Tag Archive for Georgia

A Year Worth of Clinical

Isai Flores, BSN Junior, BUNDLES Scholar

The night before clinical I could not sleep from excitement. Filled with nervousness and anxiousness, I tossed and turned in my bed unaware that the morning was quickly approaching. I had organized everything I needed prior to going to bed. I neatly folded my scrubs and placed them on top of my dresser. I imagined how it would feel to finally be in the hospital in my uniform. I felt proud about all the skills that I had learned in the classroom. However, I also knew that I would not perform my skills on mannequins but rather on living people. I did not have the luxury of getting a second opportunity to perform the given skill. When I woke up in the morning, I put that anxiety behind me and pushed forward knowing I was prepared. I put my scrubs on, double-checked if I had packed everything and headed out the door anticipating my first footsteps in the hospital. I expected to see a wide array of patients – each unique with different health concerns and with different plans of care. I yearned to see how nursing theory translated into practice.

Turning left off of Ponce de Leon Drive, I saw the sign: Emory University Midtown Hospital. I was ready to enter the hospital and arrive at Unit 31. The culture of the unit could be summed up in one word: inviting. This was my first semester in nursing school.  They were very open to us even though we were students with very limited knowledge. I think by the end of that semester I had mastered the art of the bed bath. During that first rotation, I shadowed a nurse who had worked on that same unit for thirty years. She encouraged me to speak to the patients and ask her questions about anything I noticed. I asked her about how she schedules her day, how she chooses what assessments to perform on the patients, and so many other questions. She answered every single question with eagerness, willing to share her knowledge.

***

Second semester, so far had been fantastic. Population health and pediatrics were the best moments of my clinical experience. Waking up the morning of my first day of population health clinical, I knew I would be greeted by familiarity. First, because I had spent time at Mommy & Me for service learning last semester. Secondly because I hoped to stay with the same kids from last semester. Despite this familiarity with Mommy and Me, Clarkston was starkly unfamiliar to me. We have only a few weeks and the thought of planning a substantive intervention slightly worried me because six weeks seemed too little. I thought: how would we do this? What was the main problem that they faced? How would we help ameliorate all the health issues that this community faced daily? I knew the answer to that question already. We simply could not. At least – not in the time span that we have. However, I know that we could think of something that can, at least for the time being, address some of the health issues. At the end of my session, we made home visits to the mothers to further assess the health needs of the community. They were a source of inspiration and bounding resilience that could only be gained by personal experience. In the end, we worked on educating the mothers on health insurance and how to renew benefits for their children.

Overall I have learned that health care is so multi-faceted. The multi-dimensional approaches to health that we have taken in my clinical experience have surpassed my expectations. I look forward to next year and the future where I can learn more and achieve more.

~~~

Isai Flores is a third year student at Emory, in the school of nursing, pursing his BSN. He is a Gates Millennium Scholar and a BUNDLE Scholar.

Caryn’s Big Word

Ariel McKenzie, BSN Candidate 2018, BUNDLE Scholar

The encounter I had with Caryn happened at the International Bible Church in Clarkston, Georgia. My service learning group was delegated the task of encouraging language nutrition amongst refugee mothers and children as a part of the Mommy and Me family literacy program. Encouraging mothers to engage their babies and children as their conversational partners can be difficult when a language barrier already exists between the volunteer and the family. I had the privilege of working with the young toddler class and the ease with which they pick up words boggled my mind at times.

Caryn, a young toddler from Vietnam was one of the more social kids in her group. She would come into class and made sure all the volunteers saw how pretty she looked that day. She played with all the children and chatted away as she moved from station to station. The room was equipped with playing stations that included cars, blocks, a play kitchen, books, and a large box filled with treasures buried in dried black beans. There was a stipulated schedule for each day and play time was the first item on the list. When I came into class on a Thursday morning, I sat down by the cars and train playing station and began talking with the kids. On any given day, few kids even respond to my over-the-top excitement and enthusiasm, but Caryn thought it was so funny. She came and sat at the station with me and we began to play with a green bus. The bus had a Triceratops dinosaur on it and I thought it would be worth a try to see if she could pronounce the word Triceratops. I pointed to the dinosaur and said di-no-saur slowly and clearly. She repeated the word “dinosaur” with ease so I proceeded to say Tri-cer-a-tops. She sounded out the word and within minutes, she was calling every dinosaur in our bucket a Triceratops. I was shocked to say the least. Few kids even spoke to me and here was one that was sounding out a word that some elementary school kids rarely use.

Empirically knowing according to Carper’s fundamental ways of knowing involves scientific, evidenced based practice (Johns, 1995). Approaching our encounter empirically, I acquired some background knowledge through the Talk with Me Baby training that my service learning coordinator organized. Through the training, I learned the importance of engaging children as soon as they’re born as our language partners and promoting language nutrition within the family. The training provided evidenced based methods for language development in children and the results of implementing those methods as early as infancy.

In addition to applying an evidenced based approach during my interaction with Caryn, I applied Carper’s aesthetic way of knowing by grasping the nature of this specific encounter and acting according to what I believed was appropriate (Johns, 1995).  I noticed Caryn’s behavior in class and I knew she was an outgoing, eager learner. She demonstrated no intimidation while happily playing and talking to the other kids in the class. Taking into account her personal attributes, I thought that encouraging her to pronounce a word might benefit her language development. Additionally, the likelihood of Caryn trying to pronounce that word was high based on her natural curiosity.

Carper’s personal way of knowing begins with the nurse firstly knowing herself (John, 1995).  By addressing my prejudices and being willing to set any obstructive biases aside, a smoother interaction with the kids can occur. Having many close friends that came to the United States seeking a better quality of life, I knew that I was biased in Caryn’s favor. I’ve witnessed my own peers struggle to learn English and how successful they’ve been with continual effort. I know learning a second language can be challenging especially when a person is still learning new words in their native language. However, it can be done and I hope for nothing more than to see the students in the literacy program excel in their language development.

Carper’s ethical way of knowing entails differentiating right from wrong and taking appropriate action (John, 1995). After reflecting on the interaction I had with Caryn and my service learning experience in Clarkston, I conclude that the right action was taken. The families that participate in the program want to be there. They want to learn English and skills that will make their transition to living in America easier. This is why I believe encouraging them to reach their maximum potential is the right thing to do. Even though my interaction with Caryn might not seem extremely important in the grand scheme of things, it was. The satisfaction children experience when they successfully grasp a new skill is one even I remember. The least I can do is help kids experience that satisfaction while enhancing their language development.

My service learning experience in Clarkston differed from other experiences I had with people because this time I felt like I was representing something bigger than myself. Not only was I serving on behalf of Emory’s school of nursing, but I was a nurse to those kids. They didn’t know that I’m only in my first semester of nursing school. I was wearing nurse’s scrubs, so, therefore, I was a nurse. Our service learning group might have been the first nurses the kids encountered since moving here and I really wanted them to feel safe and happy around us so trust could be established instead of fear as early as possible. I’d like to think that with every human encounter that I have while I’m in uniform that I have the opportunity to increase a person’s trust in health care workers. The techniques I used to guide the conversation were building rapport, smiling, over enunciate, and offering positive reassurance. These techniques were helpful because the kids were very young and they often shy away from adults if they sense the person is unenthused. Hopefully, the program will continue to thrive and Caryn’s vocabulary will continue to grow.


References

Johns, C. (1995). Framing learning through reflection within Carper’s fundamental ways of knowing in nursing. Journal of Advanced Nursing, 22(2), 226-234. doi:10.1046/j.1365-2648.1995.22020226.x

A Global Health Opportunity in Our Own Backyard

Jessica Nooriel, junior BSN student and BUNDLE scholar

In my first semester of nursing school, my volunteer hours were spent at the Friends of Refugees program called Mommy and Me in Clarkston, Georgia. In this Family Literacy program, mothers are taught ESL while their children are exposed to the English language as well through language nutrition. This intervention is based upon evidence and multiple studies, and these studies have shown that the more exposure to words a child receives in his or her first few years of life, the higher their chances of achieving literacy in his or her younger school-age years and the better chances they have of attending university and obtaining jobs later in life. So, in short, language nutrition is of utmost importance, especially for this population of refugee children who are being raised in homes in which English may not be used often.

After my first semester volunteering with this program, I had spent sufficient time in the various classrooms interacting with the children and I thought that I had a grip on what public health meant for this community. It was plain and simple. Learning the language was the most important factor in the process of these refugees becoming integrated into American society, so I thought.

This semester, my second at the nursing school, was when I began my full population health clinical. Coincidentally, I was placed at the same site as where I volunteered last semester, the Friends of Refugees Mommy and Me program. Since I had spent some time volunteering at Mommy and Me last semester, I thought I knew what to expect for my clinical portion of population health at Mommy and Me. As before, I thought I would arrive at the Clarkston refugee school, be introduced to a new class’s teacher, and then spend the morning speaking and playing with the refugee children of that class until their mothers came to retrieve them at noon.

During my second clinical day at Mommy and Me, though, all of my expectations were exceeded. This time, I felt more empowered. During our pre-clinical meeting in the morning, we discussed our roles as student nurses in this clinical—which involves responsibilities such as noticing refugee children who may have health conditions that aren’t being treated or observing community-wide health issues or gaps in knowledge. This time around at Mommy and Me, I was given a task and a tangible goal, to improve the overall health outcome of the Clarkston refuge community, whether through individual or community actions.

My morning began as I expected. I joined an older toddler classroom, where I aided with snack time, played with the children during playtime, and gave the children as much language nutrition as I could. However, after lunch, my instructor took my group to a refugee resettlement agency, New American Pathways. All we were told was that we would be helping the agency with a program they were planning. I went into this meeting with few expectations.

When I walked out of the New American Pathways building after our meeting, I felt empowered. I felt that my one year of nursing education could already be used to make a difference. The opportunity that we were asked to help with was a Women’s Sexual Health Education class for Middle Eastern and Eastern African Refugee women involved in the North American Pathways organization. My clinical group was given the responsibilities of finding reliable academic sources, creating an appropriate lesson, and fully executing the class when the day came. The education of these women now fell in our hands. And we could feel the immense responsibility that we now all had. We have just begun research on topics in women’s health, and my excitement is growing with each step in the process.

In my time at Mommy and Me, I feel that this experience will equally benefit me as it does the refugees we interact with. I will have my assumptions challenged, and I will come out a more aware and conscientious person. Since my own parents came to the United States as immigrants just two decades ago, I am gaining a better glimpse through interactions with the families at Mommy and Me, just what my parents went through on their journey toward making the United States their new home.

 ***

Jessica Nooriel is a junior BSN student. She chose nursing for its holistic views on both preventative and curative medicine. Her passion for exploring the various health practices and beliefs of different communities and cultures drove her to join the Emory International Nursing Students Association (EISNA). She is tri-lingual in English, Farsi, and Hebrew, and hopes to use these skills for interpretative services within health care.