Hunger for knowledge: educating nurses on food insecurity
Written by: Deborah (McConnell) Dalebroux (BSN '02), MPH, RN, PHN
Since graduating from the University of Michigan School of Nursing, my career has grown to focus on nursing education with a special interest in nutrition and health. In September 2019, I joined the faculty at St. Catherine University in Saint Paul, Minnesota, designing and implementing interactive learning exercises within the Introduction to Professional Nursing Practice course. Researching and reading about the financial resource limitations faced by many college students, I was alarmed by recent studies on the rise in food insecurity among student populations that was reflective of broader community health issues.
I drew on the research and a decade of public health practice experience to create a learning activity for the community health unit of the course that explored the different roles of the nurse in the community and best practices for assessing and advising patients on referral resources for food insecurity. The goal was two-fold: Equip nursing students with skills to quickly assess and educate patients in their future clinical practice, and empower these students with knowledge of food resources and support available, should they or someone they know be faced with food insecurity.
The class simulation exercise assigned each group of three to four students a community nurse-client scenario representing a different patient population throughout the lifespan:
- A school nurse screening a high school student.
- A family home visiting nurse seeing a new mother and infant for postpartum care.
- A community health center nurse at a well-child visit with an uninsured family.
- A public health nurse doing outreach to a disabled veteran in public housing.
- A parish nurse serving a farm family who qualified for disaster relief benefits due to climate change-related flooding.
- A home health nurse visiting an elderly, recently widowed suburban woman.
In the exercise, students are provided a simulated assessment using the validated Hunger Vital Sign tool and use technology to explore several relevant local food resources to assist their clients. To prepare for the exercise, students receive an introduction to the Hunger Solutions MN Get Help Now map, a digital tool that provides a wealth of food resource information by ZIP code. The classroom activity asks each team to identify key teaching points for the client in their scenario. The student groups then share their scenario with one another and the associated food resource client education in a peer-to-peer learning circle.
As instructors, the course faculty and I facilitated the discussion among students and added supplemental information about the different food programs or services, qualifying conditions or special populations to consider recommending for particular resources. Conscious to set an inclusive tone given the diversity of our students and their life experiences, we prefaced and closed the exercise by reinforcing that many people may need food support at different points in their lives. We also discussed the stigma or resistance to some of the resources such as government-funded food programs, and suggested ways to talk with patients to address concerns and offer alternatives to ensure patients and families get the support they need. Many nonprofit and community-based food organizations in states and localities provide internet-based referral resources, but they are often underutilized in clinical practice by health professionals for a variety of reasons. As trusted health professionals, patients and families often open up to nurses about challenging situations like food insecurity, which they might be reluctant to discuss with others. The nurse’s role and scope of practice are ideally situated to accurately assess and successfully refer patients to food resources, thereby improving nutrition to prevent and manage chronic diseases and promote healthy growth and development.
The COVID-19 pandemic and the severe economic downturn have made this learning exercise seem more vital and urgent than ever. With the upcoming election, increasing students’ understanding of the importance of public funding for crucial health resources like food support programs is critical to ensuring that nursing students are well-informed voters and active citizen professionals, empowered to advocate for themselves, their patients and their communities.
