Kiley Petersmith
Good health doesn’t start in a hospital.
“We know through research that 80% of our health is dictated by the factors outside the four walls of the hospital,” said Kiley Petersmith, registered nurse, MSN, doctor of nursing practice. “Yes, critical care at the bedside is important, but we need to bring more preventative care into the community where the patients live and address the problems they are living with, instead of waiting for them to arrive sick at the hospital.”
The ingredients for a healthy life start with the basics — access to food, shelter, water, education and transportation. Digging deeper, one could say critical periods throughout our life make us more vulnerable to the long-term health impacts, starting in utero and continuing through childhood. Adverse childhood experiences have been strongly correlated to chronic disease as adults, said Petersmith.
In her current position as the director of the center for diversity and community engagement at Nebraska Methodist College, Petersmith is addressing the community’s health needs by bringing accessible health care to those in need. A former ER and ICU pediatric nurse, Petersmith said her experience working with patients over the years shifted her mindset from bedside care to community-based care.
“I saw how our nation’s health care system creates barriers for large groups of our population,” she said. “Things like access to health insurance and the ability to afford the cost of procedures not covered by insurance, access to healthy food, exercise and green spaces. We even need to look at how pollution and proximity affects those spaces. I always tell my students that adverse childhood experiences will dictate our health as adults.”
Petersmith, a nurse for 14 years, vividly recalls the young child who died from an asthma attack in the ER, a consequence of not having access to a rescue inhaler due to affordability and accessibility barriers. To this day, she reflects on if this child had access to an inhaler rather than a home nebulizer, or if barriers could have been broken down, if the child's outcome could have been different.
“For me that was a life-changing moment. Here I was thinking I was a hero saving lives in an ER unit and despite doing everything in our power, I felt like a failure,” Petersmith said. “It was in this moment I realized we needed to start moving to prevention, understanding how the environment we live in affects our health, and breaking down barriers that exist for children and families.”
Kiley Petersmith receiving her Heart of Healthcare award
Determined to be part of the change, Petersmith, who had always dreamed of becoming a nurse and a teacher, accepted a teaching position at Nebraska Methodist College where she herself is a three-time graduate.
“My goal was to integrate more community-based healthcare into the curriculum across the board for these future healthcare providers,” she said. “We needed to make the learning more impactful so that students could see where patients come from before they arrive at a hospital. It’s much more expensive to meet patients later in their life cycle when they’ve already been diagnosed with diabetes. Our healthcare needs to target prevention and not just the treatment of a disease.”
So Petersmith oversees mobile health outreach programs, which provide health screenings, flu and COVID-19 vaccines, assessments, education and referrals to individuals in urban and rural communities throughout Nebraska and eastern Iowa. The mobile units, which consist of the Mobile Diabetes Center and a mobile sprinter van, are staffed by NMC students, faculty and alumni. In 2023, the units tallied 13,000 community volunteer hours and served 8,375 people.
“It’s critical for frontline public health workers to understand the values and cultures and experiences of the communities in which we work,” Petersmith said. “That’s how you develop trust with individuals, in their own environment, rather than waiting until they walk into the ER with an emergency.”
When working with students at the mobile unit, Petersmith helps them understand how to better communicate with children, work with interpreters and translate instructions when clients don’t speak English, inquire about an individual’s access to food and medical care, including if they have a home to live in, among many other topics.
Her dedication and commitment to the profession is why Petersmith was recently recognized as a recipient of a Nurses – Heart of Healthcare award. The nominees underwent a voting process by a committee of nursing administration and faculty members at Clarkson College.
“Nurses put in long hours and often work in very vulnerable conditions,” Petersmith said. “I’m very thankful for the recognition and know that everyone receiving this award is very deserving.”
