Archive for Atlanta

First Week at the Atlanta VA!

Hello from the Atlanta VA Group! We have had a great start to our two week immersion experience with our Veterans! There are so many experiences to be had here at the VA, so we have been jumping in where ever we can. We started last Friday by attending an M, M and I meeting (Morbidity, Mortality, and Improvement). During this monthly meeting, a topic is chosen and a case within that topic is discussed. This month’s topic was Delirium vs. Dementia. It was so interesting to hear the experts discuss their views on something we have been discussing in class recently!

This week we started off by doing a scavenger hunt to orient ourselves with all the VA has to offer! We were able to introduce ourselves to many of the employees and volunteers that serve here. We were so impressed by the warm welcome we have received by everyone (patients, employees, volunteers, etc.). We can tell that the VA really takes pride in the amazing work that they do every day.

We have also been helping out with some research by transcribing interviews for part of a project called “Choosing Wisely” which focuses on starting a dialogue on how providers and patients can avoid unnecessary tests, treatments and procedures. As future providers, it is essential to be conscious of how we are utilizing resources while providing quality care for our patients.

Coming up next, we are excited to participate in Internal Medicine rounds and participate in another quality improvement project involving Value Stream Mapping.

St. Thomas: Photo recap of our first week!

 

Greetings from beautiful St. Thomas! Where do I even begin? We have so much to share from the past 7 days, so we decided to do a photo blog so you could experience it with us!

As Holly mentioned in her previous post, the eight of us were split up for the first week (1/2 with Dr. Barzey, 1/2 at the FQHC). The lovely staff at the FQHC welcomed us with a sweet sign 🙂 Annie, Rachel, Eyelle, and Kelly have been working hard to distribute ambulatory care surveys, creating educational materials for patients, shadowing the providers, and making the health center more patient friendly.

Rachel, Eyelle, Annie  & Kelly at the FQHC

Rachel, Eyelle, Annie & Kelly at the FQHC

The other group worked with Dr. Barzey (the only endocrinologist on the island)  to create a comprehensive booklet on diabetes education that she can give to her patients. We also had the chance to go out into the community and survey the locals about their nutrition and exercise choices.

Mackenzie, Christina, Mary Macon, & Holly getting some cultural education from Dr. Barzey

Mackenzie, Christina, Mary Macon, & Holly getting some cultural education from Dr. Barzey

Speaking of food choices, the most popular fruit on the island are mangos! They are sold on almost every street corner, and are some of the most delicious mangos we have ever tasted!

A local fruit stand in downtown St. Thomas

A local fruit stand in downtown St. Thomas

If you don’t believe me, ask Eyelle!

Eyelle enjoying a mango!

Eyelle enjoying a mango!

Both groups worked dilligently all week to meet their goals and deadlines. We have learned so much about the culture here on the island. It is amazing how differently islanders live, and how much they appreciate the small things that we often take for granted.

The most frequent mode of transportation on the island: The "Safari" serves as a taxi to the locals. Usually less than $5 per ride!

The most frequent mode of transportation on the island: The “Safari” serves as a taxi to the locals. Usually less than $5 per ride, and can fit up to 18 people!

At the end of a long week, Dr. Wright invited us to have dinner at her and her husband’s beautiful ocean side home in St. Thomas.

The girls with Dr. Wright and her husband Chip.

The girls with Dr. Wright and her husband Chip.

Did we mention the view from Dr. Wright's front deck? (#nofilter)

Did we mention the view from Dr. Wright’s front deck? (#nofilter) p.s. that is St. John in the distance

Before we knew it, the weekend was here! We took a ferry (only $6, 10 mins) to the gorgeous island of St. John to enjoy our weekend off! Here are some pics of our trip:

St. John

Welcome to St. John!

The girls enjoying the view of Trunk Bay- one of the beautiful beaches in St. John

The girls enjoying the view of Trunk Bay- one of the beautiful beaches in St. John

A traditional dish of the island: curry chicken, yellow rice, boiled sweet potatoes, and veggies

A traditional dish of the island: curry chicken, yellow rice, boiled sweet potatoes, and veggies

The girls showing off their “Caribbean Hook Bracelets”

"Caribbean Hook Bracelets have been worn for centuries by islanders in the Caribbean, serves as "island time" to be a popular symbol of unity and love. The open end of the hook pointed up toward the heart means your love is take, the open end of the hook worn down away from the heart, means your love is free (unattached or single)"

“Caribbean Hook Bracelets have been worn for centuries by islanders in the Caribbean, serves as “island time” to be a popular symbol of unity and love. The open end of the hook pointed up toward the heart means your love is take, the open end of the hook worn down away from the heart, means your love is free (unattached or single)”

 

We had an amazing time in St. John and were sad to leave 🙁 But also excited to start another week, and this time, all eight of us were reunited at the FQHC!

Annie pausing for a smile while preparing her ambulatory care surveys!

Annie pausing for a smile while preparing her ambulatory care surveys!

Mackenzie and Christina going over some important details for their clinical day

Mackenzie and Christina going over some important details for their clinical day

Rachel and Dr. Wright at the FQHC

Rachel and Dr. Wright at the FQHC

We’ve had an incredible week so far here in the Virgin Islands, and look forward to this week’s adventures!

Nursing love,

Christina

 

 

 

 

 

Senior Year – Community Health Interventions

This past week, multiple groups of students finishing their Community Health Clinical rotations gave presentations to fellow students, faculty, and staff on the experience of working as student nurses in a Community Health setting. For many of the students, this was the first time we had worked in a larger, population-based community setting. Some of the areas represented included: The Gateway Center for homeless men and women in downtown Atlanta, Moultrie migrant farm-worker populations, the Clarkston Community Center (home to a variety of ethnicities and refugee populations), and Café 458 Restaurant for the homeless. Overall, the majority of students expressed that they had an incredibly informative, moving, and successful experience working in the community.

Student activities ranged from education with the populations, to interventions to address specific issues – such as high rates of teen pregnancy or increased rates of hypertension. Many of the main health topics and interventions focused on exercise promotion, healthy diet promotion, and prevention activities. The levels of prevention included primary, where clients were provided education; secondary, where clients were screened for different ailments; and tertiary, where clients already suffering from diseases were taught ways to decrease morbidity and mortality from their illnesses. Many of the groups were able to evaluate the effectiveness of their interventions through the use of surveys and data collection of community members’ thoughts. The prevention activities were based on the goals and objectives of Healthy People 2020, a US Department of Health and Human Services nationwide program dedicated to disease prevention and treatment. As a part of these Healthy People goals, it is especially important to reduce the disease burden in vulnerable populations – such as the homeless, minority groups, and immigrants.

One of the most common themes described by the students when reflecting on their experiences included the importance of cultural sensitivity, such as respecting cultural differences and different beliefs. Many students expressed that they learned a variety of new information about different cultures and communities that they had not previously come into contact with. Another similarity discussed among the students was the importance of recognizing the heterogeneity inside of the groups. We learned that community groups often have more intra-group variation among their individual members, as compared to inter-group variation. It quickly became apparent that members of the same community cannot necessarily be easily categorized or stereotyped into one or two broad descriptors.  In this sense, we learned the importance of breaking down barriers, such as stereotypes and assumptions about group needs and desires, in order to deliver the most culturally-relevant and appropriate care.

The feedback that students received from the Community Health Interventions was overwhelmingly positive. The majority of community participants were incredibly appreciative of our work with them in multiple areas. In addition, all of the students were mutually grateful that we were so readily accepted into these different communities. The people we worked with embraced not only our education and teaching, but also our cooperative spirit and developing sense of unity with them.

Senior Year – Topics in Class

The last semester of Senior year is somewhat hectic for most of the students. Not only are we busy keeping up with schoolwork, we’re also applying to jobs, applying to graduate programs, culminating research projects, and practicing for our NCLEX Licensure Exam. In addition, we all have two 12-hour clinical shifts per week. Needless to say, there isn’t a lot of free time! Our courses this year are geared towards bringing together all of the fundamental information we’ve learned in the previous three semesters. Senior Year courses include: Synthesis, Core Concepts: Acute Care Nursing, Community Health, Role Transition, and Professional Development: Politics and Public Policy.

Synthesis is a course that focuses on preparing Nursing Students to take the NCLEX Licensure Exam. We take practice quizzes every week on a variety of different topics, such as general Medical/Surgical care, Psychiatrics, Pediatrics, Maternal/Infant Care, and many others. Overall, we’re reviewing what areas we need to review prior to taking the NCLEX exam.

Core Concepts: Acute Care Nursing focuses on the “sickest of the sick.” Many of the patients that nurses come into contact with, especially in the hospital setting, have some type of illness. However, this course instructs students on how to care for the “acute” patients – such as those patients experiencing Hypovolemic Shock and Cardiac Instability. Thus far in the course, we’ve learned a variety of different monitoring devices for patients with Cardiac Output issues (i.e., patients whose hearts aren’t functioning/pumping effectively). In addition, we’ve also learned techniques never before discussed in Nursing School – Emergency/Disaster Nursing. We’ve covered many different subtopics under this umbrella, from care during an environmental emergency (e.g., flood or tornado), to care during biological terrorism events (e.g., Anthrax and Viral Hemorrhagic Fever).

The Community Health Nursing course addresses nursing care on a larger, population-based level. Students participate in a Community Health Clinical two days a week at a variety of different locations, working with vulnerable community groups, such as immigrants and the homeless. As mentioned in some of my previous posts, my clinical is at the Gateway Center in downtown Atlanta. This facility caters to homeless men and women in the area, and provides them with shelter, healthcare, educational opportunities, and assistance finding work.

The additional Clinical course this semester is Role Transition. This course focuses on the students’ involvement and experiences in their Role Transition/Practicum site, where they are placed based on their particular interest. Students participate in either the Community Clinical or the Role Transition Clinical for half of the semester, and then switch mid-way through. I will be finishing up my Community Health Clinical in a few more weeks, after which I will begin my Role Transition Clinical. I’m placed at the Mother-Baby/Postpartum Unit at Emory University Hospital, Midtown. During this clinical, I’ll have two 12-hour shifts to complete each week. It sounds a little hectic, but the students in Role Transition now are somehow managing to meet the requirements, so I know it’s possible!

Our last course is Professional Development: Politics and Public Policy, specifically relating to Healthcare. Because of the rising costs of healthcare, and new policies being enacted regarding healthcare, it is imperative that students become informed and aware of these changes. This course provides invaluable information to us about a variety of different topics, such as the economics of healthcare, healthcare reform, and quality improvement. In addition, we also attend some type of legislative day for this course. I attended the Georgia Nurses Association Legislative Day this past January, where I was able to speak with a variety of senators and representatives about Healthcare delivery.

This is a busy semester for virtually all of the students, but I think we’re gaining information that will be highly useful for our future careers as BSN nurses. I think one of our biggest motivators to keep working through this semester is the countdown to our graduation on May 14th!!

Senior Year – Community Health Clinical

Throughout the last semester of Nursing School, the seniors have either one of two clinicals – Community Health or Role Transition (i.e., practicum/preceptorship). After half of the semester is completed, the students switch from one to the other. For the first half of this year, I’ve been in my Community Health Clinical at the Gateway Center in downtown Atlanta. This facility serves homeless men, women, and children that have come to the Atlanta area for a variety of different reasons.

The Gateway facility is able to provide temporary shelter to these clients, but it places a special emphasis on gaining work and education. Many of the clients are enrolled in a variety of educational or treatment programs in an attempt to restore their lives and regain their independence. The initial intake area is a large, open room with a variety of clientele – all different ages, races, genders, and ethnicities. One of the first things I learned very quickly in this clinical rotation is that there is no stereotypical “face of homelessness.” Many people have preconceived notions about what a homeless man or woman looks like. However, just from working in this Center for only a few weeks, it is quite clear to me that this is not the case at all. Many of the clients we work with were once in very stable positions, but due to some unforeseen event, they have come to find themselves homeless. In fact, one of the staff members of Gateway was even a former client of the facility. Working with this population makes it quite obvious that all of us, no matter what our situation or background, are susceptible to homelessness.

During our clinical shifts at Gateway, we participate in a variety of different activities, such as educational sessions, art therapy, and health fairs. Some of the topics that the clients are most interested in include hypertension, diabetes, stress management, and heart health. We usually get a pretty good turn-out at each event, with a record set for our group of 39 participants in last week’s health fair on Heart Health (conducted by students Chelsea Pharr and Marcus Whitlow). The patients are always especially interested in finding out what their blood pressure is, ways to reduce these numbers, and information on healthy diets. I’ve been so impressed by how interactive and receptive the majority of them are with all of the students; they’re genuinely interested in hearing what health advice we can provide, and ways to improve their situations.

The nursing students at Gateway act in many different roles during the clinicals – student nurse (of course!), educator, counselor, and listener. I’ve found that the latter role, listener, is often one that the clients appreciate most. As our clinical instructors, Prof. Monica Donohue and Jordan Simcox, have informed us – many of these men and women are never even routinely called by their own name when living on the streets. So many of us get caught up in all of the busy work we have to do each day with school, friends, and family, and while this work is difficult and time-consuming, it’s important to think of populations that are quite worse off than us. Imagine living on the street and having most people avert their eyes whenever they walk past you, as if to ward off any type of conversation or pretend you aren’t even there. When a student, or anyone, sits down with any of these men or women and takes the time to talk to them, and especially listen, it truly seems to improve their outlook. Once again, the “art of listening,” that is often highlighted as a gift of nurses, serves to provide a connection with these clients that may have been missing in their lives for quite some time.