Skip to main content

Stephanie Spinosa: Learning in the Community

Building on her experiences in the classroom and clinical rotations, this summer Penn Nursing student Stephanie Spinosa worked as a nurse intern at the Mary Howard Health Center. A primary care community health center for the homeless population in Philadelphia, this experience has had a profound impact on her understanding of the scope of nursing and her career options going forward.

Stephanie was one of four Penn Nursing students selected for the prestigious IBC Foundation Nursing Internship Program, which drew an applicant pool of over 200 from almost 20 regional schools, with a final cohort of just 20 students. Assigned to Mary Howard, she spent ten weeks out of the classroom, getting on-the-job training from passionate nurses and nurse practitioners. Because the clinic is a nurse-managed facility, she recalls, “It was awesome to see the nurse practitioners in this true leadership role, where they were the main care providers for these patients and they were able to make these big decisions. They were fundamentally working to their full scope of practice.”

While Stephanie had worked with the homeless population before, this was the first time that she had gone beyond surface-level interaction, and it was challenging in the beginning. Learning how to communicate with them in a way that they didn’t feel inferior was important, especially since patient education is such an important part of community health. “It’s hard to ask, ‘How are you?’ when you see someone who is clearly struggling,” she says. By the end, she had built a rapport with many of her patients, which goes a long way in providing quality out-patient primary care.

To conclude the 10-week program, Stephanie and three others were invited to give a speech at the IBC Foundation Nursing Internship closing ceremony, and she delivered a powerful message: “…working at Mary Howard has taught me to be open to the greater scope of humanity. We can be smart and safe without allowing fear to dictate our lives. I believe that as nurses, we need to rise above the discomfort we may feel in order to provide compassionate care. We need to recognize and respect a person’s humanity before we can do anything else. That is the foundation. Our shared humanity is the starting point.”

Engaging diverse communities and promoting health are just a couple of the priorities that move Penn Nursing forward, and it takes getting students out into the community to make the greatest impact and learn the greatest lessons. And this is just one of the many reasons that Penn Nursing was at the very top of Stephanie’s list. “Penn was the dream school. When I got in, I was sold,” she says. “I wanted to be challenged…at Penn, they are taking the basics one step further. We’re delving into ‘why are we learning this,’ and ‘why is this important,’ and ‘how does this connect with an interdisciplinary approach?’ We’re learning about how to anticipate what the next steps will be, so that we can make smart decisions and recommendations on behalf of our patients. This mindset is unique to Penn’s program. There is a big emphasis on taking that leadership role as a nurse.”

On the subject of interdisciplinary approaches, one of Stephanie’s favorite experiences to date has been her medical-surgical clinical on the general medicine floor at the Hospital of the University of Pennsylvania. Traditionally, a physician’s ‘rounds’ include checking-in on a patient and then gathering with a larger team of care-providers – that might include nurses, physical therapists, social workers, and more – in a conference room to discuss that patient’s care. So she was thrilled to learn that at Penn, this interdisciplinary care team actually meets together at the patient’s bed-side. This is a great way to keep the patient at the center of his or her care, and occasionally, the nurse is asked to lead off the discussion. She explains, “The nurse is with the patient all day and can often provide a holistic view of what the patient has presented with. It has been so empowering to see nurses leading these conversations as patient advocates.”

What’s next? Stephanie is considering sub-matriculating into a nurse practitioner program for adult-geriatric acute care. And being a self-described “fast-paced person”, she originally thought her path might lead her to clinical care work in a city hospital setting, but, having completed this internship, she now has other ideas. Working at Mary Howard, she saw first-hand how many people in our communities go without care, or don’t receive proper care, and she realized how important helping people in one’s community really is. “If we keep our local communities healthy, we’re going to have a healthier population overall.” It’s a trickle-up effect, and for Stephanie, wherever she ends up, she knows that she’ll be making a difference. “As a nurse, I know that my work is going to help people.”