more than just solutions to health problems, they offer emotional support and encouragement to the patients. The project also offers health information on topics such as safe lifting techniques, alcohol abuse and sexually transmitted diseases.
"The problems we see with day laborers are not often isolated physical issues, but manifestations of a combination of psychological, chronic muscular issues and illness," said August-Schwartz. "The student volunteers from a variety of disciplines - be it nursing, physician assistant or physical therapy - enable us to address the whole individual. The community support from area health clinics, such as the Davis Street Family Resource Center in San Leandro, allows us to follow up with patients, a critical component to maintaining good health."
Crossing Cultural Barriers
According to the center's staff, 86% of patients who come for the free health screening are bilingual in Spanish and an additional indigenous language, such as the Mayan language K'iche'. Most patients are from Guatemala. That's not a problem for PA student Britta Hult. She is fluent in Spanish after volunteering six months in Chile.She believes that two-way communication is the key to better care.
"When they learn that I do speak Spanish, you see a definite relief and opening up of their comfort level," said Hult. "It benefits not only the patients who receive treatment, but also providers like myself who are no longer limited in the people they can help."
"I feel comfortable with the students," says Spanish-speaker Daniel Sanchez, a forklift driver working in Hayward. "They were nice and calm and very gentle. They listened to my concerns and it looks like a good team, they consulted each other all the time, which made me feel confident. I would come again."
| Hispanics are the fastest-growing ethnic group in the United States, yet they are also one of the most underserved by the healthcare industry. As that population grows, so will the need for Spanish-speaking healthcare workers. The following statistics highlight the pressing need for Spanish-speaking healthcare workers:
• Spanish is the language of more than half of all non-English speakers in America, making it the second most common language in the nation. (U.S. Census Bureau)
• There are currently more than 32 million Hispanics in the United States, which means that about one of every eight Americans is of Hispanic descent. That number is projected to steadily increase to 98 million - one in four Americans - within the next 50 years. (U.S. Census Bureau)
• 70% of Hispanic adults and 85% of Hispanic children report seeing a doctor regularly. This percentage is significantly lower than their white and black counterparts. (National Center for Health Statistics)
According to Michael De Rosa, MPH, PhD, PA-C, chairman of the Master of Physician Assistant program at SMU, access to basic healthcare is often restricted due to language and cultural barriers. "Two-way communication is the key to better care," said DeRosa. "If the patients feel comfortable in sharing their symptoms in their own language they are going to get well quicker."
"At first some patients were shy and didn't know who we were, but after we explained that we are skilled students and we consult our findings with our faculty supervisors, they came to trust us and realized they have support from people they didn't know even cared for them," said FNP student Susan Donovan.
A Benefit to All
SMU students and faculty say they find they too have been positively impacted by the project. These practices broaden the students' experiences, develop an understanding of the barriers the population face and provide for specific needs of day workers. It's also an opportunity for the students to gain cultural competency to meet the healthcare needs of underserved populations where they live and work.
"Physician assistants and nurse practitioners are everywhere in medicine. They are in operating rooms, emergency rooms and urgent care centers," explains De Rosa. "With the changes in healthcare and the healthcare system, PAs and FNPs are really being pointed to as the profession to take on that front-line management."
"Our students have the chance to gain real medical experience by focusing on interacting with patients, taking vitals and filling out medical history forms," says August-Schwartz. "Working at the Day Labor Center also helps the students gain perspective on their career and future."
"I am able to gain good experience. I definitely plan on continuing this type of work as a physician assistant," said Hult. "There is such a shortage of doctors that we just need more people willing to help."