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When in Columbus, Tour Like a Public Health Pro

May 29th, 2024, will forever be etched in our minds as the day we explored the depths of public health—and had a blast doing it! Armed with curiosity and accompanied by our delightful Norwegian friends, we embarked on a fun-filled adventure through the Columbus Public Health (CPH) Building. Spoiler alert: it was enlightening, educational, and sprinkled with moments that made us chuckle!

From Blind School to Beacon of Health

Our journey kicked off with a warm welcome from Ms. Tiffany Krauss, MSN, RN, the chief nursing officer at CPH. Her enthusiasm set the tone for the day. Ms. Beth Ransopher, REHS MEP, then took us on a fascinating trip down memory lane, revealing that the CPH building once housed the Ohio State School for the Blind back in the mid-1800s. Who knew? Talk about a building with layers of history!

Beth didn’t stop at the historical tidbits. She dove into the importance of public health and shared CPH’s role in tackling the COVID-19 pandemic. It was a humbling reminder of the tireless efforts of health professionals in times of crisis.

A Tour of Health Wonders

Next up, Ms. Courtney Daniels, MSN, RN, walked us through the intricacies of clinical health operations and nursing education at CPH. We were ready for a break after soaking up so much knowledge, but the adventure was just beginning.

We toured various clinics within CPH, including the Women’s Health & Wellness Center, Sexual Health & Wellness Center, Immunization Clinic, and the Tuberculosis (TB) Clinic. And speaking of TB…

Front of Informational Handouts describing the clinical services provided at the CPH.

Back of Informational Handouts describing the clinical services provided at the CPH.

Women’s Health and Wellness Center

Immunization Clinic

TB: A Poster Child for Health Disparities

Our TB Clinic tour was eye-opening. We learned that TB is often a glaring example of health disparities and inequities. The treatment regimen is no joke—patients must take their pills daily under supervision for six months, and if drug resistance is an issue, more complex treatments follow. The fact that no new first-line drug has been developed since 1968 left us aghast. On a positive note, TB cases have dropped from 7,000 to 200 this year, with 70 cases in Franklin County. Progress, but there’s still work to be done.

Tuberculosis (TB) Clinic

Playing Detective: A Public Health Case Study

Post-tour, we put on our public health professional hats for an interactive case study. In small groups, we investigated a mock scenario involving a 7-year-old (played by yours truly) who fell ill after returning from a sleepaway camp. The symptoms? Bloody diarrhea, nausea, and vomiting. We honed our investigative skills, asking detailed questions about symptom onset, camp activities, and potential exposures. After some detective work, we pinpointed the culprit: E. Coli-contaminated red meat from the camp cookout. Who knew public health could feel like an episode of “CSI”?

Trivia and Tunes

Our day didn’t end there. We wrapped up with a lively music trivia night at a local eatery with our Norwegian companions. It was the perfect blend of brainy fun and camaraderie, reminding us that learning and laughter go hand in hand.

Dr. Stephen McGhee joins us and our Norwegian friends as we battle it out during Music Trivia Night!

Reflections and Takeaways

Our time at CPH highlighted the importance of SDG 3—ensuring healthy lives and promoting well-being for all at all ages. The ongoing battle against TB and other infectious diseases exemplifies the need for sustained efforts to improve health outcomes and reduce health disparities. By addressing TB rates and enhancing patient adherence to treatment, we can make significant strides toward achieving SDG 3. One aha moment was realizing just how much effort goes into pinpointing disease sources. It’s not just about medical knowledge; it’s about thorough questioning and critical thinking.

Until Next Time…

May 29th, 2024, will be remembered not just for what we learned but for the bonds we formed and the fun we had. Here’s to more adventures in public health—and to making a difference, one day at a time.

We started our morning with our Norwegian friends putting together a phenomenal presentation for OSU Primary Care group providers. The presentation outlined in great detail the healthcare system in Norway. It was very interesting to learn that the most they would pay is only $300 dollars a year before hitting what would be equivalent to our out-of-pocket max! It was clear that in Norway they prioritize preventative medicine much more than in the United States where we generally excel in critical care and management of acute illness or trauma. We learned the impact the sugar tax has on improved cardiovascular health in Norway. It was interesting that Deon pointed out that area’s near the border of Norway where people could cross the border to get cigarettes and sweets for little money had the highest incidence of cardiovascular disease.

We quickly packed up into our cars and headed south to the Mid-Ohio Market at Norton Road, a community food pantry for those that qualify. Immediately we felt as if we had entered a massive grocery store! Aisle upon aisle there was nutrient dense food with very few processed foods in sight. The SDG goal “ensure healthy lives and promote well-being for all at all ages” is an excellent representation of our shared goal during this clinical. We set up our station for health screenings right after registration so that we could easily offer health screenings(blood pressure, blood glucose) to pantry patrons. By offering health screenings we are promoting well-being by helping educate on indicators of health and direct people to resources in the community if necessary.  It was a great experience for many of our students who are working on their Spanish Language skills to practice conversing as there were not any translators present.

Today was somber as we knew it was our very last clinical day with our sweet Norwegian friends. After a long day of service and education we ended out the day at Budd Dairy Food Hall, a local market with a wide array of tasty eats and treats. We said our farewells on the rooftop as this would be the last day we would all be together(that is until we visit our friends again in Oslo one day).

Looking back on the COIL experience I feel incredibly grateful to OSU College of Nursing for facilitating this enriching experience. I have gained a new perspective and have recognized all the areas of growth we have to impact and change our communities through our role as a nurse practitioner. I recognize the importance we have as future nurse leaders to be involved politically and support leaders who seek to expand nursing roles and preventative medicine. During my community clinicals, I have gained a new perspective on all of the healthcare disparities and lack of culturally affirming care that exists and how this greatly effects the health of our community members.

This morning, we set out early on a sleepy Saturday morning to perform health screenings/foot baths in collaboration with the Nspire group. We met up with our Norway exchange friends who were in sleek, bright white scrubs that were much more subtle in sharp contrast to our fire hydrant red scrubs. We met with the priest of the church who explained to us more about the outreach that occurs for people in the community for those who are without a home. We learned that the area had the highest rates of violent crime in Columbus, and one of the highest rates of maternal mortality and infant mortality than anywhere else in Ohio. He also told us that many of the people in the area had 10–20 year shorter life spans due to lack of access to healthcare. It was clear that there are many health disparities that this community faces that need urgently addressed.

As we set up our stations for blood glucose, blood pressure, and feet screenings we immediately noticed how excited people were to shuffle in and interact with the students. The Nspire group, a volunteer student organization, puts together hygiene bags with toiletries and other essentials for those who are in need. Some students were running the foot screenings/baths where people could come and soak/scrub their feet and get a fresh pair of clean socks. We learned from the priest that the un-homed are very hesitant to take of their shoes and often sleep with them on which is why the feet baths are so helpful as often it is the first time they have taken off their shoes in months.

Other students were performing blood glucose and blood pressure screenings and providing education on why they are helpful indicators of overall health which is a great example of SDG Goal “Increase the health literacy of the population.” Many of those who attended today have limited access to preventative medicine or have many barriers to accessing community resources due to lack of transportation for example. By having a simple chat, we were able to learn so much about the community members and the great challenges they face in accessing things we take for granted like dental care. Overall, I can see how pivotal of a clinical experience this is to have and am grateful that we have the opportunity to serve our community in this way.

May 22, 2024

Four minutes away from Nationwide Children’s lies the largest distributor of free food in Ohio – the All People’s Fresh Market. This week my classmates and I had the honor to assist this food pantry – this was the first time I had stepped foot in one. 

All People’s Fresh Market is open!

Prior, when I had thought about food pantries, I imagined rows and rows of canned, processed, or packaged goods; in fact, when I searched up the address for the clinical site, I was a bit confused when a “Fresh Market” popped up as a search result. To my surprise, this pantry was stocked with fresh produce ranging from watermelons to “unlimited” (one crate of!) eggplants market members could take home. Members have the opportunity to come in once every day the market is open. 

Restocking produce!

Upon entering the food pantry, we were all assigned various roles for the day; these roles included blood pressure screenings, signing in members, greeting market members, and restocking vegetables. I was assigned to blood pressure screenings; however, as the day progressed, I found myself helping members pack their produce to promote a steadier flow of individuals coming in and out. The pantry limited the number of guests in the pantry by limiting the number of circulating baskets. 

One thing that surprised me most about All People’s Fresh Market was the number of resources it provided that was not simply food. Depending on the day, All People’s Fresh Market hosts various outreach events (i.e. Maryhaven, SSTC) and even dance and gardening classes! There was also a community outreach representative from OSU educating and distributing Naloxone and Fentanyl/Xylazine test kits. 

South Side Thrive community outreach stand!

To be able to be a market member of All People’s Fresh Market, you have to be a household earning less than 200% of the Federal Poverty Guidelines. An ID is all it takes to become a member; though, if one is in the process of obtaining an ID, they are still permitted to shop here. Food pantries like these address Sustainable Development Goal 2.1 which states, “By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round.” By providing opportunities for underprivileged individuals to obtain adequate food, food pantries are one of the driving forces in achieving food security for all, and in turn, a hunger-free world. 

Working in inpatient psych, I have come across many patients that are underserved and/or underprivileged. This experience re-opened my eyes to what sort of resources are available for this demographic and what life might be like for them. Amidst boxing produce for an older gentleman, he expressed deep gratitude for us volunteering here. He spoke with heartfelt emotion about his nephew’s battle with cancer, mentioning that the food he had acquired that day was intended just for him. Today, I brought home not only the lessons of this experience, but the powerful narratives of those who enter All People’s Fresh Market. 

May 23, 2024

Today, Raegan, Jenni, I and carpooled once again to the lovely city of Springfield. We woke up bright and early to beat the traffic and stop by Schuler’s for a delicious donut (Thanks, Bri for the recommendation!). Then, we headed to the schools to get started on the hearing and vision screens. Jenni and I were assigned to screen kindergarteners at Perrin Woods and let me just say it was an eventful and fun day.

Springfield delicacy!

We were greeted by Nurse Donna and she taught us the ins and outs of vision and hearing screenings. She also mentioned the great program that Springfield implements for low income families. This includes free breakfast and lunch for all the kiddos, free school supplies, and they pay for families to live there which includes having their kids join the school systems. Sustainable Development Goal 1.3 states, “Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable.” I have never heard of a program like Springfield implements and they definitely are protecting the poor and the vulnerable in any way they can. Perrin Woods also is creating a Spanish/English classroom next year to help the students learn better for those who still can’t speak English well enough. Nurse Donna said she estimates about 2,000 new students will be joining their district next year just because of Springfield’s program. This will probably cause a lot stress on the teachers and faculty but I believe that they are shaping these young minds for the better.

Learning all of this got Jenni and I excited for the day as we dove into screening these kindergarteners. They definitely kept us on our toes as many of them did not want to be there on their last day of school (I don’t blame them) and some were having a little too much fun with it. However, it was a very cool experience and we were able to adapt to the students who didn’t speak English or simply were afraid to talk to us. I was able to utilize my Spanish minor and pointing skills as they were very beneficial to helping identify these shapes. Everyone passed the vision screenings and only two failed the hearing screenings. I call that a successful day! I definitely don’t remember doing these screenings at school but I was very glad to be a part of it. Again, school nurses do a lot for these school systems and I was happy to help Nurse Donna and she was definitely grateful for us to take some of the load off her plate.

Hearing Screening Tools!

Vision Screening Tools!

Upon arriving to our clinical site today at All People’s Fresh Market we were quickly assigned an individualized role in preparation of the bustling opening rush at 10:30 sharp! While the building was no larger than a small gas station, I was quick to notice unlike other food pantries it was packed full to the brim with nutrient dense and non-processed foods like lettuce, eggplant, grapefruit, watermelon, potatoes, peppers, and zucchini.

We were swiftly divided up into teams: registration/welcome team, blood pressure screenings, produce, and assisting in checkout of items. Raegan was eager to assist with registration where she was a great asset!

Raegan Heitzenrater providing smiles, support, and her spanish skills to registration staff!

After opening, market members were quick to greet us with a wide grin. I enjoyed chatting with them as they perused through the produce. Many were thrilled to chatter about how they planned to prepare each dish – sauted, steamed, grilled, air-fried, or thrown together into a stew! It was instantly clear to see the joy this organization brings to the community. In many cultures and families preparing dinner is a source of connection, so it was heartwarming to see families come in together galvanized to cook up nutritious ingredients.

Our clinical instructor Dr. Edwards helped us set up a table for us to perform health screenings, which many patrons took us up on! We were able to provide blood pressure screenings, which we were eager to do after mastering the art of the manual blood pressure earlier this month in lab and clinical. We were also able to provide patrons with children sunglasses which were exceptionally popular given the weather warming up.

Many Ohioans face food insecurity, in fact a shocking 11.5 percent of Ohioans are food insecure with 1.6 million facing hunger, 500,000 of those being children. (What Hunger Looks like in Ohio, 2024). Sustainability goal number 2 is to “end hunger, achieve food security and improve nutrition and promote sustainable agriculture”.  After speaking to a few of the volunteers at the market, I learned that the All People’s Fresh Market, a partner of Mid-Ohio Food Collective, provides fresh produce for any household earning less than 200 percent of the federal poverty guideline.  The market is open 6 days a week and can be accessed by those who qualify once per day.  Staff members said it is not uncommon for the pantry to see up to 400 people come through a day and lines a great distance down the road, making community volunteers pivotal to the mission. The market frequently has other community organizations within the community like South Side Thrive and Project Dawn that serve a similar mission of community based health promotion.

Project Dawn is a local organization that had a representative from OSU providing Naloxene and Fentanyl test strips along with education of how to use these items that can save a life. We enjoyed also learning about the organization South Side Thrive which helps promote healthy living resources, financial/housing stability, and community connection.

Near the end of our clinical day, we were able to take a short break and neandered over to Bake Me Happy, a local gluten free bakery near the market. It was the perfect refreshing snack after a long day of community cares! Reflecting back on our long clinical day, my biggest takeaway is how important improving access to not only food, but nutritious non-processed food can have a big impact on community health and wellbeing.

South Side Thrive!

Reference

May 16, 2024

“What makes a good nurse?”  

These are the questions that, almost a year ago, we asked random strangers, friends, and family during one of our first nursing courses. We collected information on what the common perception of a nurse was and many of those answers revolved around someone that is kind, caring, helpful, and honest.  

One thing that I did not realize, at that time, was that many people’s first personal encounter with a nurse is with their school nurse. Sure, they may encounter a nurse in the doctor’s office while growing up, but they are often accompanied by a parent or guardian. A school nurse, however, is a safe space within a school; a space where children can go for medicine, diabetes management throughout the school day, a band aid, or a place to rest when not feeling well; a space where children learn to vocalize their needs, their ailments, and their concerns confidently to an adult; and a space where a young child begins to form their perception of a nurse.  

Ultimately, there is far more to being a school nurse than I had assumed, and on May 16, I witnessed the New Albany Primary School nurse in action.  

The entrance of the New Albany Primary School!

But not without caffeine and a sweet treat to prepare for the energy of the young ones we would encounter throughout the day. New Albany sits in the northeast corner of Columbus and is home to one of Fox in the Snow’s location (some of the best coffee and pastries in town). We (Myrna, Jenni, and I) stopped for a morning cup of coffee and set off to get settled before the school day commenced at 9:05.  

A sweet treat from Fox in the Snow to start the day!

The morning consisted of routine medication distribution, including pills and inhalers, and monitoring the blood sugar of the 4 diabetics within the building. The day was busy as the school year was coming to an end, particularly with concern to the diabetic patients. Increased activity levels of second recess and fields days, coupled by class snacks of popsicles and cookies, had the school nurse chase the sugars of some diabetic students for most of the day.  

To my surprise, these young students were given much of the responsibility of their diabetes management. Among this student population, each student had a Dexcom monitor synced with their own device and the nurse’s iPad. When the student trended low, the nurse called the teacher and requested that the student be allowed to eat a snack. When the student trended too high, the student was requested to come to the clinic for management (insulin or encouraged to drink water).  

Overall, the school nurse encouraged the students to understand their illness and manage it accordingly while being a liaison between teacher, parent, and child. In addition to diabetes management, the office was full of tummy aches, scraped knees, bumped heads, and runny noses.  

The children in this school, first through third grade, are very young and many of them are managing illness with the assistance of the school nurse. As expected, understanding the many pillars of health is essential in addressing a young person’s health. Many of the complaints that were made by students regarding ‘not feeling well’ were followed by questions regarding what the child had eaten that day and if they had any water. Nutrition, sleep, and hydration are essential for a child’s health and wellness (and adults, too) and ensuring that these needs are met is a key focus of the school nurse.  

The promotion of independence and self-management of diabetes, even among the young children, aligns with the United Nations SDG Goal 4.6 which states “By 2030, ensure that all youth and a substantial proportion of adults, both men and women, achieve literacy and numeracy”. Literacy and numeracy, and promotion of such, translates to health literacy and health numeracy, in my perspective. Managing chronic illness warrants a certain degree of education and understanding to promote compliance.  

In conclusion, I not only have an increased appreciation for teachers but an immensely increased appreciation for nurses, specifically working with school nurses, and all of those that work together to promote the health of young children and support their education!  

Nestled within the busy halls of a high school lies a hidden hero, the school nurse, who is always ready to heal, comfort, and empower. I recently had the privilege of shadowing one such nurse, and the experience was nothing short of inspiring. I visited Westerville Central High School, a suburban community with a diverse student population.

As the day began, the school nurse, Amanda, and I embarked on a journey of care and compassion. Throughout the day there were the usual teenage mishaps, where we handed out ice for injuries, bandages for cuts, and even ice for new and healing piercings! Each interaction was met with a smile, a reassuring touch, and a listening ear, showcasing the unwavering dedication to students’ well-being.
We were also called upon to train some of the teachers chaperoning senior students to Cedar Point the following week, ensuring they were equipped to handle any medical emergencies that might arise. We covered everything from using an AED and performing CPR to administering medications and providing basic first aid care, leaving the teachers feeling confident and prepared for their upcoming trip. We also prepared a “Grab and Go” medical bag that included all of the necessary supplies and medications for the trip.

Amidst the excitement of training, we also took some time to reach out to new admission parents, kindly reminding them of Ohio’s school rules regarding immunization records. This task, though seemingly mundane, highlighted the nurse’s commitment to ensuring a safe and healthy environment for all students. We provided families with the following colorful and easy to read chart and instructions that highlights the necessary immunizations.

As the day drew to a close, I couldn’t help but reflect on the invaluable role school nurses play in the lives of students. They are not just caregivers; they are mentors, confidants, and advocates, shaping the futures of students and their relationship with healthy and safety.

My experience at Westerville Central High School addresses Sustainable Development Goal number 3, which aims to ensure healthy lives and promotes well-being for all at all ages. In particular, the role of the school nurse includes addressing target 3.b of this goal, which states, support the research and development of vaccines and medicines for the communicable and non-communicable diseases…to protect public health, and in particular, provide access to medicines for all. We provided families and students resources and education regarding immunizations and vaccines that are required for all high school students in the state of Ohio. It is imperative that families and students are aware of the benefits, risks, and health outcomes that are associated with administration of immunizations and vaccines. I am confident that the families we spoke with today are now well informed and are equipped with the knowledge and resources to make important health decisions.

In conclusion, my day shadowing a school nurse was a whirlwind of excitement, compassion, and learning. It reinforced my belief in the power of kindness and empathy and left me in awe of the incredible work done by school nurses every day.

I also stopped by Rooster’s for dinner, a mid western staple for chicken wings and sports. I grabbed some Cheryl’s Cookies for our COIL friends, hoping to introduce them to a delicious Columbus sweet staple. The Roosters Foundation gives back over 1 million dollars to local charities and organizations each year, with their Cheryl’s Cookie sales being a top contributor. 100% of proceeds from sales goes directly to The Urban and Shelby Meyer Fund for Cancer Research, a fund that helps to recruit experts in the field of cancer research to
the OSUCCC – James. I am excited for the students to try the cookies while also supporting
a great cause!

This week we had the pleasure to work with New Albany Plain Local Schools where we were able to play school nurses for the day. Four of us were assigned to separate buildings including the Early Learning Center, Primary, Intermediate, and High School. It turns out that school nurses do a lot more than give bandaids and handout ice packs (although, many students still came in for those).

Community clinical is more fun when you carpool!

I was assigned to work with Nurse Joy at the Early Learning Center where the Pre-K and Kindergarten students have tons of fun and learn so much. Our day started off pretty bloody as a Pre-K student came in with a busted, bloody lip that was an aftermath of pushing a classmate on a swing and it backfiring, hitting her in the face. Crisis was averted as we applied some pressure with gauze, rinsed with water, and provided some handy dandy ice. That was probably the craziest thing that happened today, other than that, everything was very chill and steady.

Nurse Joy explained her day to day process which included monitoring a student’s diabetes where we would give her insulin (if needed) during her snack time and during lunch. Today, the kiddo’s sugar was declining faster than our liking before snack time and we gave her a pick me up Starburst (4 g of carbs) to bring it up. Nurse Joy also administers medications that are needed such as inhalers and ADHD medications. She is also responsible for hearing and vision screenings in the beginning of the year and keeps track of all of the vaccinations that are needed to attend the school. With her background in trauma nursing, she is the person to call for any medical emergency such as seizures (this happened this year) or broken limbs (I saw many students with casts). Teacher and faculty CPR training was taught by her, as well. Overall, she is an incredible asset to the school and everyone loves her!

Very fun visual for the kiddos at the clinic!

I forgot how germy kids can be! Most of these kids are snotty, coughing everywhere, and covered in dirt from recess. One major health concern would be how fast communicable diseases could spread in the classroom. It made me wonder how teachers and nurses handled the COVID outbreak. Nurse Joy definitely mentioned how it was a very tough time and it consisted of a lot of COVID testing, contact tracing, and keeping track of quarantines. Sustainable Development Goal 4(Quality Education) states that ,”The pandemic caused learning losses in 4 in 5 og 104 countries studied.” This is why it is important to keep very sick kids at home to prevent an outbreak in the school. It will prevent many students from missing school and protect the teachers, as well. Kids are also notorious for trying to home from school from “tummy aches” and other excuses to miss class. Nurse Joy did a great job at comforting these students giving them options to use the bathroom, enjoy a snack, or simply rest in the clinic for a little bit. She didn’t send any kids home and this will definitely protect their learning.

Overall, I really enjoyed this experience and it was very nostalgic for me as I haven’t been inside of a school (that wasn’t a college) in a very long time. Seeing all of these kids with very oversized backpacks having fun learning was cute to see! It was great to be on the nurse’s side of the clinic and not the student. I never knew how much a school nurse did for students and what they put up with. Nurse Joy was very patient with the students that came for very simple things. Although, I am on the Adult-Gerontology Primary Care track, I learned a lot from these kiddos and Nurse Joy that I will take to practice with me in the future.

The school focuses on mental health and emotions for the kids