Graduate Immersion Experience During West Virginia Flooding

Flooded streets and businesses in Clendenin, West Virginia

Graduate students in the School of Nursing’s Nurse Practitioner program Phil Dillard (Emergency) and Abby Wetzel (Nurse-Midwifery) discuss their immersion program experience with Cabin Creek Health Systems. The students worked alongside staff of the Clendenin Clinic to evacuate medically-fragile residents during the region’s recent storms and devastating flooding. Cabin Creek is a federally-qualified health center that provides essential health services to vulnerable populations in rural West Virginia through several community-based clinics.

 

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Graduate Students Reflect on Immersion Experience during West Virginia Flooding

WV_Houses

School of Nursing graduate students participate every year in a two-week immersion program in West Virginia through the Lillian Carter Center for Global Health and Social Responsibility. Our students work in partnership with area federally-qualified community health centers to promote health and prevent disease throughout the region. Led by faculty Advisors Carolyn Clevenger and Debbie Gunter, students Andrea Brubaker, Phillip Dillard, Kimberly Eggleston, Hannah Ng, Jill Peters, Allysa Rueschenberg, and Abigail Wetzel, were providing essential health services through four community clinics located in cities to the north and south of Charleston. Two of our students, Phil Dillard and Abby Wetzel, were working in a clinic in Clendenin, a town 25 miles northeast of Charleston that was hit hard by the storms.

Phil Dillard discusses the experience in this WSB-TV Channel 2 interview. WSB Interview – West Virginia Flooding

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Day 10 (6/24) – Las chicas de Moultrie

Day 10 – Las Chicas de Moultrie

For the final blog post, I thought I’d switch it up a little bit. I took part in this program alongside 14 amazing nursing students. Before this trip, most of us did not know much about each other, or the program, for that matter. But we are leaving Moultrie as sisters and more culturally competent nurses. For this blog post, I asked each of these wonderful girls how they felt about the Farm Worker Family Health Program. These were there answers:

"It's great to see how much good we are doing now. I would love to see how this program continues to grow in the coming years." Taryn Connelly, BSN Candidate '17

“It’s great to see how much good we are doing now. I would love to see how this program continues to grow in the coming years.” Taryn Connelly, BSN Candidate ’17

"Thank you Moultrie, and all the staff members, for providing us with an invaluable experience ." Ashley Rim, BSN Candidate '17

“Thank you Moultrie, and all the staff members, for providing us with an invaluable experience.” Ashley Rim, BSN Candidate ’17

"It's incredible to see how choosing to make a small difference can make a huge difference in someone else's life." Jennifer Zhang, BSN Candidate '17

“It’s incredible to see how choosing to make a small difference can make a huge difference in someone else’s life.” Jennifer Zhang, BSN Candidate ’17

 

 

"This was a better experience than I expected. The farm workers are very humble and appreciative. I wish we were here for a longer time." Alejandra Mendez, BSN Candidate '17

“This was a better experience than I expected. The farm workers are very humble and appreciative. I wish we were here for a longer time.” Alejandra Mendez, BSN Candidate ’17

"I had an amazing experience in Moultrie. The need is great in the farmworker population, but I am glad I was able to serve them through this program by putting a little seed forward. I am eager to take all the experiences and knowledge I gained through this trip to help vulnerable populations in the future." Karime Parra, BSN Candidate '17

“I had an amazing experience in Moultrie. The need is great in the farmworker population, but I am glad I was able to serve them through this program by putting a little seed forward. I am eager to take all the experiences and knowledge I gained through this trip to help vulnerable populations in the future.” Karime Parra, BSN Candidate ’17

"The best moments down in Moultrie happened when we were able to break down language barriers and share genuine laughter with the hardworking men we were caring for. It's that basic human connection that causes us to invest on a deeper level and to spark change for the future." Halle Sovich (left), BSN Candidate '18

“The best moments down in Moultrie happened when we were able to break down language barriers and share genuine laughter with the hardworking men we were caring for. It’s that basic human connection that causes us to invest on a deeper level and to spark change for the future.” Halle Sovich, BSN Candidate ’18

"This was really a great experience. I'm gonna go home and learn some Spanish!" Olivia Atlas, BSN Candidate '17

“This was really a great experience. I’m gonna go home and learn some Spanish!” Olivia Atlas, BSN Candidate ’17

"The children and farm workers we treated in Moultrie taught me one of the best lessons a nurse could ever learn. Sometimes the best medicine isn't medicine at all, but just some love and attention to let them know that someone cares." Jamie Smith, BSN Candidate '18

“The children and farm workers we treated in Moultrie taught me one of the best lessons a nurse could ever learn. Sometimes the best medicine isn’t medicine at all, but just some love and attention to let them know that someone cares.” Jamie Smith, BSN Candidate ’18

"I really learned a lot about myself during this trip. I am really thankful for this experience." Lucy Barr, BSN Candidate '18

“I really learned a lot about myself during this trip. I am really thankful for this experience.” Lucy Barr, BSN Candidate ’18

"The most important lesson I learned from the Farmworker Family Health Program is a lesson in appreciation. It is so easy to get swept up in the small stressors of daily life and to lose sight of the many gifts we are given. The farmworkers, however, continuously smiled and were grateful to see us, despite just finishing a fifteen hour day of hard labor out in the sun. They never seemed to let their work conditions, living conditions, or being away from their families get the best of them. Instead, they focused on what they had in the present: companionship with one another and the opportunity to receive some love and attention through our care. Being able to see this first hand definitely made a lasting impact on me. Like the farm workers, I will be grateful for what I do have; I won't worry about what I lack. I joined the program to give back to a population that provides so much, but I ended up receiving so much more." Kari Burdzinski, BSN Candidate'18

“The most important lesson I learned from the Farmworker Family Health Program is a lesson in appreciation. It is so easy to get swept up in the small stressors of daily life and to lose sight of the many gifts we are given. The farmworkers, however, continuously smiled and were grateful to see us, despite just finishing a fifteen hour day of hard labor out in the sun. They never seemed to let their work conditions, living conditions, or being away from their families get the best of them. Instead, they focused on what they had in the present: companionship with one another and the opportunity to receive some love and attention through our care. Being able to see this first hand definitely made a lasting impact on me. Like the farm workers, I will be grateful for what I do have; I won’t worry about what I lack. I joined the program to give back to a population that provides so much, but I ended up receiving so much more.” Kari Burdzinski, BSN Candidate’18

"I feel very fortunate to have been able to attend Moultrie as my first clinical experience and will remember how appreciative these farmworkers were. Moultrie offered me the opportunity to work in an interdisciplinary team with other compassionate and dedicated health care providers. I sincerely hope that Emory continues to send nursing students to help provide care to this deserving population." Grace Pixler, BSN Candidate '18

“I feel very fortunate to have been able to attend Moultrie as my first clinical experience and will remember how appreciative these farmworkers were. Moultrie offered me the opportunity to work in an interdisciplinary team with other compassionate and dedicated health care providers. I sincerely hope that Emory continues to send nursing students to help provide care to this deserving population.” Grace Pixler, BSN Candidate ’18

Jennifer Ratcliffe, BSN:

Being involved with the Moultrie FWFH project for a second time has given depth to my understanding of this population’s circumstances. Their personal stories were heart wrenching and their medical histories will help me remember musculoskeletal disorders, and the effects of pesticides on integumentary and nervous systems, among others.

“This trip taught me to be open to change.” Cathy Wei, BSN Candidate ’18

 

As for me, I am beyond grateful. Grateful to the amazing preceptors and directors of the program. Grateful to the churches, organizations, and people of Moultrie who opened their arms and hearts to us. Grateful to the hotels and other donors in Atlanta who gave us clothes, pillows, toiletries, and various other items to give to the farm workers. Most importantly, I am grateful to the wonderful men and women who endure so much to bring food to our tables so that they may try to provide for their families. Being able to practice what I love while providing a necessary service to an oftentimes overlooked group of people has been such an amazing experience for me. I am so happy that I was one of the special students chosen to participate in this incredible program.

 

-Haja Kanu

 

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Day 9 (6/23/16) – No More Night Camps

Day 9 – No More Night Camps

I find it so hard to believe that we are really approaching the end of this program. We spent most of our time today at Cox Elementary packing up our stations and cleaning the classrooms and the gym. It feels like just yesterday we were setting up to see students. It also makes me sad to think that for some of the children, we are the only access they have to healthcare. Some will not get another check-up until next year when the program comes back into town. Being here makes me realize how fortunate I am to be able to see my doctor whenever I am not well or have a health concern. It’s easy to forget that not everyone has that luxury.

Packing up the gym

Packing up the gym

Emory NP students finish up the final charts at Cox Elementary

Emory NP students finish up the final charts at Cox Elementary

Final lunch in Moultrie

Final lunch in Moultrie

 

 

 

 

 

 

 

The interdisciplinary team (Emory BSN & NP students in blue scrubs, UGA Pharmacy in red, and Clayton State Dental Hygiene in green scrubs)

The interdisciplinary team (Emory BSN & NP students in blue scrubs, UGA Pharmacy in red, and Clayton State Dental Hygiene in green scrubs)

 

Night camp was not very busy due to the size of the camp that we visited tonight. I was stationed at the blood pressure table again. As I measured my patients’ blood pressures, I thought back to the first time I did the same task last week. I was not used to trying to listen for systolic and diastolic sounds out in a field, surrounded by gnats and loud noises. I found it quite difficult the first time, but now, I feel like a pro. We have developed this saying on the trip: “If you can do it in Moultrie, you can do it anywhere.” We are all a little sad that this was our final night camp. Overall, it has been such a wonderful and educational experience.

The blood pressure team

The blood pressure team

Alejandra checks her patient's blood glucose

Alejandra checks her patient’s blood glucose

– Haja Kanu

 

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Day 8 (Wednesday, June 22) – Foot Care Technician by Night

Day 8 – Foot Care Technician by Night

Today, I took another turn at Height, Weight, & BMI. We did not see that many children since most of the students already did rotated through the stations. Because we had a lot of downtime, we began taking inventory of the materials we had at each station. While taking inventory, it began to dawn on me that our time in Moultrie is coming to an end. It feels like just yesterday we were unloading the van and setting up our stations. Time flies!

Setting up the penultimate night camp

Setting up the penultimate night camp

Night camp set-up

Night camp set-up

 

 

 

 

 

 

 

After dreading it for a week and a half, I finally got stationed in foot care. But surprisingly, I felt ready. I have been practicing Spanish this whole trip and this was my opportunity to showcase what I had learned. Thankfully, it went well! With my broken Spanish, I was able to learn a few things about the men as I examined and took care of their feet. We spoke about Mexico, their families, and what kind of music they listened to. I even got a few song suggestions for my night camp playlist. I noticed that some men came to the station a little shy and self-conscious, but the more we talked, the more comfortable they seemed. I was happy to know that though my task was not specifically nursing-related, it helped people feel better, which is what nursing is all about.

Selfie with Don Jose (bottom right), an Ellenton Clinic employee

Selfie with Don Jose (bottom right), an Ellenton Clinic employee

 

– Haja Kanu

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Day 7 (Tuesday, June 22nd) – Farm Tour & the Realities of Field Work

Day 7 – Farm Tour & the Realities of Field Work

As we are nearing the end of our trip, we assess less and less children at the elementary school.Today I was stationed at the hemoglobin and glucose table again. Because I had been at this station once before, I was not really nervous or worried. I only screened four children, which is so much less than the number of kids I saw last week. Also, because most of the other kids had told their friends how easy the test was, I did not have any criers.

In the afternoon, we had the option of donating blood to the survivors of the unfortunate Pulse Nightclub shootings. Because I am away from home and I have never given blood before and therefore am not sure of the effects it will have on me, I chose not to donate. However, a lot of people from my BSN cohort and the other schools went to a local blood bank to donate. Luckily, most of the people that donated felt fine afterwards.

Karime and Halle rest after giving blood

Karime and Halle rest after giving blood

 

I feel as though I do not write enough about the generosity of the local churches that provide lunch for us every day. Not only is the food always delicious, the people are also very friendly and genuinely happy that we are providing care to those in their community that need it the most. We always feel so welcomed by the church volunteers and so touched that people take time out of their busy schedules to provide for us. Moultrie residents truly have a wonderful sense of community.

BSN students enjoy lunch courtesy of a local church

BSN students enjoy lunch courtesy of a local church

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One exciting thing I got to do today was go on a farm tour. Both of my parents grew up in farming communities and we have a huge garden in our backyard. I’ve always appreciated fresh vegetables, so I was really excited to be able to pick a wide variety of produce FOR FREE! I was one of 12 students on today’s tour, which was guided by employees of the Ellenton Clinic. We all had a blast picking vegetables and taking pictures of the beautiful landscape. However, when we got back into the van, we talked about how hard it was picking vegetables for an hour under a beating sun. We could not even imagine how the migrant farm workers we care for do the same at a much faster pace for a longer period of time. Such hard work greatly contributes to the variety of complaints they present to us everyday.

Alejandra looks for ripe squash

Alejandra looks for ripe squash

Students try their hand at picking vegetables during a farm tour

Students try their hand at picking vegetables during a farm tour

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Today’s night camp made me realize how difficult it can be providing medical services outside of a traditional medical facility. The HemoCue machines we use to check the hemoglobin of our patients overheated several times and had to be taken back to the air-conditioned RV to cool down. During the times the machines were cooling down, we could not assess hemoglobin levels. By the end of the night, none of the glucose machines were functioning properly and we had to close down our station half an hour earlier than originally planned. Had we been in a traditional medical setting, we most likely would not have had a problem with overheating and we could have easily switched machines. However, being out in the field meant we had to be as resourceful as possible or go without. This can be quite frustrating when the patient line grows longer and longer, but we just have to be flexible and keep pushing forward. I love the challenges we are overcoming because they prepare me for real world nursing. If you can make it work in the middle of a 3,000 acre farm in Moultrie, you can make it work anywhere.

– Haja Kanu

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Day 5 (Friday, June 17th) – Home-Bound

Day 5 – Home-Bound

I can’t believe it’s really the end of week one! Time is going by much faster than I expected it to. We were only in the elementary school for a couple of hours today because a few children still needed to see physical therapy. The physical therapy students are only here for one week, so they will not be back next week. The dental and pharmacy students are switching out with their peers for week two, so we will have a new set of people next week. The only students that will remain are the NP’s and the BSN’s. Although the Farm Worker Program is hard work, I am really happy to be coming back for a second week. I have learned so much about working in an interdisciplinary team, and it feels really good to know that I am providing a beneficial service to people who otherwise would not be receiving that service. I am also happy that we get the weekend off to go home and recharge for whole new experiences.

End of Week 1 photo

End of Week 1 photo

See you next week, Moultrie!

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Day 4 (Thursday, June 16th) – Childhood Obesity

Day 4 – Childhood Obesity

Day camp was a little hard for me today. I worked in the height, weight, and BMI station at the elementary school. As we all know, childhood obesity is becoming a huge problem in America. Childhood obesity is more prevalent in minority populations due to factors such as income disparities and lack of access to healthy food and medical services. However, I saw a lot more overweight and obese children than I expected to see at the elementary school. It really hurt me to see children struggling with weight issues so early in life. I was sad to know that for some children, their parents could not do much to help them lose weight because they may not have the money, time, or knowledge to make better food choices. I learned from my clinical instructor that if the children do not adopt better health habits soon they could carry their poor health practices into adulthood and have a much harder time losing weight.

Graces plots a child's height and weight on a growth chart

Graces plots a child’s height and weight on a growth chart

Karime poses with Dr. Science in the donation room

Karime poses with Dr. Science in the donation room

Haja learns how to hula hoop during down-time

Haja learns how to hula hoop during down-time

A lovely lunch courtesy of a local church

A lovely lunch courtesy of a local church

Lunch at a local church

Lunch at a local church

Tonight’s camp was also a hard experience for me. The farmworkers’ quarters were in very bad shape. The outside of the buildings were decrepit. Trash and beer cans were scattered all about and dogs wandered up and down the area. Worst of all is that children lived there. Seeing the condition in which the workers and their families live really made me realize how important what we are doing is. With such poor living conditions, there is no way they could afford to seek medical services. Their work also depends on their health, so being able to know what health condition they are in is very important to them. Though this experience has been exhausting at times, tonight’s camp refreshed my sense of purpose.

BSN students and clinical instructors pose in front of the Ellenton Clinic van

BSN students and clinical instructors pose in front of the Ellenton Clinic van

Ashley and Jennifer take advantage of the beautiful sunset

Ashley and Jennifer take advantage of the beautiful sunset

Haley, the TA, and her BSN crew

Haley, the TA, and her BSN crew

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Day 3 (Wednesday, June 15th) – “It Gets Easier”

Day 3 – “It Gets Easier”

Today felt like a typical day, but it wasn’t until we got back to the hotel from night camp that I realized how smoothly everything had went. I woke up feeling well-rested, despite only getting 4 hours of sleep. I was assigned to the Hemoglobin & Blood Glucose station at the elementary school and had been dreading my shift since I read the assignment schedule on Monday. I, a second year nursing student, dislike being pricked and seeing my own blood, so I dreaded the reaction a six year old may have to the test. I imagined lots of sweat, tears, and of course, blood. I am pleased to say that there was only the latter…for the most part. Most of the kids I tested were a little nervous but put on their big boy and big girl faces when they learned that they could pick out stickers after the test. Most surprisingly was a kindergartener who was excited (yes, you read that correctly) to check his glucose level. Thankfully, there was only one crier today. All the nursing students worked together to calm her down but she refused to be pricked until she saw the procedure demonstrated on my finger. Yes, it hurt a little, but I, too, put on my big girl face and said “see, that was easy.”

Laura demonstrates how to prick a child for a glucose test

Laura demonstrates how to prick a child for a glucose test

 

Tonight’s camp was my favorite experience so far. As I mentioned in my previous posts, I took a little Spanish in high school but am so out of practice that I can barely make a five word sentence. But through a lot of practice with my roommates and the interpreters, I am remembering a lot of what I had forgotten. I was stationed at the blood pressure table in night camp. I was also a little nervous about this assignment because night camp can be noisy, making it hard to listen to and measure systolic and diastolic pressure. To my surprise, this station was also a breeze. Not only was I able to easily obtain blood pressure values, I was also more confident in my Spanish speaking ability. I could tell that my patients really appreciated the fact that I was trying to make them feel more comfortable by speaking their native language, even if I did mistake “esto es su numero” (this is your number) with “esto es su nombre” (this is your name).  Because we had learned that migrant workers do not make much money and therefore buy a lot of cheap and unhealthy food, I was expecting a majority of my patients to have high blood pressure. But in fact, a majority of them had great blood pressure and were in great shape. This makes sense, considering how labor-intensive their work is.

Night camp selfies

Night camp selfies

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Because we had done it four times already, loading and unloading the van was very easy tonight. All teams have become so used to the routine that we were able to see all our patients and leave night camp at 11:30pm.

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Day 2 (Tuesday, June 14th) – Under Pressure

Day 2 – Under Pressure

No, not literally, but I felt that the Queen song best describes a blood-pressure filled day. To me and you, getting our blood pressure taken during a routine healthcare visit is rarely preceded by tears. That statement is far from true when it comes to children under the age of eight. Though it took a lot of reassuring and sticker-bribing, the first few kids I examined were a piece of cake. Then came the kindergarteners. It was like a domino effect; one child walked into the room, saw the blood pressure cuffs, and began crying inconsolably. Seconds later, three more children in line were terrified of entering the room and begged to go home. Patient zero refused to be examined but the others eventually settled down enough for us to distract them with stickers and songs as their blood pressures were being taken. I quickly learned that saying “I’m going to give your arm a hug like this” is a much better calming phrase than “I’m going to squeeze your arm like this.” I also found that covering my stethoscope with colorful stickers makes it seem a lot less scary.

Nursing students start their day by discussing the events of night camp

Nursing students start their day by discussing the events of night camp

Alejandra and Grace practice taking manual blood pressures

Alejandra and Grace practice taking manual blood pressures

The star team of blood pressure

The star team of blood pressure

Jaime helps a young student conquer her fear

Jaime helps a young student conquer her fear

Lucy and her vision-checking glasses

Lucy and her vision-checking glasses

 

Night Camp seemed to run a bit more smoothly today compared to yesterday. I measured height, weight, and BMI. At first I felt awkward speaking to my patients because I was scared of saying the wrong words in Spanish. But with time I could easily say “I’m going to check your height, weight, and BMI.” The workers were excited to know what their weight was and whether or not that was healthy. I was happy to find that a majority of them were at a healthy body weight.

 

Foot care station - Day 2

Foot care station – Day 2

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Foot care station

Foot care station

 

My station moved pretty quickly, so when I had finished with all of my patients I was able to float around and observe the nurse practitioners and the physical therapists at work. One thing I really love about this experience is how closely the different disciplines of medicines get to work together. As a nursing student I assess the patient and send him or her off to the nurse practitioners. The nurse practitioners make a diagnosis and send the patient to physical therapy or dental if either service is needed. The nurse practitioners also write a prescription for the patient which is filled by the pharmacy students. It’s really great to see what really goes into taking care of a patient. In the future, I hope to come back to Moultrie as an NP student.

Update: The gnat population dramatically decreases following a rain storm. It rained earlier in the day, so the gnats were not much of a problem tonight.

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