Archive for January 12, 2015

Montego Bay: Day 3

We went to women’s center and a school for the deaf. In the women’s center, many of the girls were pregnant and had difficulties with areas of their life. We taught them about proper care during pregnancy and advice on how to be less stressed and maintaining a good mental health. We engaged them and helped connect them to each other. 

At the school of deaf, through using a translator, we were able to teach them about dental hygiene, nutrition, and maintaining positivity and having a healthy mental health. The children loved it. In addition, we also provided healthcare screenings. The people were very welcoming and thankful. I’m glad I can be part of this great experience.  

Montego Bay – Day 4

Today was clinic day!  Our group ran a health clinic at the New Testament Church of God in Montego Bay; we were able to screen 118 members of the community for BMI, blood pressure, blood glucose, and vision.  After each participant was screened, they received individual counselling on their results.

Many of our participants were anxious to have themselves tested. They were worried about their health and concerned about what their results would mean.  Many of them had elevated BMI’s, blood sugars, and blood pressures, and therefore, had cause for concern.  Counselling provided these patients a chance to strategize about how they could change their patterns in order to improve their health.  Many were receptive, but some were not.

Something that struck me today was that, as nurses, there is only so much we can do for our patients.  We can give them all the information we have, we can help them plan changes in their health behaviors, we can encourage them to make those changes, but they have to actually make the adjustments for themselves.  It was difficult to watch patients leave knowing they probably wouldn’t make any modifications and their health would continue to suffer.  On the other hand, it was extremely rewarding to teach patients health strategies, knowing they likely would make those adjustments and benefit their overall health in the long-term.

Montego Bay – Day 2

Adjustment and flexibility were the themes of our second day in Montego Bay.  The ability to be flexible with plans, teaching, and scheduling was required at each place we visited.  Our team was able to meet these challenges, however, by working together and supporting each other.  At the end of the day, we were exhausted, but the extra effort was worth it in order to meet our patients’ needs.

Our first stop for the day was the Challenge Basic School.  More than 100 children dressed in their yellow gingham school uniforms were waiting for the nurses from the United States to come and teach them.  Our plan was to teach basic dental care, nutrition, and exercise.  We quickly realized, though, that we didn’t have all the materials we needed, forcing us to improvise.  Working together with the teachers in the school, we got the children to sing and dance, to talk about their favorite fruits and vegetables, and to sing songs about brushing their teeth.  There were smiles all around, and the students learned quite a bit about maintaining their own health.  Success!

Blossom Gardens Orphanage was our second stop for the day.  Our plan was to teach the caregivers at the orphanage about childhood developmental milestones and methods to help the children meet those milestones.  We also planned to spend time with the children, giving them some extra attention and love.  We were late to the orphanage because our first session had run over, and when we arrived, two other groups were already there working.  Running short on time to teach the caregivers, we had to abandon our teaching plans altogether and focus specifically on interacting with the children.  No complaints from these nurses, and the kids seemed to thrive on the extra attention!

By the time the day was over, we were hot, tired, and hungry.  Our goals had been to reach our patients, teaching them some basics about how to protect their health and the health of those they care for.  The methods we used were not necessarily the methods we had planned to use, but with a little extra effort and some adjustment along the way, we were successful nonetheless.  Learning the values of adjustment and flexibility in the provision of nursing care was another great lesson from our second day in Montego Bay…

Montego Bay – Day 1

Day one of our Alternative Winter Break experience in Jamaica was spent at Montego Bay’s Cornwall Regional Hospital.  Cornwall is a 10-story, 400-bed public hospital operated by the Jamaican government.  It provides comprehensive medical services free of charge to the residents of western Jamaica.  Our job today mainly was to observe and reflect.

I was overwhelmed by the huge number of patients this hospital serves.  People were waiting outside the main entrance to get in, people were everywhere inside the hospital waiting to be seen in clinic, and most beds in every ward were full.  In the Accident and Emergency department, a sea of patients waited their turns to be triaged and seen by a doctor.

Watching the providers work, however, was inspiring.  According to one, resources are scarce and funding is limited, but providers work together for the good of the patient.  Often, nurses work overtime or shift their schedules to accomodate their patients.  As one provider said, he could make 60x the money in the United States that he makes in Jamaica, but his passion is to serve his patients in Jamaica and to advocate for better resources for their healthcare.  His statement was a reminder of why I chose nursing in the first place – not for the money, but to serve my patients however I’m needed.  A good lesson for the first day of Alternative Winter Break…

Fun Times at Cornwall Regional Hospital

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.

Jamaica- Alternative Winter Break Day 1

Jamaica, we have arrived! The alternative winter break Montego Bay Jamaica crew just had our first service day on the island. All 19 of us woke up early and excited to tour Cornwall Regional Hospital. After leaving our debriefing session tonight, I realized that I was not the only one inspired by this hospital. Where do we even start?

We were greeted this morning by the certified nurse administrators of the hospital which is a very highly regarded position. They were formal in their attire and their communication around the hospital. They were also very excited to see us. We separated into two groups to tour all TEN floors of the hospital. My group, led by Sister Brown (All of the CNA’s are referred to as sister because they are a part of the British Ministry of Health) started on the first floor and worked our way up. I must note that walking ten flights of stairs in an open air/outdoor hospital in the Jamaica sun is a but of struggle, but it was worth every minute.

After the tour, we split up into several groups and worked in the various clinicals. Some were in the emergency department following doctors or injection nurses, while others were observing the orthopedic and general med clinics. Tonight, we were all asked to say four things that we were impressed by… To give you a better impression of how we felt about it I have listed some below:

Caitlin Brown “I was impressed by the attitudes of all of the nurses. They work so well with the resources they have and it reminded me of why I want to be a nurse. They have this job because they want to help people- not for the paycheck or anything like that.”

Angel Padgett “I really like how respected the position of a nurse is. It seems like they run the hospital and that is the profession that people aspire to be in this region.”

Anat Vajima “The doctors and nurses work very well together. They also all take time with the patients. I didn’t see them rushing patients through the system. They explained things very well and if patients were having a hard time understanding, they would go to great lengths and take the time to help the patient.”

Overall, we were very impressed with the attitudes, interpersonal relationships and communication capabilities. We are looking forward to visiting orphanages tomorrow and presenting our health promotion modules.

Day One of Adventure

ADVENTURE was the theme Drs. Coburn and Abraham chose for our trip, but I don’t think anyone thought our first day would turn out the way it did. It started off well; our entire group made it to the airport in time for our first flight and that ride was uneventful in a great way (very significant considering I’m not the best flyer). The really adventurous part of our day started during our wait to get from Nassau to Eleuthera. We got to spend some time transitioning from chilly Atlanta to the breeziness and warmth of the Bahamas. We had a nice greeting at the airport of a Bahamian band playing live music in the terminal, then we checked in for our second flight and got settled in for the 3 hour layover. By the time the sun and breeze lulled me into two naps on the patio and our group had snacked through all the restaurants near our gate, our 3 hour layover turned into a 5 hour one. By 5PM, we were all boarded, waiting in an unusually long line of planes waiting to take off on the runway. Our captain assured us he would try to get us to Rock Sound airport before sundown, but warned that we wouldn’t be able to land if it was too dark outside. After sitting for a few more minutes, we were disappointed to find out that the timing was too close and we wouldn’t be able to fly to our final destination. That led us to a Wendy’s airport dinner and about 2 more hours laying over and searching for hotels. And now, although we had an interesting time getting here, my belief that things happen for a reason is confirmed. I’m writing this entry under a cool fan in the hotel’s restaurant, listening to one of the employees explain the unique decor. Our group is settled now and I think we’re starting to let the Bahamas’ relaxation come over us. Tomorrow, we get back to the airport for a 6:30AM flight to Eleuthera and the next day of adventure 🙂 To be continued…

Montego Bay – Day 3

Our team came to Montego Bay to teach healthy behaviors, from dental hygeine to breast health to factors that affect blood pressure and blood sugar.  Today, we put the teaching aside and focused on simply spending time with our patients, listening to their stories.

Many of our patients today were in a nursing home/hospice facility.  Their health was failing, but they shared the common thread of choosing to have a positive outlook on life.  They talked with us, prayed with us, laughed with us, and even danced with us.  Spending time with our patients allowed us to see them as people instead of as a diagnosis, and this reinforced to us the importance of caring for the whole health of our patients.

More from Montego Bay tomorrow…

Montego Bay Alternative Break

Today was another great day on the island. We started off early at Montego Bay Women’s Center. This center aims to give pregnant and postpartum mothers a chance to continue their education while their babies are only one building over with caregivers. In Jamaica, pregnant teens are kicked out of school during and after their pregnancy. Many of the teens; however, have the support of their family and are provided the opportunity to come to the women’s center. Our job at this location was to teach breast health and breast feeding while others screened the teachers and administration.
We went straight to the School for the Deaf after that where we had a chance to interact and speak to children of all ages with the help of an interpreter. We also screened many teachers and administrators here. One interesting thing about the school of the deaf was the well-kept and large facility. The school was set on top of a mountain with a breathtaking view of the beach and city. We learned from our driver, “Uncle Willie” that this school was run by an American institution that sends groups here yearly to work and maintain the property.
After lunch on the bus we made our way to one of our favorite locations yet, Hope Hospice. At hope hospice there is a variety of patients ranging from aids to diabetes and cancer problems. Each student was able to interact and provide some therapeutic communication to an individual patient. Our visit was greatly appreciated by every patient and really showed us the reality of what many people go through while living in Jamaica.
Tomorrow we are starting our first day of health fair. We are excited to screen and teach even more residents. So far, we have screened over thirty adults and we hope to at least triple that number by tomorrow!