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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