Public Health Nursing Vol. 21 No. 1, pp.
32–40
0737-1209/04
# Blackwell Publishing, Inc.
Essential Concepts in Developing
Community–University Partnerships
CareLink: The Partners in Caring Model*
Henrietta Bernal, R.N., Ph.D.,
Juliette Shellman, R.N., C.S., Ph.D.,
and Karen Reid, R.N., B.S.N.
Abstract University and community partnerships are being
created to increase community-based educational experiences
for nursing students and to assist agencies in facing ever-
decreasing resources to pay for health services for clients.
Many challenges often burden these partnerships, leading to a
less than satisfying experience for all those involved. The Part-
ners in Caring Model described in this article is one approach to
forming a successful partnership, proven effective in meeting the
educational needs of the University of Connecticut, School of
Nursing students, while providing additional resources to the
Visiting Nurse Association of Central Connecticut, Inc. Using
Anderson and McFarlane’s Community as Partner Model as the
framework, the essential principles behind the development of
this successful partnership are discussed. The Partners in Caring
Model demonstrates that community–university partnerships
can sustain themselves when the partners have a commitment
to care for the population being served, and it is a shared
responsibility between education and practice.
Key words: community-based education, community–university
partnership, Partners in Caring.
*CareLink is partially funded by The North Central Area on Aging.
Henrietta Bernal is Professor Emerita, University of Connecticut,
School of Nursing, Storrs, Connecticut. Juliette Shellman is Assistant
Professor, University of Connecticut, School of Nursing, Storrs,
Connecticut. Karen Reid is Director of Public Health Services, Visiting
Nurse Association of Central Connecticut, Inc., New Britain, Connecticut.
Address correspondence to Juliette Shellman, 231 Glenbrook Rd., Unit
2026, Storrs, CT 06269. E-mail: jms821@aol.com
32
A mini-revolution is taking place in nursing education. In
1991, the American Association of Colleges of Nursing
(AACN), at its annual meeting, voted to support the idea
of collaboration between education and practice. ACCN
established the goal ‘‘…that all member schools of nurs-
ing develop collaborative relationships with practice set-
tings to advance the goals of nursing practice, education
and research.’’ (Hegyvary, 1991). More recently, in the
fall of 2000, the AACN hosted its conference in Chicago,
focusing on community-based education. Over 200
schools of nursing were represented, and presentations
focused on the development of community-based curri-
cula. This shift to community-based curricula is endorsed
by nursing leaders and health care organizations (Hegyvary,
1991; Tresolini & the Pew-Fetzer Task Force, 1994).
Colleges of nursing are now experimenting with new
models motivated by leadership organizations, by the
changes occurring in the health care delivery system,
and by funding provided by such organizations as the
Helene Fuld Foundation. With the increased interest in
community-based nursing education, it is time to look at
models that can facilitate the development of these uni-
versity and community partnerships. The purpose of this
article is to describe the Partners in Caring Model developed
between the University of Connecticut, School of Nursing
and the Visiting Nurse Association of Central Connecticut,
Inc. and discuss its underlying principles.
The Partners in Caring Model emerged from the
experience of developing the CareLink project. CareLink
is an award-winning partnership that provides services to

a population of elders by undergraduate and graduate
students. It has been recognized by the Connecticut
Home Care Association with the outstanding leadership
and creative community program award for 1999. This
project arose out of a mutual need for health-maintenance
care for elders who were no longer eligible for compensated
care and the need for improved community-based edu-
cational experience for senior nursing students (Bernal,
Reid, & Shellman, 2000). CareLink was modeled after a
similar project of the Neighborhood Visiting Nurse
Association (VNA) in Chester County, PA (Tucker,
Nester, Gross, & Johnstone, 1996). In the Pennsylvania
program, the idea was to provide students with a more
comprehensive experience, while providing chronically
ill wellness care to patients who were no longer followed
up by the Care to the Sick program of the VNA. Their
experience in developing the program was very helpful
to us. Many adaptations have been made to fit the
needs of our particular community and students.
REVIEW OF THE LITERATURE
A review of the literature reveals a growing interest in the
issue of university and community collaboration/partner-
ships. Some of this literature has identified concepts that
are relevant in any definition of partnership. Henry,
Schmitz, Reif, & Rudie (1992) identified three essential
concepts. These concepts were communication, commit-
ment, and credit. The authors point to the centrality of an
open communication system, the need for commitment of
time and resources. They also report the need for both
physical and emotional commitment, as well as the
importance of establishing ground rules for ownership
of data and other products. Sebastian, Davis, and
Chapell (1998) identified seven principles in good partner-
ships. These principles included concepts of trust,
commitment, respect, genuineness, and accessible com-
munication. Sylvester, McTavish, and Taranki (1998)
identify equity, communication, responsiveness, and sus-
tainability as key concepts in the development of their
partnership model.
The literature also reveals that partnerships oftentimes
have problems with long-term sustainability. There are
historical tensions that have existed between university
and community relationships (Tresolini & the Pew-Fetzer
Task Force, 1994). The need by universities for educa-
tional sites, research subjects, and field sites has not
always been in the best interest of communities. While
well intentioned, many of these relationships have ended
poorly, leaving the community feeling ‘‘used’’ and
‘‘abused.’’ It is not surprising that many of the problems
that have arisen between universities and communities
Bernal et al.: CareLink: The Partners in Caring Model 33
involved minority and vulnerable populations. These
populations have felt unequal in these partnerships, lead-
ing to suspicion and caution brought on by time-limited
projects lacking long-term sustainability.
Examining the theoretical underpinnings and principles
of CareLink will demonstrate how this partnership has
sustained itself through the challenges and changes that
often burden these relationships.
CONCEPTUAL DEFINITION: PARTNERSHIP
A partner, according to Webster’s Dictionary, ‘‘is one
who shares; a partaker, a colleague; either of a couple
who dance together.’’ A partnership, according to the
same source, is ‘‘a relationship resembling a legal partner-
ship and usually involving a close cooperation between
parties having specific and joint rights and responsibil-
ities.’’ The essential idea in this definition is that of shar-
ing and joint responsibility. Both parties, while coming
from a different context, share an interest that allows
them to work together for their mutual benefit and, in
the case of nursing, for the ‘‘larger good.’’ The image of
dancing together is particularly apt to illustrate the point.
In dance, both individuals have to be in tune with each
other’s moves and be synchronized and aware of each
other’s ‘‘steps.’’ As a result of this joint sharing, the
dance itself transcends the individual partners, and its
beauty depends on how well the dancers move together
and understand each other. Many times in community–
university partnerships, the dance is difficult to master.
There are missteps that occur in the development of
these community–university partnerships that create ten-
sion and result in a disjointed dance.
THE PARTNERS IN CARING MODEL
The Partners in Caring Model has three major constructs:
(1) knowledge of the community, (2) the culture of caring,
and (3) an open communication system. The central the-
sis of the model is the creation of a partnership whose
commitment to the population being served is para-
mount. The starting point for the model was Anderson
and McFarlane’s Community as Partner Framework.
According to Anderson and McFarlane (1996), there is
a reciprocal relationship between the people in a given
community and eight-community subsystems. These sub-
systems are the physical environment, economics, educa-
tion, safety and transportation, politics and government,
health and social services, communication, and recre-
ation. The subsystems are influenced by the residents of
the community and, in turn, affect the people in the
community. The second component, the nursing process,
34 Public Health Nursing Volume 21 Number 1 January/February 2004
involves the analysis of assessment data of the eight sub-
systems, leading to a community health diagnosis with
subsequent planning of appropriate interventions. These
authors evolved their model from viewing the community
as a client to viewing the community as a partner. This
was an important leap in our conceptual thinking and one
that we adhere to and support with enthusiasm.
In the CareLink partnership, the VNA represents the
community insofar as its very diverse programs are linked
directly to the community they served. The VNA,
through its partnerships with social agencies, neighbor-
hood leaders, governmental agencies, etc., is the hub of
the wheel, as described by McFarlane and Anderson.
Their continued assessment of the needs of the commu-
nity and populations served by their many programs led
them to conclude (arrive at a nursing diagnosis) that there
were needs for wellness and chronic care services for a
vulnerable elderly population.
Complementary to this assessment was the work car-
ried out by graduate students using the Community as
Partner Model to assess the community and the elder
population at the onset of the CareLink project. A well-
ness inventory was used to gather data from an elderly
population to identify unmet needs. In addition, a profile
of the community was developed using secondary data
from census and health statistics. The profile of the com-
munity revealed a large blue collar retired population that
was culturally diverse and limited in its ability to pay for
services beyond those allowed by Medicare. The wellness
inventory identified many unmet health-maintenance and
chronic illness needs.
The key intervention developed as a result of the assess-
ment involved undergraduate nursing students in the
delivery of health services to this population under the
supervision of an onsite clinical instructor. These nursing
students have provided home visits, health assessments,
health teaching, monitoring of chronic illnesses, referrals,
and telephone support to over 400 older adults in the
community. At the same time, the students have met all
of the objectives of the community health nursing course
and have expanded their view of community as a partner.
A major assumption of the Partners in Caring Model is
that the creation of a culture of caring will provide the
best learning experience for students, regardless of the
curriculum model being implemented. Creating a culture
of caring was facilitated by choosing partners who share
similar values, beliefs, and goals. This included the belief
in the centrality of caring both for the clients and for the
students. The overriding value has been the creation of an
environment of support for students that helped them feel
part of a valued and important undertaking. From the
start, they were helped to take ownership of the caseload
and pride in all aspects of their experience in CareLink.
The faculty, through joint visits and pre- and post-visit
contacts, modeled a caring process both for the client and
for the student.
The culture of caring is maintained through an open
communication system that utilizes formal and informal
methods of communication between all of the parties.
Continuous and open communications engender trust in
each other and allow change and expansion to occur with
minimum distress. Students have many opportunities to
provide both informal and formal feedback, and their
input becomes part of the decision-making process. For
example, as the program has grown, there have been
increased demands for assessments and recording. Stu-
dents have noted this, and adjustments have been made in
the number of home visits that they are expected to make.
While many students are able to make four visits in each
clinical day, this is not always possible, and a more flex-
ible approach has been taken.
Seven principles form the underlying structure of the
Partners in Caring Model. Both the literature and our
experience have provided the support for these principles.
These are discussed in detail with illustrative examples
from the CareLink project.
ESSENTIAL PRINCIPLES OF THE PARTNERS IN
CARING MODEL
Develop Partnerships Based on a Solid Personal and
Professional Relationship. Choose Wisely
Many times, out of necessity and due to time constraints,
universities enter communities with a commando raid-
type mentality. They do not have a firm foundation for
building a sound partnership and choose agencies based
on expediency. Promises are made that are impossible to
deliver, and unrealistic expectations emerge on both sides
that usually lead to trouble.
In CareLink, while many VNAs and communities
could have been approached for the project, the Visiting
Nurse and Home Care Agency of Central Connecticut,
Inc. was contacted for several reasons—a thorough
knowledge of the community and the agency by the first
author, a sound past working relationship with the prin-
cipals involved at the VNA, and a close personal relation-
ship with the former president of the agency that
facilitated contact and openness to the idea. Very impor-
tant to our needs was an agency that had maintained a
diverse service portfolio that included not only home care
services but also very dynamic public health programs.
The same applies to understanding the services and
organizational structure of the partner or partners

involved (Kataoka-Yahiro, Cohen, Yoder, & Canham,
1998). This can only be done through participant obser-
vation, spending time in the agency, and becoming
known and trusted within that environment. Those per-
sonal relationships will become the bridges that form the
strong links in the partnership (LeCompte, Schensul,
Weeks, & Singer, 1999; Mintzberg & Gouberman,
2001). These are time-consuming activities and, more
likely than not, have to be done on the instructors’ time.
Becoming involved in community boards and committees
in the agency are all-important activities that cement the
relationship but do call for the expenditure of additional
time and effort. Universities need to be more enlightened
about the importance of this work and reward these
activities accordingly (Tresolini & the Pew-Fetzer Task
Force, 1994; Mintzberg & Gouberman, 2001).
Entry into New Communities has to be Guided by Sound
Principles of Fieldwork. See It, Feel It, and Think It
A thorough knowledge of the community is of import-
ance, because to provide the most meaningful experience
to undergraduate students requires broad exposure. It
requires geographical and infrastructure understanding
of the community along with population characteristics
to ensure sound planning and a safe learning environ-
ment. In community health, this is a major responsibility
of the clinical instructor and cannot be based on hearsay
but on sound fieldwork. Collecting statistics and data
about the community and meeting with key informants,
gatekeepers, and stakeholders in the community are
essential aspects of this work.
The central partnership with the VNA led to side
agreements and partnerships with other agencies and
groups in the communities, including two large senior
centers, the health department, a school system, aggregate
housing, neighborhood agencies, and churches. In each
case, relationships were built from our central partnership
and drew on the goodwill that the agency enjoys in the
community.
There Must be Continuous Opened Communications and
Mutual Planning. Keep No Secrets
Volumes have been written about the importance of an
open communication system in any relationship. The
literature reviewed is clear on the importance of this
concept. Central to this communication process is the
need to respect other’s viewpoint and ideas. The view
that those with the higher degrees or titles coming from
the university hold all of the knowledge can be a deadly
blow to any successful community partnership. The
majority of times these attitudes are reflected not in
Bernal et al.: CareLink: The Partners in Caring Model 35
overt behaviors but in subtle acts of omission and exclu-
sion that to communities raise red flags. Examples of
these types of behaviors abound, e.g., not communicating
about meetings with others in the community, not sharing
in publicity of the program, not taking turns in the leader-
ship position at presentations, not inviting the community
participants to be copresenters, joint authors in articles,
and not communicating about curriculum changes.
In our relationship, a minimum of one meeting per
week was set up for the three principals to communicate
and share ideas, formulate plans, work out logistics, and
solve problem. Mini-retreats were held at the end of each
semester to review the progress of the program and to
consider plans. It was during these mini-retreats that we
created ideas for grants and new services such as the
Youth-Link and Pet Therapy programs. All presentations
have been a shared endeavor, whether they were in state
or out of state. Public relations works, such as TV
appearances, were jointly presented. In the final analysis,
however, it has been the continuous informal communi-
cations based on mutual trust that has kept the program
on a sound footing.
The lines of responsibility were clear from the start.
The faculty had as their main role, the learning of the
students; the agency, service to the CareLink clients. It,
however, was also true that both partners participated
and influenced each aspect of the program. Key to the
success of our communication process was the organiza-
tional structure that was developed (Fig. 1) and the piv-
otal role played by the coordinator. The coordinator has
responsibilities both to the university partner and to the
VNA. He/she is a clinical instructor and supervises one of
the university’s senior clinical groups in the agency and is
also hired by the agency to coordinate the case manage-
ment aspects of the program and to serve as a liaison to
other schools of nursing involved in CareLink. While
there is always potential for role confusion and stress in
these shared roles—and this did occur at various times—
it was the open communication and availability of the
other two members of the team that allowed for clarifica-
tion and adjustments to take place.
Most of the communication discussed thus far has been
geared toward horizontal communication within the
organizations involved. Critical to the survival and sus-
tainability of the partnership is an engaged and com-
mitted administration both at the university and at the
agency level. Many programs fail because they are invis-
ible to the stakeholders and gatekeepers. In our situ-
ation, there has been continuous effort to keep our
respective colleagues and administration informed and
engaged in the process. This has included formal and
informal presentations, poster presentations, creating a
36 Public Health Nursing Volume 21 Number 1 January/February 2004
VNA
Coordinator
Carelink
Coordinator
Clients
Community
Figure 1. Partners in Caring Model Organization.
web information page for the school of nursing website,
publications in both organizations newsletters, etc. It is
important to understand the political realities of a part-
nership and its vulnerability to change.
The Mission and Goals of the Partnership have to be Clear
and Based on a Strong Mutual Commitment to the
Population Served. Keep an Eye on the Ball
Partnerships can get mired in the business of running
programs, logistics, procedures, legalities, and con-
straints. While smooth running of the programs does
depend on developing sound procedures, such as a refer-
ral process, the ultimate goal must always be patient care.
When this commitment to care permeates all of the think-
ing and planning, it becomes evident in the behavior of
those involved—it is translated to students and to the
population served. In our case, the population is elderly
with a mean age of 76. Most of the population (80%) live
alone and are female (67%). They are generally chronic-
ally ill individuals who are no longer eligible for com-
pensated care under third-party payers.
While ultimately the VNA is responsible for the case-
load, it is the nursing students and instructors who, with
the coordinator, manage the caseload. Regular VNA staff
refers cases that are discharged from care to ill services
and felt to need health-maintenance services. In turn,
staff takes referrals back from CareLink when acuity
levels change. Additionally, other VNA staff such as a
diabetes educator, social workers, or physical therapists
act as consultants to the students and faculty. Post-
clinical reports are always given to the VNA partner on the
team. This becomes an additional opportunity to discuss
UConn
Coordinator
Students
Undergraduate
Graduate
Ph.D.
the management of cases and obtain his/her expert clin-
ical input and wide knowledge of community resources.
The culture of the program is defined by the high value
placed on delivering the best care possible to our patients.
This is enhanced not only by the lack of third-party
restrictions but also by the beliefs and values of the team.
Partners Should be Committed to Assimilating Changes
While Keeping the Core Values of the Program Intact.
Don’t Sell Out
Change is inevitable. Curricula in nursing, either by
necessity or by design, are always undergoing changes.
Agency and communities are always under one more set
of restrictions that affect services. For example, personnel
changes may occur or new program ideas create expan-
sion. At one level, there is tendency to protect what has
worked well and not change anything—‘‘If it is not broke
don’t fix it.’’ Many of the changes that occur, however,
may be out of the range of control of the parties involved.
Furthermore, programs that do not respond to change
may grow stagnant and redundant. Regardless of the
pressures to change directions, expand, or alter the pro-
gram, however, the core values and beliefs about the
central idea need to be protected. The bottom line has
to be how will the changes affect patient care and the
learning of students.
Our program has been able to incorporate new ideas—
some have worked, some have not. For example, teaching
students to facilitate reminiscence with their clients, a
program initiated by the second author as a master stu-
dent, has been a resounding success. The Pet Therapy
program, while a very worthwhile idea, however, failed
 Bernal et al.: CareLink: The Partners in Caring Model 37

TABLE 1. Sample Student Evaluation Responses in the CareLink Project

‘‘Carelink was a very positive experience. As a student nurse I was able to establish a level of confidence in my assessment skills,
perform patient teaching, and use reminiscence where I was able to establish trusting and therapeutic relationships with my clients.’’
‘‘I feel that I have gained so much from the experience with my clients. In addition to enhancing my nursing skills, I was able to
establish relationships with my clients. I became very concerned for their needs and advocated for them in so many ways.’’
‘‘The Carelink Program is a wonderful opportunity for students to grow as nurses, both professionally and personally. The hard
work and long hours provided rewards beyond measure.’’
‘‘I believe the Carelink Program is a tremendous benefit to the elderly. I feel that the CareLink clients would agree strongly with this
statement. From this experience and what I have seen, they are just as grateful to have us as we are to have them.’’
‘‘My experience in the Carelink program has taught me that if a client has faith in you as a practitioner, a lot can be accomplished.
So, take the time to build a relationship, because without it you have nothing.’’
‘‘This semester has been an incredible experience for me. I never thought that our participation would actually impact our clients,
but in fact I believe it had a tremendous impact. I learned so much from this experience and will carry this knowledge with me
forever.’’

because of all of the logistics and legalities of bringing
pets to people’s home using existing resources.
Some changes may appear to threaten the partnership
as originally constituted and give anxiety to one or both
of the partners. In our case, the primary relationship, as
stated earlier, was between the University of Connecticut
and Visiting Nurse Association of Central Connecticut,
Inc. Two senior student groups, totaling 20 students per
semester, have been able to see all of the clients during the
academic year. While this worked very well during the
academic year, however, summers were left uncovered.
This necessitated exploring other nursing programs that
offered summer student clinical experiences. One school of
nursing responded initially, St Joseph’s College, and their
students have been instrumental in providing care during
the summer. Yale University students have also joined the
St Joseph students in the summer. Thus far, these new
affiliations have not created any discord with the partners.
This has been due to the aforementioned organizational
structure, open communication, trusting relationships, and
commitment to patient care. The patients needed care in
the summer and that is what dictated the expansion—not
who was going to lose control or identity. Issues of owner-
ship of the idea and who has the right to move in a
particular direction are tricky, but ultimately, patient and
student needs must take priority.
There Needs to be a Commitment to Evaluation. Don’t be
Afraid to Look!
Evaluation strategies
Many times, in such partnerships, the university is inter-
ested in data, research, and publication, because it is in
the mission of the institution that faculty are required to
pay attention to these issues. Community partners do not
always consider research and data in the same way. Their
needs are usually much more pragmatic. Both the
research and data have to be directly relevant to their
work. It, however, has been shown that communities can
be engaged in conducting and applying research when
they have been part of the process from its inception
(LeCompte et al., 1999). The challenges are seeking and
obtaining funding for research that has relevance to both
partners. In the case of nursing, the most relevant area of
inquiry in these partnerships is to look at patient care
outcomes or outcome evaluation.
In CareLink, multiple approaches have been taken to
conduct program and student evaluations. From the pro-
gram perspective, data have been obtained using patient
interviews, observation, case studies, community assess-
ments, and record audits. A statistical data sheet that
provides the program with patient utilization data is
also part of the data-gathering system. The patient
record, with its various assessments and screening
forms, provides valuable patient data. A central part of
the database is the wellness inventory that is completed
by students with each new client admitted to the program.
The wellness inventory is entered in a computerized data
management program.
Student outcomes are assessed using a variety of
methods—rating scales, open-ended questions on evalu-
ation forms, and clinical evaluation tools. Student journals
are summarized to obtain the essence of the students’
lived experience. We have an overwhelming response
from students and clients about the program. Our student
evaluations have consistently been in the excellent range
(4.5 on a 1–5 Likert scale rating, with 5 being the highest
satisfaction score), while clients have evaluated the
program very positively both in formal and in informal
feedback. One of the most telling student behaviors has
been their willingness to consistently stay after the official
clinical day is over to complete their work, to be in contact
with clients between visits, and to ask about follow-up
38 Public Health Nursing Volume 21 Number 1 January/February 2004
TABLE 2. CareLink Program Outcomes
Number of clients served
Number of students educated
Number of home visits made
Equivalence to billable skilled nursing visit
Yearly program costs
Referrals back to the VNA
with their patients from instructors. It is common for
students who are in the program to want to be in contact
with their clients after the semester is completed, due to
the close bond they have developed with their clients. Their
journals are full of descriptions that give evidence of this
commitment and the ownership they feel toward their
clients (Table 1). As instructors, we have been surprised
at the ease with which clients have accepted new students
as semesters change. Partly, this has been due to the
consistency of instructors who have become well known
to the long-term clients through joint visits with students
and follow-up visits and because the way the clients are
oriented to the program and prepared for these changes
to take place.
Data utilization
Through the analysis of these data needs, identification
has taken place, resulting in program development.
Graduate students have been an integral part of the
program-development work. Needs such as loneliness
and depression have been addressed by developing
reminiscence—Pet Therapy and Youth-Link programs.
One of the record audits done revealed a 15% fall rate
among our caseload. This led to the development of a
fall-prevention program by the Yale students. In addi-
tion, a nutritional assessment was carried out with a
nutrition-screening tool to identify at-risk individuals,
and a nutritionist presented an in-service program to the
students to assist them with their interventions.
The utilization data (see Table 2) gathered through the
visit data form are entered into the data management
program. The amount of service provided was consider-
able, and among the benefits to the VNA are the referrals
that are made back to the care of the sick program.
The agency is able to sustain this population in its network
and not lose clients to other competing home care
agencies.
One patient-satisfaction study was carried out by one
of the graduate students using face-to-face random inter-
views with a sample of the caseload. The results were
gratifying and gave us some indication that we are on
1999–2000 4-year estimate
105 420
47 173
682 2728
$59,334 $240,000
$14,045 $56,180
15 60
the right track as far as the consumer of the service is
concerned.
Grants have been written, and small pockets of funding
have been found to expand the program to other popula-
tions served by the agency and to provide outreach to the
minority groups. This has resulted in screening and other
outreach activities with ethnic neighborhoods and churches
and has provided students with a great community health
experience. The largest challenge is in designing and obtain-
ing funding for a patient outcome evaluation program. This
is under development as this paper is being written and will
be our focus for the near future.
Our case data provides ample evidence of the impact
that the students are having on the well-being of the
patients, and our filed observations support these data.
Our challenge is to provide the measurable outcome data
that lend further support to our observations.
The Continuation of the Partnership Requires Persistence
and Perseverance by all Parties Involved. Don’t Give Up!
It is not unusual in such partnerships to experience doubt
and anxiety over the ability to carry out the program.
What seems like a great idea can also appear as an over-
whelming challenge when you start to plan out the logis-
tics and the nitty-gritty of the program. The original goals
may seem too lofty or unrealistic, difficult to implement,
and too time consuming. It is easier at this point to
‘‘chuck it all’’ and blame time constraints and lack of
resources than to struggle through each problem and
find alternatives solutions. Individuals who attempt
these partnerships need to be flexible, while being deter-
mined and persistent in their effort.
In CareLink, we were reassured by the fact that the
program was based on the experience in Pennsylvania.
Agency representatives visited the program and were
generously given all of the information the Neighborhood
VNA had about their program. While others’ experiences
can alert you to potential problems and issues, ultimately,
every situation is different and challenges have to be
worked through based on local realities.

We started with the idea of providing wellness care. We
soon, however, realized that our clients with their multiple
chronic illnesses were facing not just issues of wellness,
but health-maintenance problems as well. Jeglin-Stoddard
and DeNatale (1999) describe a similar experience in their
project, as they discovered the need to serve the growing
chronically ill population. Our challenge became how to
incorporate health maintenance within health promotion,
based not only the wellness inventory but also on the
challenges faced by patients as they tried to manage
their chronic illness and functional limitations. Our first
year was somewhat chaotic and less than satisfying, as we
struggled with not only our overall model of care but also
with records, referrals, and student motivation. We could
have easily given up after that first year but knew that the
idea was sound, the client need was there, and there was a
great learning opportunity for the students.
Challenges were also faced when we saw the need to
outreach to minority populations. Reaching out to our
key informants and developing relationships with
churches and neighborhood groups were time consuming
but a very good experience for the students. A bilingual
graduate student and several bilingual undergraduate stu-
dents conducted outreach and screening services in
Spanish-speaking neighborhoods, which resulted in an
overwhelming response from a population that had pre-
viously not participated in these services. More bilingual
students are asking to be placed in this program, and we
are able to continue the outreach services. Evening blood
pressure screenings in an African-American church
resulted from the relationship established with the minis-
ter of the church. At any point along the continuum, it
would have been easier to say, ‘‘No, we cannot take this
on.’’ Because of our commitment to caring for our clients,
however, we looked for alternatives and possibilities, and
in most cases, we have found solutions.
Another challenge we faced was how to incorporate
research into the program. One of our colleagues from
the university asked us to help field-test a computerized
self-learning medication module for elderly clients. The
goal of this program was to prevent over-the-counter drug
interactions in older adults (Neafsey & Shellman, 2002).
While we hesitated at first because of the logistics involved,
we also saw it as a great teaching and learning opportunity
for our clients and for our students. The program has
become part of the teaching that students conduct in the
patient’s home with their medication regimen.
CONCLUSIONS
Nursing education is being challenged to increase the
community-based education of its students and commu-
Bernal et al.: CareLink: The Partners in Caring Model 39
nities, and health care agencies are facing ever-decreasing
resources to pay for health services. University and com-
munity partnerships are being created across the country
in an effort to meet these challenges. The Partners in
Caring Model is one approach that has proven to be
effective in meeting the needs of the University of Con-
necticut for better community-based experiences. At the
same time, it has provided additional resources to the
Visiting Nurse and Home Care Agency of Central Con-
necticut, Inc. to service elderly and chronically ill clients
no longer eligible for compensated care.
The essential concepts of the model, as well as the
principles described, are supported by others (Henry
et al., 1992; Sebastian et al., 1998; Sylvester et al., 1998).
A pattern seems to be emerging on the centrality of such
concepts as open communication, sharing of power, and
commitment to and trust on the development of partner-
ships that work and are sustainable. Our Partners in
Caring Model adds one important component—the
creation of a culture of caring that permeates all aspects
of the partnership. It is our belief that nursing education
is most relevant when commitment to care and ownership
of that care is not simply the responsibility of the practice
setting but a shared responsibility between education
and service. Nursing educators need to be creative
(Hall-Long, 1998) and design experiences that best
model our most cherished nursing values. Therefore, nur-
sing instructors should be active players in creating
patient care environments/experiences that promote and
sustain our beliefs in the centrality of patient care.
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