After early morning preparations, we stepped onto the bus and started our two hour ride toward Cornwall Regional Hospital. When we first reached the place, we immediately noticed the difference between that hospital and our local Emory hospital. There were many people standing in front of the entrance, casting their shadows on the pinkish hospital exteriors, and waiting for entry into the hospital. Before anyone could enter, a security guard made sure no hazardous materials were allowed in. Unfortunately my Canon made that list so we had to store all of the cameras in the nursing administration room, which the nurses were kind enough to share with us. We were introduced to the various nursing officers of the hospital. They all wore very strict uniform consisting of bleached white attire and a little white tiara-like hat. It seemed to be the uniform that we used to have in the states many years ago. We then received a tour of the entire hospital complex. The hospital building itself seemed to be divided into various units like in the US. However, the interior were less technologically advanced and also lacked many of the strictness that we have in our nursing units. The patients were put into the same room, meaning patient privacy is significantly reduced and forget about HIPPA compliance. However, the hospital staff seemed to know how to efficiently use their resources and amazingly managed to run the hospital successfully with their constraints.
The nursing culture in Cornwell seemed to be consist of a supporting environment for coworkers and everyone seemed to respect everyone. They addressed each other as “sister”. Furthermore, the nurses and doctors also seem to be very friendly with each other. While many nursing units such as Emory G6 in the US have been improving on creating positive and collaborative workplace culture, we certainly have some road to go when it comes to the culture of “eating the young” that might still exist in some of the areas in our healthcare system. The Cornwall hospital did not seem to have the “eating the young” culture.
However, the hospital was extremely crowded and patients often have to wait more than four hours before seeing a physician. According to one of the nurses, many Jamaicans underutilize the primary providers and prefer to go directly to the hospital because it saves them time. The healthcare system in Jamaica is funded by the government, meaning patients do not pay for their care in the same extent as in the US. This might contribute to why many patients seem to be grateful and patient as they wait the long hours to get treated by a doctor.
After lunch, our group was divided up and sent to different areas in the hospital. One of those areas was the ER, which is where I ended up at. I was able to witness the triage model the clinicians used. Since they were still using paper charting, when a patient first come into the ER, a doctor would assign a colored paper, ranging from red, yellow, and green, indicating the acuity of the patient. That color also indicate how long the patient might have to wait so while it is bad to get a red paper since it indicates high acuity, it also means seeing the doctor faster. The nurses played a vital role in the ER like many other places. They had a special room where nurses assessed vitals, conducted labs, and other tests to help with healthcare issue. Despite the many patients, the workflow was efficient enough that they tend to get all their patient looked at by the time they close. With their limited resources and amazing culture between the staff, Cornwall was inspiring.