Nursing students raise awareness about post-incarceration challenges

The research team partnered with several Chippewa Valley organizations on a project, titled “Returning to the Community: A Quality Improvement Project.”

“A lot of people think that being released from jail or prison is the easy part, but it actually brings another list of demands and challenges,” says Brelynn Updike, who graduated from UW-Eau Claire with a degree in nursing in May. “I hope our research helps to shed light on the voices of individuals experiencing this injustice.”

Increasing understanding

For their project, the Blugolds, under the guidance of Dr. Pamela Guthman, assistant professor of nursing, collaborated with the Chippewa Valley Justice Action Team, Eau Claire County Human Services Department, FREE Reclaiming Women's Freedom of the Chippewa Valley and Ex Incarcerated People Organizing.

Over the course of three semesters, teams of students developed questionnaires for people who had been incarcerated and for correctional officers to help the future nurses better understand the gaps, challenges and barriers that exist in the systems that impede the successful return of people to the community.

They also met with the local organizations to learn about and better understand what support already exists, conducted a community assessment, and used statistical data to learn about people who had experienced barriers and challenges within the systems that prevent them from succeeding.  

“Students had an opportunity to challenge their own biases, stigmas and misperceptions as they learned about the significance of the issues, barriers and gaps in the services and systems that support the success of people trying to return successfully to the community,” Guthman says.

Their goal is to make more people aware of the issues surrounding the incarceration system and for people returning to the community, including barriers such as systematic racism, homelessness, poverty, addiction, mental health disorders and employment discrimination, says Emily Webster, a May nursing graduate from Brooklyn Park, Minnesota.

“Spreading awareness and creating conversations is the first step in creating change,” Webster says. “I have learned so much about the injustices and lack of resources that people trying to return to the community face. Individuals who are returning to the community face extensive barriers and must work extremely hard in a system that does not promote their success. The systematic racism, prejudice, lack of resources and lack of awareness of these issues is astounding.”

The students hope their project will encourage community, public and private organizations, and policymakers to come together to form more comprehensive recommendations for quality improvement initiatives regarding programmatic and systematic changes.

“It is vital for the community to collectively intervene to diminish the gaps and barriers around mental health, adverse childhood experiences, addiction disease, transportation, housing, employment and poverty to address health inequities in the Chippewa Valley,” Updike says.

Giving voice to people often not heard

The students’ project is powerful because it prioritizes the voices of people who have firsthand knowledge and experiences that expose the systemic barriers and challenges that do not support success in returning to communities, says Guthman, who teaches courses in community, public and population health.

“Populations who are most at risk and vulnerable, who have experienced trauma and/or have not had equitable opportunity and are marginalized in our communities, often don’t have their voices or experiences represented in an equitable manner,” Guthman says.

To make change, communities must consider the voices of those who know from their own experiences how challenging it is to survive without a well-paying job, health insurance, transportation or housing, she says.

“The complexity and the need to move upstream into prevention involves community resources and populations to encompass a broader and more prevention perspective,” Guthman says. “We need to address the stigma, biases and policies that exist in our systems that perpetuate the likelihood of people not being able to move forward to make positive changes when they return to the community after experiencing incarceration.

“One of the most important things we can do is to listen, center and hear the voices of those who’ve been directly impacted by incarceration so we can better align our resources and systems to prevent a return to incarceration, but also to prevent people from even having to experience incarceration.”

A passion for nursing and advocacy

UW-Eau Claire’s strong nursing program is among the reasons Updike became a Blugold. However, it was the experiences she had as a nursing student — including the community health research project — that taught her that advocating for those whose voices often are not heard is an important part of being a nurse.

“I’ve been working as a CNA since my junior year of high school, and my very first CNA job is what made me know that nursing was what I was meant to do,” Updike says. “I formed so many great patient relationships with residents at my first nursing home and I found my love of being the light when others are going through hard times.”

To gain more experience in health care during her years as a nursing student, Updike took a job as a personal care assistant at Mayo Clinic Health System in Eau Claire in the inpatient psychiatry and psychology unit.

“This is where I grew a strong passion for addressing the stigma surrounding mental health, addiction disease and incarceration,” says Updike, a native of Platteville who was part of UW-Eau Claire’s University Honors Program. “Participating in this research project was exactly what I was looking for to practice advocacy, which is such an important part of the nursing profession.

“This research project challenged some of my own biases toward incarceration and opened my eyes to the injustice in our system for individuals that are trying to successfully return to their communities.”

Her hope is that the research will inspire more members of the community and health care workers to reflect on their own biases toward individuals who have experienced incarceration and to treat them with kindness and respect.

“It may just save someone’s life,” Updike says of changing attitudes and actions.

Updike says the project has given her even more confidence that she has the knowledge and skills she needs to be successful as she begins her nursing career working on the medical-surgical unit at Mayo Clinic Health System in Eau Claire.

“This research project definitely helped me to work on my advocacy skills and direct the focus of conversations on real-life stories and the voices that need to be heard,” Updike says. “I hope this helps me in my nursing career by advocating for all patients with confidence and their best interest in mind.”

Like Updike, Webster also knew since high school that she wanted to be a nurse and was drawn to UW-Eau Claire because of its excellent nursing program.

“I grew up with some chronic health issues, and the great nurses that were kind, patient and cared for myself and my family made so much of a difference in my life,” Webster says.

As a nurse, Webster hopes to make the same kind of difference in the lives of others. Experiences like the community health research project will help her achieve that goal, says Webster, who will begin her nursing career in a medical-surgical unit in Minnesota this summer but hopes to eventually work in public and/or mental health and to someday teach nursing.

“I gained so much from this experience that will make me a better, more well-rounded nurse,” Webster says. “I bettered my interview and public speaking skills, especially when talking about sensitive topics.  I learned how to consider issues from new perspectives and how to use the nursing process to address these issues. And I learned how to be a better advocate; how to effectively gather and share information to promote change.”

Webster, Updike and other students working on the project say their own stigmas and biases were challenged as they came to better understand people's lived experiences.

They also began to better understand how important it is for nurses to be advocates for those whose voices often are not heard, Updike says.

The student researchers did a phenomenal job in all aspects of the project, from developing questionnaires to communicating with community partners, Guthman says. All those skills will help them be successful in their future nursing careers, she says.

“The students have excellent interpersonal skills and are genuinely interested in helping people overcome the systems' issues and barriers that prevent their successful return to the community,” Guthman says. “They spoke with genuine compassion and concern for people who have had such challenging experiences and situations.”

Next steps

The researchers hope their project will be used in the community to increase conversations around and awareness of the issues surrounding the incarceration system and returning to the community. For change to happen, they say issues like systematic racism, homelessness, poverty, addiction, mental health disorders and employment discrimination all must be part of the conversation.

After interacting with the community groups, Webster is confident that those conversations can grow, and that change is possible.

“The advocates, both with and without lived experience of incarceration, blew me away with their passion and drive for change,” Webster says. “The hope and ambition seen in those trying to promote change for themselves and their community is striking.”

Updike and Webster already have shared their research with community partners and have presented it on campus and at professional conferences, including the Wisconsin Public Health Association Conference and the Association of Community Health Nurse Educators Conference.

While Updike and Webster are presenting the research, multiple UW-Eau Claire nursing students have been involved over three semesters. In addition to Updike and Webster, Blugold researchers included senior nursing majors Devan Oliver, Jami Ruvelson, Hannah Schaetzel and Lili Wagner; May 2021 nursing graduates Kayla Thomas and Nicole Willmus; and 2020 nursing graduates Madison Duellman, Elizabeth Fredrickson and Payton Kaldenberg.

Current and future nursing students may continue to build on and learn from the project as well, Guthman says.