Jamaica, Day 3

Hello! 
Today we had two sites on deck; Blossom Garden’s Children’s Home and the Church Street Police Station!

At the Blossom Garden’s Children’s Home, nursing students spent time playing with and giving some well needed TLC to the children in the home’s care. Students could be found playing jump rope, tag, or just sitting and cuddling with the home’s 30 or so children ages 2-10. Students remarked that, while troubling that such a place must exist, there was a radiance and warmth exhibited by the children and staff that was infectious and uplifting. A fantastic start to the day.

Next, we were on our way to the Church Street Police Station to provide blood pressure, blood sugar, and BMI screenings for the staff. A highlight of this site visit was having all the students cheer on one of the men who was afraid to get stuck for his blood sugar and a little girl who was very excited to receive reading glasses in her goodie bag.

A late dinner at an Italian restaurant on the resort topped off the evening leaving everyone full and tired. 

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Grady Hospital – Day 1

First off, I’m grateful for the opportunity to be part of the Grady immersion experience. This trip provides the unique opportunity to work with a specific patient population within the local Hispanic community: undocumented individuals suffering from end stage renal disease.
Today our group started the morning with a tour of Grady, including the emergency, trauma and dialysis units. Afterwards, we had a group huddle to discuss the pre-experience assigned literature we read. The intersection of healthcare and government policies, specifically access to health care services for undocumented immigrants, was the key topic.

To offer a brief recap, individuals from this population cannot qualify for government health insurance and, often, cannot afford private health insurance. Without insurance, they cannot receive the routine dialysis treatments they need to survive and maintain a decent quality of life. However, no one can be denied emergency health care services in the United States. Undocumented immigrants must therefore wait until their condition worsens to the point of crisis and then report to the emergency room for dialysis treatment. While this loophole offers some hope, it severely impacts the quality of life these individuals are able to have. Grady has sought solutions to this issue while staying within bounds of current policies.

After our roundtable discussion, we went to the dialysis unit and met with some of the patients and staff. We broke into groups of three and met with individual patients, asking them general questions about their day-to-day lives and current health issues. One of the other topics we discussed during our roundtable was patient adherence to the renal diet. Patients in end stage renal disease have to avoid certain potassium-rich foods, in addition to other dietary restrictions. Adherence to the diet is an issue within all populations, but I wondered if there were cultural-specific reasons within the Hispanic community.

I asked the patient we interviewed, a man in his mid-40s who has been receiving dialysis treatments for six years, what he thought the reasons were behind non-adherence. He explained that economic barriers were a factor because many families couldn’t afford the healthier foods they were suppose to eat. He also said it was very difficult for one person to maintain a specific diet when they lived with many people who did not follow the diet. I also asked him what the morale was like between the Hispanic patients and the health care staff. He replied that, just as it is everywhere, some people were kind and some were not. When asked if he believed there was trust between the two groups, he said “no.”

Why is there a perceived lack of trust? It could be because these patients and the health care providers aren’t able to establish routine schedules and, therefore, are incapable of building the same kind of relationship that insured patients are able to have with their health care team. It could also be due to burn out within the health care staff, who are faced with a large patient population, a lack of consistent scheduling and staff shortages. Or, perhaps, the lack of trust is related to the fear undocumented individuals have of any agency that is driven by government policy. It’s difficult to say, but it may factor in to the issue of diet non-adherence. Are we more likely to take diet advice from someone we trust, like our family and community, or from people we barely know?

Our interview concluded and, as we prepared to leave, I told the patient “nos vemos el jueves.” (We’ll see you on Thursday.) He responded automatically, “primero Dios.” (First God.) This is a common response, as Latino communities’ concept of time is oriented in the present. They don’t worry about the future, but rather live for today.

“Hay más tiempo que vida.” (There’s more time than life.)

Que Dios los bendiga,

Ginger Rodriguez

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Jamaica Days 1 and 2

By Carly Whalen

Greetings from Montego Bay, Jamaica!

Our group of 15 Nursing Students arrived in Montego Bay on Saturday, January 5th. We were greeted by both warm weather and the warm smile of our driver for the trip, Willie! Wiped from the trip, student nurses and faculty enjoyed a quick dinner and were in bed early.

The next day, we visited the New Testament Church of God in Montego Bay. We were greeted by the joyful faces of the minister and his congregation. Word of our arrival spread like wildfire, and people from all over the surrounding area flocked to the church to have us take their blood pressure, blood sugar, calculate their BMI, and to receive education on diabetes and hypertension. We quickly set up stations for people to flow through, and almost immediately had an efficient and effective way to manage the large volume of people who sought our care. By the end of the day, we had seen 70 members of the community, both adults and children.

In debrief, we talked about seeing many similar health problems that face Americans in this population. We identified that the Jamaicans we encountered were concerned and informed about their own health, asking us very pointed and specific questions about diabetes and hypertension, as well as management of co-morbid conditions. Additionally, we were amazed at the values of patience and generosity exhibited by the community. The wait times to see nurses at the education station were long at some points, and there were times blood sugars or blood pressures needed to be taken twice, yet no one complained about the wait or the extra time. Additionally, the congregation provided us with a local staple known as patties; after a long day of work these were greatly appreciated and received with enthusiasm!

A great start to a week of service!

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A celebration of achievement at Winter Awards 2018

By Andy Goodell
Communications Manager, Nell Hodgson Woodruff School of Nursing

Hundreds of family members, friends, and fellow students celebrated the achievements of ABSN, DNP and MSN students during the 2018 Winter Awards at Glenn Memorial Auditorium.

These students joined the more than 7,600 Emory nursing alumni worldwide who proudly call themselves Emory School of Nursing graduates and are making meaningful differences in the lives of individuals throughout the world.

Student speaker, Rachel Branton, urged students to remain courageous and confident in their abilities to serve others.

“We have just graduated from the number three nursing graduate program in the nation. The sky is the limit,” said Branton.

DNP student speaker, James McLeod, noted that he was proud to be among such talented nurses at the MSN/DNP Winter Awards.

“Tonight is a celebration of hard work, new friendships, and marks a milestone for us at various stages of our careers,” said McLeod.

ABSN class speaker, Kiah Ford, said some students would go on to work in their first bedside jobs and others will continue on with masters programs. But regardless of where they end up, Ford knows they will be successful.

“All of our backgrounds have come together to form an amazingly talented group of nurses,” said Ford.

Much like Ford, student speaker, Jamie Quinlan, said she has very high hopes for the future of her cohort.

“I cannot wait to see the remarkable things that each of my classmates will accomplish in the future,” said Quinlan.

2018 WINTER AWARDS RECIPIENTS:

MSN

  1. Award of Excellence – Kimberley Spence-Jensen
  2. Excellence in Collaboration – Tomi Ojeniyi
  3. Excellence in Social Responsibility – John Stanton
  4. Excellence in Innovation – Danielle Bulinski
  5. Excellence in Leadership – Kara Slavoski

MSN Silver Bowl – Tara Noorani

DNP Silver Bowl – Sharon Vanairsdale

MSN Heart of the Students Award – Dr. Phyllis Wright

ABSN

  1. Award of Excellence – Kiah Ford
  2. Excellence in Collaboration – Casey Detwiler
  3. Excellence in Social Responsibility – De’Von Cross
  4. Excellence in Innovation – Allie Schlitz
  5. Excellence in Leadership – Katherine Tipton

ABSN Silver Bowl – Case Nafziger

ABSN Heart of the Students Award – Dr. Ann Horigan

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Population Health students provide recipe ideas for busy families

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Clinical experiences in Haiti leave lasting impression

Photo by Kaitlyn McGregor

By Samantha Stacks

We are back from completing our last clinical day in Haiti, sitting around the table in the Foundation for Peace Compound yelling over the noise of a generator while playing Uno. Any hope we had of adapting to the Haitian climate has been lost, we still all are sweating, but we also appreciate the warm breeze.

Our final day operating the clinic in Bousquet went shockingly smooth. Of course, on the last day, we worked out all the kinks. We had triage nurses arrive early to have patients’ vitals taken and chief complaints known before being seen. For those who were waiting, we had patient education sessions running on a myriad of topics such as hygiene, stretching, hydration, hypertension, women’s health, and eye problems, just to name a few. I helped stock and run the pharmacy along with Ben, an FFP staff member, filling prescriptions and troubleshooting when we ran out of stock. Every patient today was so gracious and friendly, thanking us for our work. We all thought the day went better than any of us could have hoped.

Now, we are back, bags packed for the flight home tomorrow, with some time to reflect on the whirlwind that has been the last nine days. Even though this was a very unique population for all of us to practice with, I get the feeling that we all are leaving with sentiments similar that we would have towards patients back home. We hope that their conditions improve, we hope that they will take their medications as prescribed, we hope that they will take into consideration the advice we have given them to help prevent future illness. Tonight, the group discussed what we would take back with us from our trip. Top of the list were things like patience, posativity, humility, new friendship, and an appreciation for diagnostic tools.

We have learned so much from our time here. Working with translators has made us more cognizant of our wording and phrasing of questions; slowly uncovering Haitian culture and religious practices has opened our eyes to the complexity of treating both body and spirit. While treating individual patients every few months is just a drop in the bucket for all that needs to be done in Haiti, getting rid of a woman’s UTI or a baby’s ear infection does create real change in patients’ quality of life. We leave here knowing that however small the contribution, we have made a difference.

And just an update on this Uno game (I know you’ve been on the edge of your seat), its been 3 hours and still going strong (with two intermissions). We hope the effects of our work here this week will be as never ending as this game.

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Lessons from Koray

Photo by Crista Irwin

By Samantha Stacks

Monday we visited a village that Foundation for Peace had never been to before, Koray. This was a last minute addition to our schedule and we didn’t quite know how many people to expect. Despite this being an unexpected visit, we had a crowd awaiting us as soon as we stepped off the bus.

We quickly got our stethoscopes and other supplies ready to begin the day and dove into seeing patients. This was our 5th clinical day and we definitely had learned a thing or two along our trip. Our excellent triage team and pharmacy were working efficiently and the nurse practitioner students had learned by this point what questions were best to ask to aid in diagnosis.

There were many of the same problems we had seen in the past week such as back pain, worms, vaginal infections, staph infections, dry eyes, and dehydration but we did have a few interesting additions: a simultaneous hydrocele and testicular hernia, a prolapsed uterus, and a wound that was infected down to the bone made the list (all these cases will be referred to surgery at a nearby hospital).

I think something that struck a lot of us was how many people came in with complaints of pains or problems that had happened long ago. We would work up a patient for abdominal pain or a fever, only to find out it had been weeks or months since such a thing had occurred. It really confused and frustrated us. But I think what we sometimes forget is context. We visit villages where there are no clinics; teams from the US working with Foundation for Peace might only come every six months or so. When you live in circumstances of poverty, poverty so profound you can’t drink clean water, feed yourself nutritiously, or get access to medical care, of course you want to take advantage of services when they finally come to you. I also think a general lack of health education contributed to this. When you don’t understand the factors that led to you being sick and a medical professional is in front of you, it only makes sense that you relay every problem you’ve had because you’re not sure why it happened or if it is permanent. It was very difficult to tell people that they were healthy because it was so clear that they weren’t always that way.

Care delivered in medical trips like ours is necessary for the moment in Haiti but what is truly needed is permanent access to healthcare for all. But for now, we can only do our part and trust, as the Haitians say: piti piti na rive, little by little we will arrive.

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Moultrie experience broadens horizons for nursing students

Judith Wold is the Distinguished Professor for Educational Leadership at the Nell Hodgson Woodruff School of Nursing at Emory University, an American Nursing Education Fellow of the NLN, and a Fellow of the American Academy of nursing. She directs the annual Farm Worker Family Health Program (FWFHP) for Emory’s Lillian Carter Center for Global Health & Social Responsibility.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

By Colleen Closson

As our time at Moultrie ended, we were surprised by how quickly time had flown by. It felt like just yesterday we had carried our belongings into the Hampton Inn, uncertain of what awaited us. This immersion gave us incredible insight into the daily life of a migrant farmworker. During our class prior to our departure, we learned how hard it was to collect data on the migrant farmworker population because they are a population that is constantly moving, going wherever produce needs to be harvested. We feel so privileged to have been a part of a solution for migrant farmworkers’ healthcare needs. It was saddening to see the needs that farmworkers had that had been neglected for so long due to limited access to healthcare. It is incredible what simple interventions, such as a blood pressure screening, can provide so that people are aware of their risks and educated accordingly.

As we move forward, we are considering how best to apply the tenets of public health to our own practice. Public health, of course, is necessary regardless of where you are, and so many of the chronic health issues that we see can be remedied through public health interventions, such as screenings and education.

We cannot overstate how grateful we are for this opportunity. Without the support of the Lillian Carter Center, Ellenton Health Clinic, and the willingness of the farmworkers to work with us, we would not have been able to see and learn so much in just two short weeks. There is no doubt that our time in Moultrie will significantly impact our future nursing practice.

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Feeling thankful in Haiti

Carissa Vyhonsky

By Carissa Vyhonsky & Amelia Remiarz

“Mesi Bondye, Mesi!” This sentence was the theme of today. Translated to English, this sentence means “Thank you God, thank you.” Today, we started off our day with a beautiful church service. Pastor Valentin, who is the National Director of the Foundation For Peace in Haiti, and with whom we are staying this trip, led the service and made sure that we felt included by having our friend Joson translate his message into English. Beginning his message today with the Scripture reading when Jesus invited Peter to walk on the water, Pastor Valentin was able to capture a larger message of trust and love. By listening to Pastor encourage the community to trust in the Lord and hold fast in their faith, many of us felt that this message also described the Haitian people as a whole community. Ever since arriving in Haiti, we have gotten to experience the love and the courage of the Haitian people.

Amelia Remiarz

Learning about the history and all of the hardships that the people of Haiti have had to endure over their years, they always come out of the struggles even stronger than before and with more trust in each other and the Lord than could be imagined. Being invited and included in this church service made us feel so welcomed and loved and accepted, and it was truly an amazing experience.

The second half of our day included a journey into Port-au-Prince, the capital of Haiti. We expected a short bus ride into the city; however, we were greeted by a traffic jam that would rival I-85 on the Friday before a holiday weekend. For three hours we entertained ourselves by watching the menagerie of goats, chickens, and pigs that roam the streets of Haiti. Upon arriving to Port-au-Prince, our first stop was an open-air market where local vendors sold hand carved wooden items and hand painted canvases. We excitedly bartered with the vendors, purchasing souvenirs and gifts for our family and friends. After working up an appetite with our fast paced bargaining, we visited a restaurant and supermarket where we gleefully perused the shelves of Haitian cookies and candies, satisfying our sweet tooth and immersing ourselves into the local cuisine. We returned to the compound with full bellies, ready to prepare our medications and supplies for our final two days in the clinics!

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Second pap campaign a success

By Kiah Ford

Today we were back at work servicing the Peruvian women at Colegio Matto de Turner, a primary school located in Cusco. Our second pap campaign was a success and we saw twice as many women this time around than our first campaign. We once again provided blood pressure and blood sugar screenings in addition to the pap smears. After spending 5 hours at the campaign we enjoyed a free afternoon exploring the city!

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