By Madysen Kovac and Sonia Ros
Day 6: Rolling through Rivas
Gooooooood Morning, Nicaragua. This morning we said farewell to our hotel in Gigante and headed out to the hospital in Rivas. We pulled up to a Pepto-Bismol pink building and we thought, “This can’t be the hospital.” We scrambled out of the car, white coats flying everywhere. This is probably the first time that most of us have worn our white coats with our scrubs. In the hospital in Rivas, scrubs are viewed as pajamas, so we wore our white coats in attempts to fit in a bit better. The nurses at the hospital wear perfectly ironed, white uniforms complete with a nurse’s cap.
We started with a tour of the library, a room about ¼ the size of P01, our favorite auditorium in the nursing school. The library has some of the same resources a medical library would in the United States. Then we began visiting the different departments throughout the hospital. The hospital is a series of small buildings all connected by a covered walkway open to air. We enjoyed the greenery because in the United States, hospitals often feel isolating. Just like in the United States, they have posters of patient quality indicators educating the staff and patients. As we walked the hospital, you notice there is more than one patient to a room, in fact, there can be up to seven patients per room. There are no curtains for privacy, just an open room with the seven beds. However, if a patient assessment is needed, the patient is taken to a separate room for privacy. The nurse-patient ratios shocked us. Each nurse is responsible for 30 patients! In the United States, usually nurses have anywhere from three to six patients. Like the United States, a large portion of the resources seemed to be dedicated to the pediatric unit. Also, the ICU unit seemed to be the most updated department of the hospital, with newer equipment and more patient privacy.
After touring, we got the opportunity to talk with a group of nursing students from Nicaragua. These nursing students are like those with a two-year degree in the United States. They serve as community nurses rather than nurses in the hospital. Those nurses working in the hospital must obtain a five-year degree, and this would be more similar to the BSN degree in the United States that qualifies one as a registered nurse. When we asked the groups where they wanted to be nurses, some did not give a specific location. Rather, they said they wanted to be a nurse wherever they were needed the most. When asked why they wanted to be nurses, their answers were the same as ours. They want to help people. It is as simple as that.
While speaking with the nursing students, we were told that there would be an earthquake drill at 11:00. Then we started heading outside. We were surprised because in elementary school in the United States, we are typically told to get under a sturdy structure, such as a desk. However, they go outside because the buildings in Nicaragua are not sturdy. Another interesting fact is that everyone in Nicaragua does this earthquake drill together, as a nation. It is a mandatory and standard emergency preparedness practice that occurs every year.
We ended the day with presentations for the nurses and nursing students. They specifically requested that we do a talk about domestic violence. Specifically, about how we approach patients who are victims of domestic violence in the United States. As it was a safe space for discussion, we had productive conversations that were powerful for both the nurses from Nicaragua and for us, as well. Additionally, we presented the program from the United States called “Talk to Me Baby.” After this presentation, one of the nurses explained that she planned to propose it to the hospital board next month in hopes of implementing the program at their hospital.