{"id":42,"date":"2016-05-17T20:22:07","date_gmt":"2016-05-17T20:22:07","guid":{"rendered":"http:\/\/Nursing%20students%20travel%20the%20globe%20to%20help%20patients%20in%20need[caption%20id=attachment_138%20align=alignright%20width=960]"},"modified":"2018-09-27T15:46:52","modified_gmt":"2018-09-27T15:46:52","slug":"making-a-world-of-difference","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/schools\/2016\/05\/17\/making-a-world-of-difference\/","title":{"rendered":"Making a world of difference"},"content":{"rendered":"

Nursing students travel the globe to help patients in need<\/strong><\/em><\/p>\n

\"Faculty<\/a>
Faculty members Janis Rice (back row, second from left) and Dr. Frank Puga (far right) work with students to help patients during mission trips to Guatemala. Pictured with them are School of Nursing Class of 2015 graduates who, while they were students, participated in the mission trips. They are (back row, left to right) Adam Rick, Sean Brady, Amy Lynn Rose, (front row, left to right) Christine Johnson, and Ann Lee.<\/figcaption><\/figure>\n

Every year since 2006, faculty, students and graduates\u00a0from the School of Nursing leave their families, work\u00a0and school to travel to remote villages in Guatemala\u00a0to provide medical and surgical nursing care to\u00a0the indigenous Guatemalan Mayans. All of these\u00a0volunteers pay their own way.
\nWhile the distance between San Antonio and Guatemala is only about 1,500 miles, those participating in this international health care mission trip find themselves in a different world.
\nOn this San Antonio Guatemalan Endeavor journey, nursing\u00a0faculty, students and alumni work with an interprofessional health\u00a0care team in very primitive environments. There are no state-of-the-art facilities here; the team has limited supplies, devices and\u00a0medicine that are donated by local clinics, hospitals and practices.\u00a0Janis Rice, M.S.N., RN, clinical associate professor of health restoration and care systems management, said the experience\u00a0makes the nursing students \u201cvery aware of how rich our country is\u00a0regarding medical care. They see how little health care is available\u00a0in other countries.\u201d\u00a0 Rice, who attended her seventh mission trip last summer but\u00a0has coordinated the trip since 2006, said the equipment and the\u00a0clinic set ups are austere. During the last two years, the group has arranged the clinic in a vacant military hospital. \u201cBecause of the\u00a0primitive facility, students get an opportunity to become proficient\u00a0in so many skills. They also see the dynamics of coming together as\u00a0a team. They learn how to deal with conflict.\u00a0 \u201cThe students live in barracks with cots and sleeping bags. There\u00a0are 40 to 50 people per barrack. The bathrooms are definitely not\u00a0what they are used to. There is no privacy,\u201d Rice explained. \u201cWe have\u00a0communal dining that brings the team together. Those who come on\u00a0these mission trips make friends forever.\u201d<\/p>\n

A week of hard work<\/strong><\/em>
\nThe volunteers arrive at the medical site in Guatemala on a\u00a0Sunday and immediately start setting up the hospital with supplies\u00a0they have brought with them on the plane plus supplies provided\u00a0by HELPS International, an organization created in 1981 during\u00a0the country\u2019s civil war. HELPS International was begun by a Dallas\u00a0investment banker who brought aid to the war-torn country.\u00a0The nursing school first participated in the HELPS International\u00a0mission trip in 2006. Faculty and students became members of San\u00a0Antonio\u2019s local team, the San Antonio Guatemalan Endeavor.\u00a0 HELPS International and the Guatemalan government decide\u00a0each year the location of the temporary hospital. The nursing\u00a0school volunteers work with health care providers from around the\u00a0United States and Europe during their 12-day mission.\u00a0 Surgeries begin on Monday and run through Friday. A HELPS\u00a0International team will already have patients lined up. \u201cWe always\u00a0have more patients than we can handle,\u201d Rice said. \u201cThe local\u00a0residents are always so excited that we are back for our annual trip.\u00a0We are loved and respected by the Guatemalans.\u201d<\/p>\n

The School of Nursing volunteers learn the challenges of treating\u00a0patients who do not speak English. The Guatemalan dialects are\u00a0very different, she said. The health care providers rely on high school\u00a0students from Guatemala who serve as translators. \u201cThese young\u00a0Guatemalan students see a different part of their country. They learn\u00a0a lot too.\u201d<\/p>\n

Nursing students provide direct patient care in triage, a preoperative\/intra-operative setting, a post-anesthesia unit, and the\u00a0post-operative arena. In addition to performing surgical procedures,\u00a0the team also offers eye exams, eyeglasses and dental care. A mobile\u00a0medical team travels to even more remote areas to see patients.\u00a0 \u201cWe usually see around 200 people a day,\u201d Rice said. \u201cOur\u00a0nursing students help in many ways. They spend one day with the\u00a0mobile team in the very remote areas. They spend a day working in pre-op preparing patients for surgery, and they work a day in\u00a0post-op caring for patients after surgery. Nursing students also\u00a0spend half a day in the operating room and the other half in the\u00a0post-anesthesia unit.\u00a0 \u201cIt is hard work, but our students learn so much. They love it.\u00a0The clinical exposure is huge for them,\u201d Rice said. The students also\u00a0spend one day installing cement floors, stoves and water purification\u00a0systems in the homes of Guatemalan families.\u00a0 The volunteers build what is called an ONIL stove, which was\u00a0created by HELPS International in response to the amount of\u00a0burns to children and smoke inhalation exposure from the floor fires traditionally used by residents. The mission volunteers build a\u00a0clay-fired firebox in an insulated, durable stove that sits off the floor,\u00a0which minimizes the risk of burns to young children. The stove\u00a0also uses one-third of the wood compared to the\u00a0traditional method.\u00a0 Nursing students also install the ONIL\u00a0Gravity Water Filter so families have safe drinking\u00a0water. The water filter removes parasites such as\u00a0guinea worm and giardia and pathogenic bacteria such as cholera, E.coli and shigella. The team of\u00a0volunteers is helping prevent future health issues.<\/p>\n

Undergrads volunteer<\/strong><\/em>
\nRice said every year five undergraduate nursing students\u00a0participate in this unique international mission trip. The trip has\u00a0been part of an Accelerated B.S.N. Students Immersion Course\u00a0for the past five years. The experience helps students meet The\u00a0Essentials of Baccalaureate Education for Professional Nursing\u00a0Practice competencies.\u00a0 Last summer, five registered nurses, who are graduates of the\u00a0School of Nursing, brought their years of experience to the team.\u00a0 Christine Ledder, RN, said she attended the trip in 2012 as a\u00a0student and decided to return as a registered nurse. She works in\u00a0the neurotelemetry unit at Methodist Hospital.<\/p>\n

\u201cI grew a lot as a nurse on that first trip. I learned so much. I was\u00a0absorbing knowledge the entire time,\u201d she said. \u201cI decided to come\u00a0back as an RN because I felt like I could contribute much more now.\u201d\u00a0 During her initial trip, she said she learned from the professionals\u00a0about team work, safety and flexibility. \u201cDuring my second trip, it\u00a0was challenging, and I still learned a lot. I really appreciate how people\u00a0who don\u2019t know other each other can come together as a team.
\n\u201cWhen I returned to work after my second trip, I came back with\u00a0a huge appreciation of the support staff, such as the phlebotomist who\u00a0takes blood and the housekeeper who cleans the rooms. We did it all\u00a0on the mission trip. There was no support staff. I really appreciate\u00a0them much more.\u201d\u00a0 Ledder said her experience in Guatemala as a student inspired\u00a0her to return later. \u201cI\u2019m so happy that I chose a profession where\u00a0I can give back to the global community.\u201d<\/p>\n

Graduate students provide care<\/strong><\/em>
\nIn the summer of 2015, Kathryn Parke, D.N.P., M.S.N., RN,\u00a0CPNP, clinical assistant professor of family and community health\u00a0systems, went on the trip with two family nurse practitioner students.\u00a0 Dr. Parke, a pediatric nurse practitioner, said the graduate students\u00a0rode out with the mobile medical units with military escorts to\u00a0remote villages. They set up a health clinic in a village named Todos\u00a0Santos, which the organization had never been to before.\u00a0 \u201cWe set up in an empty building and saw adult and pediatric\u00a0patients for two days. We saw a lot of women with ob-gyn health\u00a0issues. We saw children with asthma, diarrhea and dental caries.\u00a0Everyone was treated for parasites,\u201d Dr. Parke said.\u00a0 She said they referred some of the residents who needed surgery\u00a0to the hospital. The two family nurse practitioner students worked\u00a0with adult care providers who were very pleased with the level of\u00a0care they administered.\u00a0 \u201cThe physicians said our two family nurse practitioner students\u00a0allowed them to provide a volume of care higher than ever before.\u00a0That was really great to hear,\u201d Dr. Parke said. \u201cWhile our students\u00a0provided health care, they received a lot in return. This experience\u00a0gave our students, who have only seen health care in the United\u00a0States, an entirely new perspective.\u00a0 \u201cOur students had to use their clinical skills and judgment. They\u00a0didn\u2019t have all the resources they have here,\u201d she said. \u201cThey worked\u00a0with and respected the different cultures. This is so important because\u00a0global health is one of the missions at our nursing school.\u201d\u00a0 Rice said after providing a week of health care, the students, faculty\u00a0and graduates spend Saturday packing and conducting inventory of all\u00a0supplies. On Sunday, the team headed to Antigua for much deserved\u00a0rest and recreation. Each person pays $2,125 for the trip.\u00a0 \u201cI have been fortunate to take this trip for seven years. I truly\u00a0enjoy seeing how the trip changes the students,\u201d she said. \u201cI am always\u00a0impressed by their commitment to their profession. It is wonderful to\u00a0see how they grow during the 12 days.\u201d<\/p>\n

Interprofessional teamwork<\/strong><\/em>
\nIn addition to providing health care, stoves and water purification\u00a0systems to local residents, the School of Nursing is also performing\u00a0research on teamwork and cultural competency during the San\u00a0Antonio Guatemalan Endeavor mission trip. A few years ago, one of\u00a0these annual mission trips raised the issue of how to improve team\u00a0performance with a group of strangers.\u00a0 Frank Puga, Ph.D., assistant research professor in the School\u00a0of Nursing, said in this unique environment, challenges exist to\u00a0achieving successful team work.\u00a0 \u201cThe challenges include limited resources, language barriers and\u00a0working with individuals who they usually don\u2019t work with,\u201d he said.\u00a0\u201cThese challenges can impact how well the team communicates, the\u00a0clarity of team member roles, and ultimately the safety of patient and\u00a0team members. To promote a culture of safety, we looked at adopting\u00a0evidence-based strategies to facilitate effective teamwork.\u201d
\nAs part of the research, they introduced concepts and strategies\u00a0to the approximately 100 individuals who went to Guatemala.\u00a0 \u201cWe trained the individuals on strategies to improve teamwork.\u00a0They practiced teamwork scenarios of difficult situations they might\u00a0encounter during the trip. This was first done the night they arrived\u00a0in Guatemala before they saw any patients,\u201d he said. \u201cIn preparation\u00a0for the week, we evaluated their perceptions and attitudes toward\u00a0teamwork. We also identified and discussed barriers to teamwork\u00a0they might experience,\u201d Dr. Puga said.\u00a0 With this information, the research team was able to anticipate\u00a0and respond effectively as a team to difficult situations. \u201cDuring the\u00a0training, we learned a lot about the situations the team was most\u00a0concerned about and how effective teamwork can result in better\u00a0outcomes. During the week they were delivering care, we performed\u00a0observations and video recordings to get a sense of how the team\u00a0was functioning in real time.<\/p>\n

\u201cWhat we found was the training really seemed to help facilitate\u00a0teamwork. Specifically, we identified opportunities for improvements\u00a0such as defining roles before going to Guatemala,\u201d he said. \u201cWe\u00a0think this research is important and contributes to the larger body of\u00a0knowledge related to global health. Delivering care in an international\u00a0setting has its unique challenges and approaches that can benefit from\u00a0effective teamwork strategies.\u201d
\nThe researchers also had the opportunity to assess the student\u00a0experience. \u201cThey get a unique experience to learn about teamwork\u00a0in an environment that is very different than what they have learned\u00a0in clinical at the nursing school.<\/p>\n

\u201cWe assess the students\u2019 perceptions and attitudes toward teamwork\u00a0before and after the trip. We are finding the students are leaving the\u00a0experience with a stronger sense of what teamwork looks like and the\u00a0skills they can transfer to their career as a nurse,\u201d Dr. Puga added.\u00a0 Based on the research performed in Guatemala, Dr. Puga and\u00a0Rice were asked to co-present their findings at the International\u00a0Council of Nurses Annual Conference in Seoul, South Korea,\u00a0last summer.<\/p>\n

\u201cThis project spoke to the themes of global health, international\u00a0learning experiences for students, and teamwork across international\u00a0boundaries,\u201d he said. \u201cPresenting at an international conference\u00a0in Korea gave us the opportunity to learn about other countries\u2019\u00a0and universities\u2019 ways of approaching the issues of teamwork. This\u00a0experience helped shape our understanding of the importance of\u00a0teamwork for global health. It highlighted the value and importance\u00a0of our School of Nursing\u2019s research and education activities.\u201d<\/p>\n

Article by Catherine Duncan<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Nursing students travel the globe to help patients in need Every year since 2006, faculty, students and graduates\u00a0from the School of Nursing leave their families, work\u00a0and school to travel to remote villages in Guatemala\u00a0to provide medical and surgical nursing care to\u00a0the indigenous Guatemalan Mayans. All of these\u00a0volunteers pay their own way. While the distance between […]<\/p>\n","protected":false},"author":42,"featured_media":307,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"magazine":[24],"issue-year":[19],"featured-story":[],"class_list":["post-42","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-academics","magazine-tribute","issue-year-19"],"yoast_head":"\nMaking a world of difference - Magazines of the Schools at UT Health San Antonio<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/magazines.uthscsa.edu\/schools\/2016\/05\/17\/making-a-world-of-difference\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Making a world of difference - Magazines of the Schools at UT Health San Antonio\" \/>\n<meta property=\"og:description\" content=\"Nursing students travel the globe to help patients in need Every year since 2006, faculty, students and graduates\u00a0from the School of Nursing leave their families, work\u00a0and school to travel to remote villages in Guatemala\u00a0to provide medical and surgical nursing care to\u00a0the indigenous Guatemalan Mayans. 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