Graduate nursing students from the Hofstra Northwell School of Nursing and Physician Assistant Studies got an unusual lesson in patient care during a simulation exercise designed to deepen their understanding of the challenges faced by someone living in poverty.
The program, called the Community Action Poverty Simulation, assigns roles and scenarios to students – gender, age, family roles, employment, and housing status – and requires them to manage their finances for a four-week period. Various stations are set up that represent community resources and social services.
“This is an immersive exercise that really changes how you see people with financial challenges,” said Debora Riccardi, assistant professor of graduate nursing. “It’s critical that we as healthcare providers understand the whole patient – including their family, their struggles, and their needs – so we have made this part of our graduate nursing curriculum.”
“It’s neither a contest nor a game. This is a simulation based on real families with real problems such as unemployment, unreliable transportation, spousal abandonment, and a lack of quality or affordable child-care,” she said.
Student Adrian Anderson played the role of an unemployed 20-year-old single mother with a one-year-old baby. He carried a doll as he tried to navigate various social services, and balance work and child- care. “I can go get a job, but I’m going to need transportation to get there,” he said. “And getting a job means I can’t take care of my child.”
Sara Devany-Tawney played a disabled grandparent. “Sometimes as healthcare workers we can get frustrated with patients because it seems like they aren’t listening to us and not doing what they’re supposed to be doing for their health,” she said. “You have to realize they have so many other stressors and barriers. This is a good sensitizing exercise.”
According to the U.S. Census Bureau, nearly 2.7 million New Yorkers lived below the federal poverty threshold in 2021. The simulation was designed to demonstrate how confusing the network of local, state, and federal resources can be.
“It’s very difficult to navigate the resources and they aren’t connected to each other,” said student Ross Rieman. “There is no centralized place and every step along the way you need to spend time and money just to be told it’s not the right place and to go somewhere else.”
This is the second year the Hofstra Northwell School of Nursing has run the simulation, and the first time it has been required for graduate students. “This experience can benefit all students, so we’re for more ways to expand it within the nursing program and cross-functionally,” said Riccardi. “Mental health came up during the post-event discussion and we are looking to bring in our School of Health and Human Services into the simulation, both as service providers and student participants. Over time I can see this becoming a campus-wide initiative.”
