March 12, 2014
By Toni Cardarella
On a recent afternoon on the campus of the University of Kansas Medical Center, a group of senior nursing students took part in an experience designed to show them what it's like to live as a low-income family struggling through day-to-day life with constant financial burdens.
"I got to see the perspective of a family in poverty working hard to no avail," says Jackie Teahan, a KU School of Nursing student who "lived" as 54-year-old Lester in a role-playing activity that gives students an inside look at a health population they will no doubt encounter as practicing nurses.
The poverty simulation is a required clinical activity for senior-level Bachelor of Science Nursing students taking the spring semester Population Health practicum. Teahan was among the 46 students at the February simulation, and the remaining 52 seniors are set to participate in the April session.
A makeshift community was created in the School of Nursing atrium when every student was assigned a role in a family facing poverty. On the perimeter were a dozen or so tables staffed by volunteers representing a bank, an employer, a utility company, pawn broker, a payday and title loan company, a grocery store, a school, a childcare center and other community resources and services.
Each family spent four "15-minute weeks" trying to secure basic needs, such as shelter, transportation, food and education, while dealing with the added stress of their particular situation, such as homelessness, unemployment, the loss of a breadwinner in the family, a pregnant teenager at home, kids in trouble at school, and grandparents raising grandkids.
The scene was chaotic as participants scrambled around the room trying to determine how to best use their limited money to pay bills, get to work and get their kids to school. Each trip cost the families a transportation pass, which was a limited resource. Lines were long at most of the tables.
"Community resources were not empowering because I didn't know what was available and how to use them to aid my family," Teahan says. "I learned there are policies, laws, and a lack of education about resources and how that can make or break a family's attempt out of poverty or to better health."
Teahan and fellow nursing students Caitlin Buerge, Venicia Lemmon and Elizabeth Grinter "lived" in the Loeke household, which includes a married couple with a teenage daughter. They both worked full-time but couldn't make ends meet. The stress was exacerbated by the care for the elderly parent of the mother and the related medical bills. For a short time, the Loekes were homeless after being evicted. "I felt hopeless and lost," Teahan says.
Two "weeks" into the simulation, facilitator Jesyca Hope Rodenberg reminds students to focus more on putting food on the table and less on "winning" the experiment. Rodenberg says it's easy early on in the simulation for students to get caught in the trap of thinking it's a game.
"The reminder is a chance to really ground participants in the truth that, while they're having fun, for 42.6 million Americans, the struggle and stress they're experiencing is real life," says Rodenberg, communications and outreach director at Kansas Association of Community Action Programs, a membership association for Kansas community action agencies to work together on issues that concern low-income Kansans. The scenarios in the simulation are based on actual clients, she adds.
It's the second year the simulation served as a clinical activity for the Population Health course, which addresses the social dimension of health that impacts the health status of the population, says Vicki Hicks, RN, MS, APRN, the clinical associate professor who teaches the class and practicum.
"It's a good fit for our new, concept-based BSN curriculum, which boasts more experiential clinical activities," she adds.
After the simulation, participants move their chairs to a large circle with Rodenberg to share what they learned from the activity. Rosenberg liked what they had to say about changed perceptions and how hard it is to live in poverty.
"It's important to see people without judgment," Rodenberg told the students. "I hope this experience will give you pause before that judgment."