Archive for Jamaica

How Nursing School Showed Me a Difference World

Elizabeth Balogun, BSN Class of 2017, BUNDLE Scholar

Whenever I get the question “Why did you choose nursing school?”, I almost always respond with my usual, “You know, it just kind of happened.” That question takes me back a bit and makes me think about why I chose nursing and how I got here. Occasionally I even think back to an information session where we were presented with the wide varieties of undergraduate studies at Emory. I remember that I turned to my friend, and laughed at the idea of becoming a nurse. Although it often feels like nursing school was just something that just happened to me, I sure am glad that it happened. I am glad that I tagged along with my friend to a pre-nursing club “Meet the Juniors” event that got me thinking about nursing school. I am glad that this profession, that is rooted in caring, found me.On my very first day of classes in nursing school I hoped and prayed that I had made the right decision, and I have found over the course of my four semesters here that I am indeed in the right place. I did not know much about public or global health or the role of nurses in those settings until I got to nursing school. I did know, even before nursing school, that I would like to spend my career providing care in any way I could to anyone who needs it. As a scholar in the Building Nursing’s Diverse Leadership at Emory (BUNDLE) program I have learned about public health nursing, the need for cultural diversity and awareness in nursing and nursing care, and being a nurse leader and a force for change. Between my classes and my BUNDLE experience I found that I wanted to be a public or global health nurse. My alternative winter break trip to Montego Bay, Jamaica (which I was on the fence about going to) really confirmed that for me.Upon arrival in Montego Bay, we were on the road and ready to take on our first project a few hours after arriving. I had never been happier and filled with a greater sense of fulfillment while immensely exhausted as I was on this trip. We were gone from early in the morning to late at night setting up clinics in churches, teaching reproductive health, doing yoga with hearing impaired students and so much more. One of many profound moments for me was when a man who had visited our church clinic came back with a bunch of plantains for a student who had taken his blood pressure to show thanks for the care he received. Our clinic on that day simply offered blood pressure and glucose checks, BMI calculation, some health education, and a few incentives such as anti-fungal cream and reading glasses. These are things that do not seem like much to us in the United States, but a farmer in rural Jamaica valued these simple things so much that he was willing to give us his produce as a token of appreciation.This experience solidified my goal to become a public/global health nurse. It reminded me that there are people around the world, and even in the United States, who do not have the resources that we take for granted. Whenever I think back to the experience, I want to continue to strive toward the goal of sharing the skills and knowledge that I have been fortunate enough to gain through my nursing school experience and training. I want to use these skills to empower others around the world to take charge of their health. I hope to continue to learn and push myself as an individual and a nurse from my experiences with the diverse groups of people I encounter.

***
Elizabeth Balogun is a BSN 2017 student and a BUNDLE scholar. She is from Lawrenceville, Georgia and hopes to become a public/global health nurse providing care for low resource and underserved populations around the world.

Montego Bay: Nursing is an art and a science

After three days in Jamaica, we all started to have a routine: wake up, get ready, eat eggs, drink coffee, and file into the two blue buses with Willie and Mr. Miller (our amazing bus drivers) to start the day.

As the blue vans started driving down the rugged gravel roads, I still could not grasp the fact that we were driving on the opposite side of the road. The separation between each lane were so small that it felt like we were hugging the other drivers going the opposite direction. However, both Willie and Mr. Miller had no fear or hesitation. They swiftly diverted the pot holes, the sharp turns, and the other experienced drivers.

We started the day by heading to a day school for children. Remi (BSN ’17) took charge and started the education with hand washing. The children excitedly washed their hands in the court yard and then vigorously rubbed glo germ all over their fingers. With a black light, Remi and the other students demonstrated how well the kids performed the hand washing. The children’s eyes widened as their hands glowed. We knew that this activity captured their interest. We then followed the hand washing education with teaching children how to brush their teeth and how to eat a balanced meal. Dr. Ades would be proud!

img_1913 img_1859 img_1846 img_1795

img_1867

We also continued to provide free health screenings to the educators of the school. They continuously smiled as we taught them about diet, exercise, and their overall health. Overjoyed with appreciation, they showered us with hugs and genuine compliments.

Filled with affirmation, we drove to Cornwall Regional Hospital where we were greeted by the Chief Nursing Officer, Marva Lawson-Byfield, at the Ministry of Health Jamaica. She intently started at us as she shared her love for her patients and for the career of nursing. “Nursing is an art and a science. The art is in the heart and the science is in the conscious.”

Her words reminded us of our choice in nursing and those words continued to resonate with us as we toured the different wards of the hospital. When we reflected afterwards about this humbling experience, we realized that different aspects of the hospital impacted us. Some of us recognized that their lack of an EMR system served them well and allowed them to break away from routine and use their minds to serve others. Some of us saw this as an overwhelming experience and how this hospital reminded them of why they decided to become nurses. Lastly, some of us witnessed nurses creating innovative solutions and loving care to their patients. Ms. Lawson-Byfield said it well when she ended her welcoming speech emphasizing how attitude towards your job and towards your patient is every thing.

With our stomachs growling, we headed to Juici Patties to culture ourselves with Jamaican patty. This flaky baked pastry shell contained different fillings (beef, chicken, or vegetables) that exploded in my mouth with a diverse mixture of mesmerizing spices.

img_1993img_1997

We then continued our day with a Cornwall Regional Hospital Nurse Graduation. The soon to be nurses slowly walked into the church with their blue striped hats and their crisp white dresses. As I watched them, I couldn’t stop my mind from wandering to our own graduation either in either May or December of next year.

After sharing the experience with Jamaica’s future nurses, we ended our day with a children after school program that overlooked the lush Jamaican mountains. As our blue van slowly drove up to the gate, Candace (ABSN ’17) opened the van door and said “Change of plans”. As team lead with Blair (BSN ’17), they decisively directed five of us to quickly prepare a skit about bullying, delegated three of us to follow the skit with yoga, and sent two of us to the office to provide health screenings for the staff.

Prior to the skit, Dria (ABSN ’17) invited two of the children up to participate in the skit and stand up for the girl that was being bullied (me-Lisa, ABSN ’17). The girls courageously said “stop!” and stood in front of me to hinder Dria and Sarah (ABSN ’17) from their actions. Through this experience, we started to see their understanding and their strength.

Alex (BSN ’17) also creatively took a few females to the corner of the playground to discuss women’s health. Besides the unexpected rap performance by the girls, she ultimately created an open space for the girls to speak comfortably about being a women, about hormones, sex, and contraceptives.

15556234_1187113241373813_1774443868_o
 

Although the day was long, hot, and sweaty, we witnessed health promotion at work through each other and through the people of Jamaica. It’s amazing to see the amount of heart and commitment my peers have for those they serve. I am excited to see our next adventure tomorrow! 

Montego Bay: 16 nursing students, two professors and one breast model take Mobay

DAY 1| The bustling of the footsteps resonated throughout the Atlanta International Airport. All 16 of us arrived with high anticipation. Dr. Muirhead and Dr. Horigan, our two faculty instructors, directed as we quickly checked in eight packed suitcases of medical supplies and incentives (blood glucose monitors, gloves, band aids, hygiene kits, glasses, lotion, etc). We promptly started walking through TSA security with no concern or doubt that we would be stopped. However, we were completely wrong. Although most of us walked through smoothly, Dria (ABSN ’17) confidently knew that she would be stopped. “I just knew it,” she said as she shook her head after the incident. The red lights immediately flashed as her luggage passed through the security scanner. The TSA officer started searching through her personal items before pulling out the breast model she had for her breast self exam presentation. The officer’s eyebrows raised as she questioned, “what is this?” Without a second thought, Dria went nurse mode and preceded to educate her about breast exams. She even encouraged her to perform her own self exams and emphasized the importance of it. By the end of the conversation, Dria walked away with not only her breast model but also with the satisfaction about her premature patient education. We knew right then that this would be a good trip.

When we finally made it to Jamaica, we went straight to work. After refueling our energy with food, we took two hours packing first aid kits as incentives for our very first event! After designating leaders for this event, we headed over to The Church of God to speak with the individuals about the health related issues in Jamaica and Montego Bay.

img_1374

img_1345img_1413

Elianne Carroll (ABSN ’17) and Fauziya Ali (BSN ’17) created and executed the health module about the Zika virus. The ladies of the church listened intently as they followed them through their poster. In order to guide their understanding, we also provided them with an educational handout that had additional information to address any concerns.

img_1446 img_1438

After the presentation, we provided free blood pressure screenings and patient education. Dr. Muirhead floated around to assist and provided further patient education about actions individuals could take in order to help lower their blood pressure. Each participant received a gift bag with deodorant, anti-fungal cream, and their own personal first aid kit. The ladies and specifically the kids at the event enjoyed both the information and our presence.

img_1448img_1511 img_1498

We returned to the hotel in good spirits and hungry. After eating, debriefing, learning about hypertension education tips, and creating aromatherapy rice bags, we went straight to our rooms to say hello to our beds. FIRST DAY, SUCCESS.

 

BUNDLE Jamaica

We are so thankful for your profession because nurses give life.

This past winter break, I had the opportunity to travel to Kingston, Jamaica on my very first international mission trip. Although I have been to the Caribbean before, I was especially excited to learn about nursing in another country and observe the similarities and differences to practices in the United States.

We spent the majority of our trip working along side the brothers of Missionaries of the Poor. Missionaries of the Poor, founded in 1981 by Father Richard Ho Lung, is an international Roman Catholic order of brothers dedicated to serving destitute and abandoned children, women and men of Jamaica. The minute we arrived at the shelter, we automatically felt the positive spirits of the residents. We were immediately greeted with handshakes, hugs, and many smiling faces.

I have especially been interested in pediatric care throughout my nursing school journey. Therefore, I was able to spend much of my time at the “Bethlehem Center” caring for children ranging from ages 1 to 22 years old. Many of the children are living with conditions such as cerebral palsy and asthma. While at the center, we had the opportunity to administer albuterol treatments, perform full body assessments on children and therefore refer those especially in critical conditions to the local hospital, as well as assist the brothers with activities of daily living such as changing and feeding the children. The children’s favorite part of the days was when we were able to take them outside to sing, dance, blow bubbles, and play with each other. I admired the beautiful spirits of the children because even though many of them had been abandoned by their families and lived with such life altering conditions, they were still children who enjoyed the simple things in life like singing and dancing.

Towards the end of our trip, we visited Kingston Public Hospital (KHP) where we compared and contrast the different aspects at hand in Jamaica’s healthcare system. While touring the hospital we spoke with many nurses to gain more insight into the everyday life as a nurse at KPH. Similar to the US, the nurses expressed that understaffing was a huge barrier they face every day. In addition, overcrowding often adds another obstacle for them to overcome. However, what I most admired about many of the nurses was their optimism.  They may not have the same resources as the US, but they’re commitment and passion to care for patients as best they could were absolutely inspiring.

Not only was I able to experience the beautiful country of Jamaica, but also I was able to meet, hug, smile and laugh with dozens of beautiful people who all continued to fuel my passion to be a nurse.


Anika, a current BSN student and BUNDLE scholar is hopeful to continue embracing the public and global health in her future nursing aspirations. Her interests include acute and chronic conditions within the pediatric population and plans to work in underserved populations in the near future.

A different World: The best experience of nursing school

Have you ever traveled? Visited different countries, cities and resorts? I’m sure at this point in your life you have done so at least once. The real question is, have you ever traveled on a mission trip? I can say I  have been blessed to have accomplished this one on my check list and hope to do many more. This past week I went to Jamaica on an Alternative Winter Break trip and I can only say it is one of the best experiences of my time in nursing school.

The trip to Jamaica started the day after my last final which made it a bit stressful. I then started to wonder about my level of insanity to have chosen a trip during this time, but I can definitely say it was all worth it. Along with volunteering at different churches and communities doing different health screenings, my group and I had a chance compare the Jamaican and U.S. Health systems. This was the icing on the cake for me. We toured the Cornwall Regional hospital, the main hospital in the St. James Parish, and shadowed the nurses. It felt like we were in a different world of nursing. It truly amazes me that even through the differences in healthcare and resources, we still manage and survive. It means so much to go on this trip as a student because the experience humbles you and allows you to think about how you can help change or improve things.

While, on this trip I learned more than a handful that will supplement my nursing role and career. If you have not had the chance to participate on a trip abroad or getting ready to do so, don’t you worry it is totally worth it. You will grow, adapt, mature and enjoy your time. I am brave enough to promise you that!

 

By: Nadege Pierre, BSN Class of 2016

 

Montego Bay: Girl’s Home, Hospice Center, Women’s Centre, Children’s Home

Day 2 (continued):

After finishing our tour at Cornwall Regional, we arrived at the Melody Home for Girls at about 4:30 on Tuesday ready to enrich the lives of some young teenagers. This is an orphanage for young girls who have gone through some tough times in life, have no parental support, and need guidance. Heather Balenger (BSN ’16), Jessica Rutledge (BSN ’16), and Xueying Cao (BSN ’16) pioneered the way with health education presentations on the importance of exercise and STD and safe sex practices. The group drew the girls first with an icebreaker known as the human centipede followed by some stretching and group talk on the importance of exercise led by Jessica Rutledge. Heather and Xueying kept the girls attention with safe sex practices by involving them with the proper condom administration performed on bananas; and it was a hit!

IMG_2811-1  IMG_2820-1

Sabrina Jahani (BSN ’16) followed their well received module with a very informative and interactive teaching on domestic violence equipped with a moving domestic abuse skit read by Erin Pollock (BSN ’16). The girls were very engaged in this subject and were most vocal on this matter. To round things off for the night, Chuncey Ward (BSN ’16) and Heather joined Sabrina for teaching on dating older men and the dangers associated with this matter. Everyone had a great time in fellowship with one another and smiles were everywhere at the end of the night. This was the first time for Emory SON at Melody Home for Girls, but I’m sure it won’t be the last.

IMG_2810-1

Day 3:

To get our third day in this beautiful city started, we visited a hospice center to provide companionship and laughter to the patients who lived there. We thoroughly enjoyed getting to know those patients and hear their life stories. Some students performed massages and others went room to room singing Christmas carols. The Christmas spirit was certainly in the air!

We arrived at the doors of the Montego Bay Women’s Centre at around 11:30 as the second stop on our Thursday leg of the trip. This is a place where young teenage girls who are pregnant can come and continue their schooling as being pregnant  is not allowed in the public schools. We found that the girls have the option to stay for 3 months post delivery if they choose and once they have given birth. Xueying Cao (BSN ’16) led the discussions by informing the girls on pregnancy prevention. Heather Balenger (BSN ’16) tag-teamed Xueying’s efforts with a presentation on HIV and STD awareness and safe sex practices equipped with her patented condom-on-the-banana race. Kate Yuhas (BSN ’16) finished everything up with a group interactive presentation on healthy food choices and nutrition pointers to keep in mind as young pregnant women.

Throughout the day the girls had several opportunities to win prizes that included baby bibs, board books, diaper rash cream, socks, nipples, bottles, diapers, and much more. At the end of our day we sat individually with groups of the girls and discussed similarities and differences between life in United States and Jamaica as well as their plans after pregnancy and high school. Gift bags including shampoo, soaps, toothbrushes, toothpaste, combs, lip balm, and candy canes were given to each of the girls on our way out. For our farewell, we sang Christmas carols for the group. Our holiday spirit carried us over to a daycare next door where preschoolers were enjoying popcorn and a bouncie house. We made lots of little friends there and also gave them a good helping of Rudolph the Red-nosed Reindeer and Jingle Bells…and they of course loved it!

Unknown-1 Unknown Unknown-2 Unknown-3 s64fxEeLp_ubgFs8dhPbhcnJ6zvyejVXP1bMOFAuYrU

Our bus driver for our stay, Mr. Willie Smith (Not to be shortened as just “Will”) took us through down town Montego Bay for lunch to introduce us to what he described as “the best beef pattie spot on the island,” Juici Pattie. Everybody enjoyed the tastes of Jamaica indulging in patties with beef, curried chicken, curried shrimp, and beef and cheese.

After lunch, we continued on to the Blossom Garden’s Children home, an orphanage that took care of many children from infants to school-aged children. We performed health screening for all the workers in the facility including BMI, blood pressure, blood glucose, and counseling afterwards to discuss the results. Other students spent time with the children, feeding and interacting with them. Jessica Rutledge (BSN ’16), Nadege Pierre (BSN ’16), and Jaine Lee (ABSN ’16) provided education about physical activity and used the game “Simon Says” to show one way to perform exercise. Marcela Sanchez (BSN ’16) demonstrated how to correctly brush teeth and all children were provided a goodie bag that included a brand new toothbrush and bottle of toothpaste. Kate Yuhas (BSN ’16) provided education regarding healthy eating.

After a long day, the group returned to the our hotel and enjoyed a meal together along the water at one of the nearby restaurants.

Montego Bay: Comparing Jamaican and US hospital systems

ocean

Day 1:

Our trip started off to a great start with our arrival to Montego Bay on Tuesday morning with 17 nursing students, our two faculty instructors Dr. Muirhead and Dr. Erin Ferranti, and four full suitcases of supplies for our work in Jamaica. Some of the medical supplies we brought include blood glucose monitors, lancets, gloves, first aid kits, hygiene kits, blood pressure cuffs, sharp containers, and stethoscopes. In addition, we collected other supplies and donations to give to the Jamaican community including bibs, pacifiers, lip balm, toothpaste, toothbrushes, candy canes, glasses, bar soap, socks, lotion, shampoo, razors, diapers, and combs.

IMG_3101     IMG_2824-1

 

IMG_2818

After checking in to our hotel, the group headed to The Church of God to speak with the men’s group about healthcare problems specifically associated with  Jamaican men.

Erin Pollock (BSN ’16) led our discussions with an education module about smoking cessation and the problems associated with both firsthand and secondhand smoking. The men were very engaged in learning about how nicotine affects the body and ways to quit smoking and/or share with friends and family. Afterwards, each participant received a handout to help develop an action plan to ditch the habit and a pack of gum to show one way to support smoking cessation.

Chuncey Ward (BSN ’16) continued with an educational module about the risks and symptoms associated with benign prostatic hyperplasia and prostate cancer, which is a very prevalent issue in the country of Jamaica. The men received handouts with relevant information to bring back home with them in hopes that they will educate their peers and community.

IMG_2823

After both presentations, we performed blood pressure and body mass index (BMI) screening. For those whose BMI was elevated, our nursing students provided one on one patient education regarding exercise, diet, and lifestyle modifications.  The men were receptive to our advice and felt very motivated to maintain healthier lifestyles.  Afterwards, every participant received a gift bag which included anti- fungal cream, condoms, and razors.

After debriefing upon return to the hotel, the group got a good night’s sleep in preparation for our day at Cornwall Regional Hospital.

Day 2:

At 7:30 am, the group left the hotel and headed to Cornwall Regional Hospital, a ten-floor facility of the West Regional Health Area that served the Montego Bay population in a variety of specialties including psych, pediatrics, and oncology. We met the director of nursing services as well as other nursing personnel who helped explain the structure of the nursing profession in Jamaica. We then divided into two groups and toured all units of the hospital. We were able to engage with the nurses and ask questions, comparing practices between Jamaica and the United States.

ydAMIojGDwwwSim08XLptHf4y5fL75DBgAYMHWr9vY4

Some examples of the differences we found include:

  • No epidurals are performed, only spinal analgesia
  • Hospital facility was open to air in center of hospital and in almost every patient floor
  • No IV pumps, gravity based drip factor calculation
  • Medications are not locked, no Omni cell
  • Nurse to patient ratio is 1:15, can be up to 1:25
  • Average wait time in the ER is close to 24 hours
  • No heparin is used in the facility
  • They use water jugs for traction
  • There were wards instead of units; individual wards are separated by gender
  • No electronic files, all handwritten notes
  • Med cards are written on index cards instead of an electronic MAR
  • Nurses here work 8 hour shifts instead of 12 hour shifts
  • Very formal dress wear including a headdress
  • 1 male registered nurse in the whole facility
  • Nursing school onsight, 5 year bonding
  • Pale comparison in pay: $641/month, $7700/yr, 32% taxes
  • Security guards at front door of hospital
  • Full healthcare coverage for everyone

Later in the day, we were able to break up into different wards and observe the nursing role in the hospital directly.

1334x1000.jpeg.3f2443a53e8e4680bd2bf7ea885e3d58.large

 

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…