Spring 2009 Issue
Taking it to the streets
Assistant Nursing Professor Gene Majka makes sure his students get out of the hospital and into the community
Gene Majka had never set foot in a homeless shelter until 1997, when he visited a Chicago facility for downtrodden men housed in the basement of a church.
“I had no idea what community health nursing was,” Majka said. “I just needed my 100 hours of volunteer work for my nursing course.”
But within months, Majka, now an assistant nursing professor at Barry, had quit his full-time job at a hospital to establish a one-man “sick bay” at the Lakeview Homeless Shelter. There he performed physical exams, administered first aid and taught the men about safe sex.
“They knew I was there because I respected them and I wanted to help them help themselves,” Majka said.
He recalled his first day as a volunteer there; showing up with 26 shiny, red apples that he had polished the night before – one for every client.
“From that point on, we just clicked,” Majka said. “I learned the men appreciated the apples more than a donut, and a smile went a long way.”
A smile or rather an easy, unforced joviality has become Majka’s trademark as he continues his community outreach efforts at the Division of Nursing. Every semester, dozens of his nursing students fan out across Miami-Dade County, helping the elderly at a senior citizen center, homebound patients and the children of migrant farm workers.
Majka, a certified adult nurse practitioner, came to Barry in the spring of 2002 to teach and oversee the fledgling community health nursing course, which at the time had 10 students a semester and two clinical sites. He has since added 12 more sites throughout South Miami-Dade changing the way scores of nursing students practice their profession.
“I have been looking forward to this part of the program,” said Laura Brown, who has 27 years of experience as a registered nurse and is pursuing her Bachelor of Science in Nursing. “It’s the first time I’ve done this type of work.”
Like Brown, many of Majka’s students are veteran nurses earning their advanced degrees at Barry. All of them are registered nurses and most of them come into the course with many years experience, but few have worked with certain types of populations through community centers or nonprofit agencies in the way that Majka’s course requires.
“The elderly are often forgotten in our society and I think we need to do more,” said Brown, whose specialty is adult care. It’s no secret, she says, that baby boomers will continue to increase the demand for geriatric services for decades to come, especially for those who are on fixed incomes or have limited health care coverage.
“It’s an under-addressed problem that will only get bigger.”
For her community nursing rotation, Brown chose to volunteer at the Seymour Gelber Adult Day Care Center, a Miami-Dade County owned facility that works in conjunction with Jewish Community Services. It is a safe haven for about 50 elderly people - one where they can try to learn a new language, paint, sew or play dominoes. Most importantly, it prevents them from being isolated. Most visit the facility every day, Monday to Friday; many suffer from Alzheimer’s disease or dementia.
“They are very vulnerable and need help,” said Brown, who volunteers every Friday as part of her course. “They feel abandoned and many times they have been.”
Originally, the idea for the course was to rotate the student’s clinical experience, but due to staff shortages the agencies could not give up their time to orientate students every week. So, instead, the students remain at one site the entire semester, gaining in-depth knowledge of the culture and values of that particular community. By the end of the semester they also visit five different nonprofit, county or state agencies to get some exposure to services in other communities.
“There are students who are so eager to learn and bring nursing services to these communities,” said Majka. “They give extra time and purchase medical supplies from their own pockets to make life a little bit easier and healthier for these clients.”
Maria Velez, a 10-year veteran of adult critical care nursing, does her community work for Majka’s class at the Redlands Christian Migrant Association (RCMA), a non-profit childcare center in Homestead. The daycare provides early education for children of migrant farm workers and rural low-income families throughout South Dade.
“You realize what other services you can refer patients for,” Velez explained. “In the hospital, you discharge a patient, you don’t get to know them, where they come from or if they can afford the prescriptions for medications they need.”
Velez, who visits the South Dade RCMA daycare center every Friday, monitors the health of more than 160 children and educates both staff and parents on health and hygiene. The children range from newborns to 5-year-olds.
Once a week, Majka visits his students at their sites, which are often short staffed, and builds relationships with their directors; always networking and finding new opportunities.
In 2006, Majka earned a grant from the American Lung Association and purchased “peak flow meters” to test migrant children for asthma. He also bought laundry soap for “Project Wash” during which students taught migrant families how to separate their work clothing from their leisure clothing when washing to prevent the spread of pesticides.
“All that applies is our scope,” Majka said. “They take with them what is out there, the many resources they can pass on to their patients.”
According to the Census Bureau’s annual American Community Survey released last year, Homestead's population ballooned from 32,000 in 2000 to close to 57,000 in 2007. The proportion of Hispanic residents in the city grew from 51.8 percent in the 2000 census to 61 percent from 2005 to 2007.
With population increases, the demand for community nursing will continue to rise proportionately, particularly within those areas that are traditionally underserved and may face cultural or socioeconomic barriers to receiving quality healthcare at traditional sites.
“The need for community nursing has always existed,” Majka noted. “In the 1990’s more than 90 percent of nurses worked in hospitals, now less than 60 percent of them do. There are other settings to work in; you see parish nurses, nurses working for insurance companies and community centers.”
The sick bay
Majka says he was fortunate that he was able to receive exposure to community nursing at a time when it wasn’t necessarily in the forefront of nursing education, and he was doubly fortunate to find a profession that continues to give him such a sense of self-worth.
“I enjoyed working at the shelter, I felt I was making an impact on the clients’ lives,” he said. “I didn’t want to leave after my time was up.”
While working toward his master’s degree at DePaul University, Majka wrote a proposal for class using what he was learning at Lakeview. He asked for a $65,000-grant from the Visiting Nurse Association’s site board in Chicago. He got it.
“A lot of the men who solicited help from the shelter were former vets, and I, having been in the Navy [for] one year, on the USS Bennington, decided to nickname our little area the “sick bay,” Majka said.
“You name it; I had it come into the shelter.”
His days consisted of treating stab wounds and high fevers. He helped men with mental illness and substance abuse. He educated them on personal hygiene and sexually transmitted diseases.
Sometimes mistakes were costly: he budgeted $500 every month for prescription medications but went over by more than half that amount his first 30 days. Other times they were funny; once he brought in videos of the sitcom “The Golden Girls.”
“Their reaction was one of collective comatose,” Majka said, adding that 85 percent of his clients were African American. “They had no connection with 50- something white women.”
Next time he brought “The Kings of Comedy” stand-up series and it was a “big hit.”
Pretty in pink
After five years, Majka left Lakeview, but he never stopped thinking about models for community service and how they could be applied within the context of nursing, his chosen profession.
Becoming a professor was a natural progression, and as soon as he arrived at Barry, he began working contacts.
“I literally would walk into a room at a place like WeCare of South Dade, Inc. and ask for a [volunteer] site,” he said.
WeCare, a coalition of many social service agencies in the county, brings together educators, ministers, health care workers and other professionals in order to help South Dade communities struggling with health care, education and other social issues.
“Professor Majka has been instrumental in serving the migrant community in Homestead,” said College of Health Sciences Dean Pegge Bell, PhD. “His passion for serving this segment of our population has introduced nursing students to the challenges in our community, but also the opportunities when partnerships are formed to identify health care need and direct resources to improve lives.”
For Christine Hall, a seven-year registered nurse working toward her Bachelor of Science in Nursing, the course has proven to be an experience unlike any other in her academic or professional career.
“It’s a whole new perspective for me,” Hall said. “To be outside of the hospital setting and actually be out in the community is something a lot of us don’t get.”
Hall opted for nursing as a second career and now works in oncology at Baptist Hospital in South Florida. She visits the Seymour Gelber Adult Day Care Center every Friday as part of her course work and says her exposure to its elderly patrons has taught her a lot about “the art” of nursing and caring for another individual.
“I love being here,” said Yolanda, one of a dozen women getting her nails painted while listening to boleros on an early spring afternoon.
Even though they don’t speak the same language, Hall picks out pink nail polish and applies it to her nails; Yolanda smiles.
“Once I’m here, I don’t want to go home,” the 81-year-old said in Spanish as she waves her hands dry.
And, that, is the idea, Majka explains, to take the nurse outside the hospital “box” and place them in a real-world setting. “It’s a different way of doing nursing, it’s why I [took over] this program,” he said.