Susan Bonnell, PhD (2010 USD) is an associate professor and the coordinator for the Master’s Entry Program in Nursing (MEPN) in the Hahn School of Nursing and Health Science. She also works in the Dominican Republic, along with MEPN and Advanced Practice Nursing students, to provide pediatric services, lay worker education and conduct research on malnutrition. Bonnell, who recently joined the “Flying Samaritans” to provide pediatric services at a clinic in Rosarito Beach in Baja, Mexico, answered some questions from Inside USD.
The MEPN (Master’s Entry Program in Nursing) is a 21-month program with course work not only preparing individuals for registered nurse licensure but with an advanced knowledge base in health care leadership, health assessment, pharmacology, public and community health, and specialty practice, leading to a master’s in nursing degree. Foundational masters’ education provides nurses who are ready to lead collaboration and care throughout all healthcare settings.
MEPN graduates learn to do the work of nursing and as they grow in their roles they will continually improve the delivery of nursing and health care. They have been given not only the “spirit for inquiry” but also the tools for evidence-based application and discovery for quality care. Students graduating from the USD nursing program are acculturated to the “pipeline” of advanced education. MSN nurses are eligible to teach new nursing students. This faculty will be the future doctoral prepared nurse scientist and educators, embracing the lifelong learning trajectory.
Why is it important for nurses to have international and multicultural experiences?
The world is changing rapidly and nurses must be prepared to work with a diverse clientele in a variety of health care settings. Working with an underserved population requires a unique skill set that includes a cultural awareness of the meaning of health to the individual, the assessment of available resources to the patient and the needs of their family, and the ability to modify the plan of care based on the medical, social and spiritual needs of the patient. International experiences and community service learning experiences with underserved populations have been incorporated in many nursing curricula as a way to increase cultural awareness.
I take nurses and nursing students to the Dominican Republic and have been doing so for about 10 years. I began by joining a former group of nursing faculty in a site that we stayed at for about seven years. Just when it seemed like it was time to move on, I was invited by Father John Cervini, a parish priest in El Cercado, (a mountain village about 30 minutes east of the Haitian border) to consider bringing students there to work. I believe immersion experiences enhance the personal and professional development of nursing students and provide a forum for sustainable projects that benefit the underserved communities.
The primary focus of the work we do in El Cercado is to provide well-child-care for the children at Francisco Fe y Alegria, a new parochial (K-9th grade) school supported by Father John’s home diocese in Long Island, N.Y. The people are very poor and before we came, did not know about the concept of preventive and well-child care. Many of the children had never had a physical examination, had their blood pressure checked or been measured for height and weight.
The first year we were there, we discovered a much higher rate of malnutrition than expected in this part of the world. Seventeen women in the community had formed a cooperative to improve their standard of living and support their families, and had begun developing a nutritional bar made with local supplies and sold as a refeeding product.
The first year there, one of my students wrote and was awarded a Social Innovation Challenge grant (Nutrition for the Malnourished — Improving health by decreasing poverty, improving nutrition and through education) which was given to the group to upgrade their small factory for sanitary production and to provide small loans for local farmers to start up funding for planting peanuts. This year we visited and saw stacks of burlap bags and peanuts that had been locally grown. The farmers donate one bag of peanuts for every two they harvest and the women’s cooperative buys all the extra peanuts that are grown to produce the products they make and sell. Working collaboratively and being sensitive to the needs within the community as the primary motivation for improvement in the health of the community is the driving force for our presence there.
What kind of research has the project led to?
The research we are working on now has grown out of what we have learned are relevant needs within the community. In order to address the stunningly high rate of malnutrition, we started studying the effect of adding the locally produced nutritional bar to the diet of a small group of children while they are in school over the period of one year. Another area I am developing is data collection that will more easily define and recognize thinness in children based on their MUAC (middle-upper arm circumference ) and correlating to body mass index (BMI). This is an established and much easier procedure than calculating a child’s BMI directly.
There are currently MUAC measures available for preschool children and widely used by the World Health Organization but school age children for the most part have been overlooked in terms of nutritional status globally. So there is a great wealth of research to be done in this area.
The community has many small villages with a cohesive lay community health network. These men and women receive support and health training and are excited to learn and work with the nursing students and myself for implementing improvement projects for preventive health care. The community has opened their homes and arms to USD nurses and every year we learn something new. Later this month I will be speaking to the National Association of Pediatric Nurse Practitioners in Boston about what we’ve learned so far.
Can you talk about your new venture with the Flying Samaritans and how that’s going?
I am a pediatric nurse practitioner and am most fortunate to have the privilege of working with some very poor families just south of the border. I joined the Rosarito Beach Flying Samaritans about four years ago and attend their bimonthly clinic. Many of the individuals who come to the clinic do not have insurance or resources for managing their health. Similar to the United States, there is a large population of of middle-aged and older adults with type 2 diabetes, hypertension and high cholesterol.
I have developed wonderful relationships with families who bring their children in for examinations. Many children have asthma, there are a few diabetic children and there are very little resources for children with special needs. The clinic is run by a group of retired American expatriates who live there and work year around to to raise income to support the clinic.
The director, Nancy Callison, is a retired Navy registered nurse and she has networked with Shriners’ Hospital in southern California as well as specialist physician groups — neurologist, orthopedic and ENTs — who come down once or twice a year and see large groups of patients that we refer to them. The clinic receives strong support by the Tijuana Kiwanis Club. Our regular nurses and physicians come from Los Angeles, San Diego and Philadelphia. It is a good group of caring individuals and it is most exciting for me to be able to share this experience with our nursing students. They travel on Saturdays with me to volunteer their time as well.
Where are your from originally and what prompted you to being a career in nursing? What San Diego neighborhood do you live in and what hobbies do you enjoy outside of work?
I have been a nurse for 40 years and I am so thankful to have found “my calling” at a young age. I think nurses are educated to think critically and and holistically about the people we care for, with a strong scientific understanding of disease and pathology. Because our work is centered on the needs of our patients, we are respected and trusted for our ability to advocate for each person and help him or her understand their health and disease processes in ways they can relate to enabling them to make informed personal decisions.
I am very proud to be a member of the nursing profession and to be at the USD School of Nursing working with faculty who are intelligent, sensitive and caring. I have been mentored positively since the first day I stepped on campus and in my current role as the MEPN program coordinator. I believe in providing the same loving support to the student and faculty I work with everyday. I am a lucky and grateful person!
I am a California native and have lived in San Diego since the early 1990s. My husband and I live in San Carlos adjacent to the beautiful Mission Trails Park. We have three adult children and will soon add a third generation to our family. Everyone who knows me, also knows my dogs, my most favorite topic of conversation. I like to read and knit, also, though I am not very skilled at it!
– Liz Harman