When migrant families arrive at Casa Alitas, a program run by Catholic Community Services of Southern Arizona, Inc. that offers short-term shelter to the dispossessed, they are tired, hungry, disoriented and often in need of medical care. They are greeted by a compassionate cadre of volunteers who are ready to shepherd them to the next stage of their immigration journey: travelling from Tucson to sponsors spread across the country in places as far-flung as Washington State and Minnesota. The program offers food, clothing, warm beds and wellness checks. Last month, thanks to University of Arizona College of Nursing Clinical Assistant Professor Audrey Russell-Kibble, DNP, FNP-C, FAANP, UArizona Nursing Doctor of Nursing Practice to Family Nurses Practitioner students (DNP-FNP) have been among the first friendly faces the new arrivals see.
“Casa Alitas has been conducting health screenings for years to make sure the migrants are safe for travel,” says Dr. Russell-Kibble. “But we wanted to do more to help them once they reach their new communities. One of the answers was to do well-child assessments on children with the goal of preparing them to start school when they reach their sponsor’s home city.”
Previously, UArizona Nursing faculty have visited Casa Alitas to dispense flu shots, but there was not a concerted effort to entwine the College’s academics and community outreach efforts. Dr. Russell-Kibble changed that by establishing clinical rotations for DNP-FNP students at the facility that will provide them with their full 90 pediatric clinical hours. “Each semester they’ll do a rotation of four weeks for eight hours,” says Dr. Russell-Kibble. The same students will rotate in the summer and then again in fall to complete their hours. FNP students are ideal for the experience because they’re trained to examine how the health care of any individual within a family impacts the rest of the family.
"You don’t have to look too much farther than your back door to find places where you can give care that is meaningful in an international way.” ~ Audrey Russell-Kibble, DNP, FNP-C, FAANP
A formal contract between the College and Casa Alitas was established last year, but it wasn’t until January, 2020, that the new rotations commenced. The program promises to be a success for Catholic Community Services, the UArizona Nursing students and most importantly, the migrant families. That’s a huge boon, considering that since 2018, more than 19,000 migrants – originating from locales as diverse as Honduras, Russia, Mexico, Guatemala, Venezuela, Brazil, Haiti, Ukraine and India – have passed through the facility.
Although Casa Alitas is housed in a former juvenile detention center, you would never know it based on the colorfully painted walls, art and decorations that transform the space into something kinder and warmer. In a Casa Alitas exam room converted into a pediatric clinic, UArizona Nursing students use World Health Organization (WHO) growth charts and American Pediatric Association guidelines to assess their patients, who range in age from birth to 18.
It’s valuable clinical experience for the students, but as Russell-Kibble points, they’re also cultivating important interprofessional skills. “They’re working with volunteer doctors, nurses, a clinical pharmacist, social workers, a lawyer, even the Guatemalan consulate,” she says. “You don’t normally have all these other people at your fingertips for involvement. That’s huge.”
DNP-FNP students Kristen Olsen and Adriana Warne started their clinical rotations on January 22. Warne, who has worked as a pediatric emergency nurse and has done international nursing in Africa, Mexico and India, is thrilled to be doing her part to help migrant families. “International work is a huge passion of mine,” says the Mesa resident, who demonstrates her dedication by travelling from home to Tucson on a weekly basis to complete her clinical hours. “I felt like this was a unique and special opportunity to serve as one of the first people that families get to interact with as they enter the US. Parents are very grateful that their kids get this opportunity to be checked out by medically trained professionals for free.”
Olsen, who has experience in cardiology, women’s health and inpatient/outpatient surgery, echoes her classmate’s enthusiasm. “Many of these people come from poverty-stricken areas,” she says. “It’s not uncommon for them to lack vaccinations, because some moms don’t have any records for themselves or their kids at all. It’s nice to focus on the pediatric aspect of things, and solely learn the developmental milestones they should be meeting.”
Although there’s no such thing as a typical day at Casa Alitas, Olsen and Warne stay busy during their clinical hours. Working as a team, they get basic measurements such as height and weight for their young patients before running through a developmental assessment sheet and finishing up with a head-to-toe physical assessment.
“We ask the moms a ton of questions,” says Olsen. “Not only about developmental things but about dental visits, and their grades in school. Then we plot their height and weight on growth charts and fill out our vaccination records. The mom comes with their records from home and we transcribe it onto what we would use here in the U.S. for entering school.”
The students agree that their work is important not just because it increases their cultural awareness, but because it augments their family practice knowledge. “This experience will help us be more aware of the types of things we deal with in family care in a wholistic way,” says Warne. “Because that’s exactly what the aim of our practice is, to apply a holistic approach to every family and patient that we encounter. And it’s not just the patient that we’re taking care of, especially in pediatrics. We’re caring for the whole family.”
Dr. Russell-Kibble couldn’t be prouder of the work she is supervising. “Adriana and Kristen are amazing,” she says. “They’re very excited, they’re very curious and they’re dedicated to helping an underserved and vulnerable population.” The Nogales native, who knew she wanted to become a nurse since she was four years old, once had dreams of providing high-level care across the world. Now, she says, she realizes that sometimes the most consequential opportunities to give to others are right in front of us. “The point is, you don’t have to look too much farther than your back door to find places where you can give care that is meaningful in an international way,” she says.