Archive for Service Learning

Welcome to the Jungle – PR Day 1

What a day! The 11 Emory students in our group, plus two wonderful Emory professors, arrived in Puerto Rico yesterday evening and ate a traditional meal of mofongo, which is a mix of fried green plantains and, in our case, shrimp. We also sampled some conch meat — you know, the creature inside the shell you hold up to your ear and listen to the ocean with. What a treat!

Delicius mofongo

 

If you like (alcohol-free) Pina Coladas…

 

Today was our one “free day” of the week, and we packed in as many Puerto Rican activities as possible. We started in the Yunque National Forest, southeast of San Juan. We hiked through the jungle and splashed around in waterfalls. We drank homemade lemonade and got amazing views of the country from atop a fire lookout tower.

El Yunque National Park

 

We ended the day with a swim in the ocean, some snorkeling, and fried fish and ceviche. We practiced our Espanol and are resting up in our Salvation Army dorms for tomorrow’s activities — let the service learning begin!

Graduate Students Reflect on Immersion Experience during West Virginia Flooding

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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

Medicine and Compassion: A Journey through Italy

Every day, we learn to remind ourselves as healthcare providers how to be effective communicators and focus on patient-centered care. We learn about therapeutic communication and how to build an empathetic and compassionate relationship with our patients. However, 78% of providers think that they are providing compassionate care, and only 54% of patients think that they receive it. These numbers are not good numbers. This past summer, I received a scholarship to travel to Italy to study what it means to practice medicine with and without compassion. The program explores in-depth Italian literature, art, architecture, history, cultural and political development throughout the ages, from the early Etruscans, Phoenicians and Greeks to the Italy we experience today visiting towns from the northern alps to the southern shores of Sicily. We visited over 50 sites and museums, and over 47 towns and cities including visits to: Orvieto, Pisa, Assisi, Cinque Terre, Siena, Montalcino, San Gimignano, Pienza, Lucca, Florence, Ravenna, Padova, Vicenza, Venice, Verona, Naples, Pompeii, Sicily, Capri, Paestum, Sorrento, Matera, and many more. It is unique journey that integrates medical humanities with on-site cultural immersion. We worked to analyze visual art, cultural history and literature in the lens of what is compassion and what lessons can art communicate to healthcare?

Through each town, we investigated notions of compassion, mercy, and charity as civic and religious virtues illustrated through Italian history, art, literature social institutions, current events and daily life. With group discussions, individual research and lectures from faculty from the Center for Ethics and Schools of Medicine & Public Health, I was able to fully grasp the scope of Italian culture, history and identity. I learned that the arts and humanities help us demystify the notion of death, dying and suffering by providing countless examples of lives that have come before us. Our world is uncomfortable with conversations that speak about human fragility and finality, and it is increasingly hard to speak about the self completely in conversations because there is never an appropriate place or time to talk about such deep questions in the whirlwind pace of the environment that we all live in. Therefore, we all find ourselves by the bedside of those who are suffering and dying where the patient, health care professional, and visiting relatives struggle with how to be present to one another in their vulnerability.

Experiencing art may help to open one’s mind to a different way of thinking, to see the world or situation through another’s eyes. This helps to develop empathy, an essential element in a healthcare provider’s character. During my six weeks in Italy, I examined historical and recent writings from the medical humanities and explored the meaning of compassion and how it has affected the care and health of people over time. I explored multiple paths of communication with “others,” allowing an enhanced sense of global vision within me. I also looked at renditions of compassion in Italian art, attempting to understand what various artists sought to communicate about compassion, suffering and healing. This program has been the most challenging academic and personal journey I have ever had at Emory, but every moment has been invaluable and transformative. It is an experience that has changed my perspective on traveling to other countries, learning about other cultures, and ultimately, I have gained a deeper understanding about myself.

Alisha is a BSN student and sees that being a BUNDLE scholar is an opportunity to embark on a path that combines clinical practice and community engagement. From her past experiences of volunteering in Honduras or doing research in the cardiology department, she has discovered her passion to would in nursing, public health and research. Alisha’s goal is to work with underprivileged populations by providing compassionate patient care despite the limited resources and tragic levels of poverty and sickness.

You can contact me at abhima5@emory.edu


Information about the program used in this article has been referenced from the source below, along with using the insights and notions she learned from her professors, Cory Labrecque and Judith Moore.

http://www.italianvirtualclass.com/pdf/summer2016.pdf

My BUNDLE Experience

Kevin_CurrieAs a future nurse, I hope to develop a strong base of critical care expertise by working in an ICU before pursuing a doctorate in nurse anesthesia practice. As I develop professionally as a nurse through college and into my career, I strive to go beyond simply caring for patients and hope to make a meaningful impact in the field of nursing and beyond; that is to say that I strive to become more than a nurse; I want to become a nurse leader. And that is why I joined the BUNDLE Program.

The BUNDLE program has prompted me to visit a fascinating exhibit at the CDC about refugee crises, question what it means to be a leader, and practice my public speaking and networking, among other things. As a man who has wanted to be a nurse for at least six years now, the questioned abilities and masculinity, lack of male mentors, and numerous attempts of redirecting my career ambitions had set doubt in the back of my mind.

The BUNDLE program has offered me an immensely supporting community of beautiful human beings that has given me confidence to cast aside doubt in pursuit of my goals as well as offer constant support through trying times. I believe that a nurse’s holistic way of thinking, constant interactions with society’s marginalized individuals, and highly recognized and respected title help to more fully comprehend and address some of society’s shortcomings and public health needs, in particular.

I see nurse leaders not as leaders confined to the domain of nursing, but rather as unrestricted leaders with unique and valuable qualities; the word “nurse” is a badge of honor to be worn in front of the word “leader”. The BUNDLE program has helped me come to that realization. Thanks to the stimulating activities of the BUNDLE program, I am increasingly more drawn to develop and apply these unique nurse leadership traits in hopes of confronting and combatting some public health and societal issues through research, advocacy, and action.

Byline: I am currently a third year student from Nashville, Tennessee pursuing my BSN at Emory. In addition to my BUNDLE Program involvement, I am in the Honors Program, VANAP Program, and serve as secretary of Emory’s Men’s Water Polo team.

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!

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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.

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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!

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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

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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.

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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.

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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.

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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.

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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…

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.