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Let’s be honest here. I have minimal advice to bestow anyone concerning nursing, for I have yet to graduate. However after two years in this program I have a plethora of advice regarding nursing school. So for those of you who will be beginning this program, or have already begun, may the following wee niblets of advice help. I give you…the SON superlatives: Best Place to Study: 4th Floor quiet rooms in the School of Public Health. Unmarked, few know about these gems. Their deafening silence can crush the ADHD in the most squirrel-ish of students. Best Way to Save Money: Do NOT buy required new books from the bookstore. You have a couple options here. Either purchase your books from a graduating student, or get your tail online (www.half.com, etc). If a class requires you to have a book that you have no interest in upon landing in your professional career, then you can always check the book out from either the Nursing School Library or the larger Welch Library (for a longer period of time). Best Bang for Your Buck: Not to many faculty or staff will tell you that you’re able to take classes at other Hopkins schools free of charge. For good reason of course as you will have your academic plate full from the buffet of nursing. However working one or two School of Public Health classes into your schedule from one of the best public health institutions in the nation is an opportunity that should not be passed up. If nothing else, audit the class. Best Underutilized Resource: When in search of a job or direction, go have a chat with the Alumni Office. They have a list of alumni in every nook and cranny across the globe and often times these fine folks are more than happy to help give you advice, direction, or perhaps even a job. Best Place to Eat: Northeast Market, only a couple blocks away from school. This place offers an eclectic mix of edible delights from a number of continents. The people that eat there are as varied as the foods that are offered. It’s great to see the nations top neuro-surgeons wait in line for veggies and noodles with Baltimore's welfare recipients. And it’s affordable! Keep your wallet and waistline plump. Best Room to Avoid: Third floor, the copy machine room in the SON’s library. You have a choice when you walk in this room. You can either 1- pound your head against the wall trying to get these two machines to work, or 2- stick a catheter in your eye as you wait in a lengthy line of a dozen other students attempting to convince these decade old beasts to function. If there is no line and they work, great. If not, walk your Danscos over to the basement of Welch Library where there is an entire room of copy machines with not a soul in sight. Copy until the cows come home. I hope this helps. If you need clarity or more advice then feel free to contact me. I see no point in reinventing the wheel every 13 or 21 months. In closing, keep in mind that energy begets energy; never underestimating the power of a good laugh and a smile. May you find these to be more contagious at the School of Nursing than ringworm, pneumonia, or god forbid, a ripe case of herpes. Now I remember why I wanted to be a nurse. First walking into the school of nursing is somewhat likened to walking into a snow-globe. Shaken up, disoriented, and all around me are shiny things floating about...classes like Issues in Aging, Research, Brown Bag lectures, student organizations, etc. Thinking to myself "ya, gerontology seems like a noble cause" or "I guess I could see myself in research." All the while, the initial reason for diving into this abusive educational relationship was in truth, D- none of the above. What originally put nursing school on radar were aspirations to work with the organization Doctors Without Borders. After taking, in my opinion the best class offered at the SON, Nursing in Global and Humanitarian, as well as making a trip down to Haiti this past December, I am reminded of my motives. Now I know it can be said, "well David, did it really take another international experience and a one-week course to remind you of this?" Apparently the answer is yes. As nursing school for most is a case of survival, it is also a case of exposure. For someone who walks in without a lot of health caring experience, zero blinders, and ADHD, it's kind of a gateway drug (a hypertensive if you will). So now that I'm about 6 months out from graduation, it's nice to be able to recall the why; for it is this why that drives the where (to work), who (to work with), what (type of nursing to go into) and how (to go about doing it). You know you're a guy in nursing school.... 10. When a conversation about shaving involves more than one's face. 9. When you find you have something to contribute when discussing mom's menopause. 8. When professors are able to notice your absence from a lecture. 7. When your lunch is twice as big as those who you are eating with. 6. When you have to either go up or down a flight of stairs to use a school bathroom. 5. When you ask your friends about the football game and the answer involves Project Runway. 4. When you're the only one on the unit receiving daily requests from elderly ladies for a sponge bath. 3. When when you see as many men in a day as there are groups in the food pyramid. 2. When you're unable to tell your OB patients "I understand"...cause really, you don't. 1. When ***/testicular exam day is the most awkward experience of your life!
I have a dirty little secret.
Without the rigors of nursing classes to hose off my new car smell…I've gotten soft this summer.
My shoulders aren't tense, I chew my food before swallowing it, and I sleep 7 plus hours a night. I almost feel guilty.
Almost.
And what is it that's been filling my dog days of summer?
Buckets and buckets O goodness.
I'm fortunate to be in a grand place (Denver) doing great work (at University of Colorado Hospital's surgery unit) having good fun (hiking, biking, feeding) with fantastic folks.
My official title at work is referred to as Advanced Care Partner (as opposed to the Primitive Care Partner I suppose?). But make no mistake about it; Custodial Engineer is to janitor as Advanced Care Partner is to nurse intern. Dare I say, a spade is a spade. Apparently the Colorado Board of Nursing thought having the word 'nurse' in the Nurse Intern title was confusing to patients and gave them too much street cred. So walla…they birthed the title of Advanced Care Partner and I've been explaining my role to patients ever since.
Patient: So what is an Advanced Care Partner?
Me: I'm in the middle of nursing school. Basically I'm a nurse intern.
Patient: Oh, then why don't they call you a nurse intern?
Me: Because they thought it would be confusing.
Somewhere in that exchange is a lesson on the beauty of simplicity.
The patient population we see on our floor is quite eclectic ranging from Thyroidectomy’s to Pancreatic Cancer to Cellulites to Kidney Donations to MRSA to VRE to Prostatectomy’s to Pelvic Exonerations to Bowel Obstructions to you name it we get it. Apparently we are the busiest unit in the hospital. The work I do is CNA in role (i.e. taking vitals, giving baths, checking blood glucose levels, cleaning code browns) with a few exceptions. For example we perform phlebotomy, insert IV’s and catheters, and change wound dressings. Stuff you’d like to write home about but can’t cause daddy gets squeamish. As this has been my first hospital work experience, everything is new and shiny to me. So the other day when a patient pulled his fully inflated Foley catheter out, Murphy’s Law says I’m the one who walks in to find it. Great for no one, bad for all…that’s the lesson learned. With 2 months completed and 1 month till my Advanced Care Partnership ends, I hope to sponge up as much as I can before headed back to 525 North Wolfe Street!
You know that feeling you get after you've changed into clean underwear, ran a marathon, or been found after 40 days lost at sea? It is the same feeling I now have after completing one year of nursing school...relief. The main take-away lesson learned from my time thus far has been the following: nursing school is a team sport. Just as in any program, there are classes you love and digest effortlessly while others are as palatable as a ball of earwax. But as with any adventure or journey in life, it isn't the place that makes the difference; it is indeed the people you share it with. To this I must say that I've been one funky lucky ducky. My schoolmates, whether in either of the Traditional Classes or the Accelerated Class have been an all-in-one gift...a support system, informational resource, study buddies, advisor's, meditation partners, and an overall lifeline. So I tip my hat, raise my glass, wipe my brow, and dance a jig to each person that has made this trek so flavorful. Now thanks to Hopkins alumni (i.e. see above paragraph) I have landed a summer job in Denver at a Hospital as an intern on a med surg floor doing things that will surely make for good writing fodder. Splitting my time between nursing knowledge and mountain mounting will bring the necessary balance needed to polish off that last year of nursing school. Bottoms up!
Remember when you were 10 and mom and dad wouldn't let you open your Christmas gifts until the entire family was up, awake, and showered...oooooh the anticipation! That’s exactly what I feel like with only 3 more weeks till summer. Note to self if you will be attending nursing school here. The 2nd semester is a much bigger bear than the 1st. And from the second year students I've spoken with, the 3rd and 4th semesters are even bigger yet. It’s cool though. It’s more of a challenge than when I tried to drink a gallon of milk in an hour...and I’m a lactard. Ugh. So as the summer approaches, my energies are focused on finding hospital work as an intern/extern/CNA/tech in the land of John Elway, Coors Light and mile-highness...Denver. What is the difference between an extern, intern, CNA, and tech? Well, come to find out it depends on the institution you're asking. There isn't a standard definition of skills for what a student does at one hospital verses another. Slightly frustrating, majorly confusing. Phlebotomy, IV's, vitals...you never know what you're going to get. Now I must take this opportunity to tip my hat and brag about Hopkins Alumni. As I am in hot pursuit of work out in Denver, I'm very aware that it is often not what you know, but who you know that lands you a job in this day and age. So I sent a few emails out to Hopkins Alum in the greater Denver area and they have been amazingly helpful in their responses. Some send advice. Some send contacts. Some even send an invite to stay at their house and offer a ride to and from the airport. It really is a wonderful community to be associated with. Fingers crossed, I will have employment in Denver soon enough! Nursing school impels you to do a grab bag of things. Now I haven't quite danced an entire years worth of schooling yet, but from what I've experienced thus far, it drives you to: 1-Combine. You find yourself combining studying while eating, driving, cooking, cycling, walking, showering and/or _________ (fill in the blank with just about anything). 2-Prioritize. Studying over eating. Eating over sleeping. Sleeping over spending time with friends and family. And at the end of two years you may find yourself hungry, tired, and alone, but definitely the most intelligent nurse in the hospital. 3-Change lifestyle patterns. That is unless of course you already spend 25 hours a week studying pharmacology, consider an 8 minute walk a day's workout and find Florence Nightingale making nightly appearances in your dreams. Yikes. 4-Ingest knowledge. While it may be somewhat likened to opening a fire hose in front of your face, the amount of information presented to you and subsequently digested is nothing short of awesome. 5-Love. Love for the job, love for the challenges, and especially love for the people who are sharing in the rollercoaster known as nursing school. Which I suppose makes the take-away message: do what you love and love what you do. At 8 years old I was rejuvenated by feasting on Twinkies, watching 3 hours of Saturday morning cartoons, and strolling down any isle in Toys R Us. Now, 20 years later, recharging my batteries is accomplished in a slightly different manner. Over this past holiday break, it consisted of a trip to British Columbia, meters of snow, hot springs, snowshoeing, skiing, and a wee mountain hostel. Round two of nursing school starts up next week and I'm surprisingly ready for it because of this lengthy holiday break. I found that five weeks is a long time to go without manhandling a catheter, fretting over an IPOC, or neurotically scribbling in scantron bubbles. Pathetically enough, I had withdrawals. Alas, in 72 hours, I will be sitting in class squirming about in a feeble attempt to stifle my squirrelish ADD while sponging up pathophysiology and pharmacology. Realizing my excitement may be curbed this time next week, I will ride the wave while it's here. Hopefully, throughout this upcoming, trying semester I will keep in mind that being stressed is a choice...as is happiness. My new years wish for 2008 is that the latter will continue to weigh more than the former for everyone in the program. But most of all, I’m looking forward to seeing the familiar smiling faces scurrying around within the walls of the school of nursing. 10. Eat. You gotta do it to survive, so why not feast twice as much as normal to kill all that study time.
9. Clean your room. Since it hasn't seen windex, 409, or pine-sol for the past 3 month, now is an excellent time to start scrubbing.
8. Open a facebook account. And then open 5 more. No time to study when you're trying to make 700 "friends."
7. Volunteer at a soup kitchen. This makes for a great excuse once you've failed that P&A exam and you have to answer your professor's question..."why did you fail?"
6. Alphabetize your CDs. Oh wait. Music is digital now and alphabetizing it only requires pushing a button. Instead organize your t-shirts...by color.
5. Call grandma. As it usually takes her 10 minutes to remember your name anyways, this conversation will easily burn an hour off the clock.
4. Put up holiday decorations. You could spend an entire morning untangling Christmas lights or bandaging the 2nd degree burns you received while lighting the menorah.
3. Take a walk down the wrong street in Baltimore. Not only will you not have to study, you probably won't have to take that exam from your hospital room.
2. Start flossing. You never knew how long it took to floss. And now that it's either that or studying...get those gums a bleedin.
1. Blog! Ahhh Thanksgiving! A time to give. Give what, you may wonder? A time to give thanks. A time to give love. A time to give hot dogs. For today, after getting rejected from multiple soup kitchens and homeless shelters, I did the latter. It is wonderful to see these Baltimore non-profit social service organizations saturated with help during the break, but I wondered if there was another niche to fill; and that’s when it hit me. Realizing not all homeless folks are mobile or drift into shelters, I decided to combine two of my loves in life to tackle this hiccup...hot dogs and cycling! So after cooking up a grill full of dogs, wrapping them in aluminum foil armed with condiment packets, packing them into a handlebar bag and backpack, I pedaled into the streets! And this is how pathetic I am...for the first 20 minutes, I couldn't get one homeless chap to take a hot dog. Not one. Absolutely zero interest. Never mind they were still hot. Never mind they were organic. Never mind that I had become the person begging them to take my food. Then I recognized I was cycling around the heart of the soup kitchen district and everyone had already eaten lunch. Sweet. The problem was in my location. So off I went further west and further north. Alas, it took no more than 45 minutes to get rid of 30 hot dogs. I chatted with some amazing people who live a lifestyle so foreign to most of us that it is hard to relate. It is in this difficulty relating that detachment from homelessness occurs. Without the ability to see myself in their shoes, I cannot develop empathy. Without empathy, I lack the motivational mechanism to help. Without...well, we can see this spiraling already. Exit soapbox stage left. Oh, and most shocking site of the day award goes to the two homeless individuals playing videogames on their Playstation 2 atop cardboard boxes. Baltimore…what a city. We are all, to some extent, products of our environments and after 3 months I find myself delighted at the caliber of people who contribute to this daily Baltimore/Hopkins circus show!
Now…can I interest anyone in a hot dog?
There is a name for people like us. I'm not exactly sure what it is, but the best I've come up with thus far are NITs ---Nurses In Training.
While we're only eight weeks deep into nursing school, the program here hasn't wasted time in getting our education and training process underway. The seem long, while most weeks fly by. If it doesn't make sense, it will when you're here. So I came to Hopkins to become a great nurse. That’s it. Simple as that. Take the appropriate classes, get good grades, learn the skills, and point me to a patient. However since arriving my peripherals have been blown off with all of the various opportunities secondary to our core objective. Center for Global Health...what's that? Student government...sure, sign me up. Intramural sports...lets play. Community Outreach program...okey-dokey. Not to mention just across the street is the School of Public Health which offers keynote big-name speakers and fascinating elective classes. One of the most powerful moments in the program thus far came during a class within the first two weeks. Up on the screen our instructor put a picture of a Johns Hopkins diploma. She then asked "so where is it?" "Where is what?" the class responded." The GPA. Where is the GPA on the diploma?" It was a point well made, as GPA's don't exist on diplomas. I could almost hear a collective sigh of relief leave the lungs from everyone in the room. The lesson stands though; am I here to get good grades or am I here to get an education? Make no scruples about it, there is a difference between the two and I for one have made my choice. I wish you luck in making yours. Now if you’ll excuse me, I need to study before our football game.
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In another attempt to have friends write about their summer experience, I got a blog back from Susan who was hired at Hopkins Hospital to be a nursing assistant, or tech, in the emergency department. She had a great summer, was super busy working her night and day shifts and here is what she has to say...I will warn you though, she does get a bit descriptive about her time there... Delta Trauma, 3 minute ETA, multiple GSW, 18 gauge in left AC… I work at the Adult Emergency Department at Hopkins. Above is an example of what comes to our hospital. A “Delta Trauma” is either a person who has been in a car accident, been shot, fallen from a great height…basically someone who is in critical condition. The person above has multiple gunshot wounds, will arrive in 3 minutes and the medics started an IV for us. When I hear the charge nurse announce the arrival of a “Delta trauma,” my job is to race back to one of the critical care rooms and get everything set up. I have to be prepared to start IVs, assess vitals, hand out supplies, do CPR, and sometimes, prepare a dead body. In the ED, we see a little bit of everything. One morning, I came in and was told to go see the guy in critical care 1. They told me someone “stabbed him in the back.” It was true, he had been stabbed in the back, and the knife was still there, being supported by gauze. He had to wait to get to the operating room before they would remove the knife. A few weeks ago, I tried to go to shift report, but one of the other techs warned me wait outside because we were keeping a patient in there. He was waiting for transport in a special stretcher that conceals what’s underneath. Minutes later, he was taken to the morgue and we were ushered in to the same room for report. Another morning, I was getting report from another tech and she said there wasn’t much going on in beds 31-33, but 30, well, she would just have to show me. She took me to the bed and I saw a young man with a large bandage on his hand. Then she pointed to a small, white basin. I looked inside and saw 3 fingers that couldn’t be reattached. What a way to start the day! I like my job for so many reasons. I love that I am constantly running around. And I do mean that quite literally, working at the ED is a workout! I feel like I have a lot of responsibility. I do vitals, bed changes, CPR, phlebotomy – IVs, blood draws, arterial blood gasses, etc. I am always busy. And I think what I like most about the ED at Hopkins is that we work as a team. I’m a tech, but my opinion on a patient matters. If I am the person who has most recently assessed the patient, the doctor will ask me what I think. I see the nurses and doctors working together to decide on the most beneficial medication they could give a patient. I see that everyone who works there respects the opinions of the other employees. It is the kind of place that I hope to work in when I become an RN! It's a crazy semester already...school lets you off for a wonderfully long summer vacation and instructors expect you to come back warmed up and ready to sprint. Or is that just me? Dan and I continue to overwork our bodies and are hanging on by the skin of our teeth to the training and event schedule we had planned. So, in addition to studying for two tests in two days, clinical, the crazy IT course where we talk to eachother through the computer (oh, yes, folks, nursing informatics is moving forward), we also ran the Nations Triathlon. It was the second annual event in our nations capital. We swam in the Potomac River (where they found male fish with eggs last year...Dan is hoping his pregnancy test comes back negative) for one mile, biked up and down Rock Creek Park for 26 miles and finally wound our way through the streets and monuments of downtown DC to finish with the capital building at our back. 3hrs and 33 minutes after the start, I completed my triathlon and was so happy to have just survived. Dan tells me that I need to change my thinking...what runs through my head the whole time is a running commentary of how beautiful the scenery is, what a nice day. That's how it is for the first 20 minutes of each leg, after that, I start saying my rosary, trying to distract myself by writing blogs in my head, singing in my head (spare my poor fellow athletes), and finally hating myself for even thinking I can complete such a long event. Ugh. As is tradition for Dan and myself, we unquestionably choose the worst pre-race dinners. This time it was our favorite Ghanaian meal of fufu and ground nut soup. Written as I wrote it from West Africa between 2002-2005 "Fufu is kasava root, plantain or yam pounded. It is pound in a round wood bowl with a long branch with a blunted end. After cooking the root (similar to yam) pound until it reaches the consistency of warm playdo. Add soup and eat with hands. DONT CHEW, just swallow." Sound appetizing? Many of my friends think I'm sick to still enjoy it, but boy do I love those simple carbs! Now, as for a pre-race meal, I don't recommend it. But, what can I say? I love that Ghanaian restaurant (it's the same one that catered my wedding this summer and I've heard from friends that it was the best wedding food they've had). As you have already heard about what I did over the summer, I thought it might be beneficial to hear about what some of my classmates did. Jenn participated in the MHIRT program and here is what she wrote about her summer abroad. Another summer has come and gone. I'm back at school now, typing away, trying to remember exactly how the summer vacation managed to pass so quickly - it all seems as if it was yesterday that I was sitting on a beach in South Africa relaxing with my friends. I haven't had much time to reflect on all that happened over the summer or to pinpoint exactly what I learned, but here's a short, perhaps disorganized summary of what I've recklessly sorted out.... By the end of my first year of nursing school, I knew that getting nurse-related work experience would be the most logical way to spend the summer vacation. Although, there seemed to be lots of clinical employment opportunities, I knew that I wanted to do something different and far away. Coming across the Minority Global Health Disparities Research (MHIRT) Program offered a unique alternative. The (MHIRT) program teams up with foreign universities to provide American students with research opportunities abroad. During the application process and orientation I was attracted to the research work being done in South Africa. Having visited there before, I knew that I would also love to spend more time getting to know the country and cultures better. As the summer heat approached in the United States, I prepared for the winter weather in South Africa by packing jackets, scarves and boots. The mornings and evenings were fairly cool, though I was endlessly surprised by Durban's tropical climate. The moderate weather allowed my flat mates (two JHUSON classmates) and me to open our windows and door for a nice cross breeze and fresh air. Unfortunately for one flat mate this also meant the squawking of nearby Hadidas (an annoying South African bird) got louder, and she did not appreciate them waking her up early each morning. Mini-buses, or kombis, took us to the city center and beaches from where we lived. With hosting the 2010 World Cup, the South African government is preparing for the population increase by exchanging mangled old kombis (where the exhaust filters through small crevices in the rusty floor), with new safer spacious ones (that sport paint jobs advertising the drivers' "interests"). With themes such as "Street fighter," "The Wailers," and "Moto Systems" accompanied by blaring music from cheap speakers in the back who could resist such an experience? At the University of Kwazulu-Natal School of Nursing, my classmate and I worked with our faculty preceptor (a midwife) and her research assistant. Our project sought to empower rural nurses by training them in advanced midwifery skills. Focus of the program was put on access to care, communication, and prevention of mother to child transmission of HIV/AIDS, and increasing clinical skill levels to assure quality care. Our role entailed conducting literature reviews to support the project's research aspect and to facilitate a five-day training workshop. While working on the project we were able to visit a rural nursing school in Zululand. There we sat in with a class of nursing students and exchanged experiences. We also toured a maternity hospital that participated in our training project. Later, we had the opportunity to visit the Center for the AIDS Program of Research in South Africa. This center collaborates with UNAIDS in HIV prevention research. All of these experiences helped me gain an awful lot of perspective. There were many moments I felt frustrated or humbled by the reality of the situation there. However, for the most part these experiences were also empowering and hopeful. Many South African are working to help one another despite their history or struggles, and they are moving forward. Most days after work, my MHIRT flat mate and I would to try to do something new every day. This meant trying a new restaurant or coffee shop, shopping at a new store, or visiting a different beach or neighborhood. This prerogative helped us to explore the rich and beautiful culture around us. We tried foods made from maize and curries. We attended plays, film festivals, and music concerts. We shopped at open air markets and browsed through the handcrafted arts and crafts. And of course, I never cease to be amazed at all the times strangers engaged us in conversation or invited us to join them, extending their friendship and then sending us on our way with nothing more than a funny story and a smile. It's 2am and I'm driving home from a failed attempt at labor. I am a birth companion. JHUSON has a groundbreaking program called Birth companions which provides labor support to high risk low income women. Women in and around the Baltimore area can call into the program and request our services. For those of you who don't know what "labor support" is or are unfamiliar with the word "doula" or the JHU verson "birth companion,' it's a person trained in offering laboring moms physical comfort measures, reassurance and most importantly (as studies show, *see The Doula Book) are a constant presence during labor. A lot of the time that means the birth companion arrives at the hospital around the time the mom does, she stays with mom and partner throughout the labor offering hot/cold packs, fluids, helping with position changes, offering reassurance and answering questions. The birth companion often has more experience in the labor room than either mom or partner so her advice, reassurance and presence are a comfort during what can be an anxiety and stress filled time. To get into the program the JHUSON student applies to the community perspectives on child bearing class as an elective, attends a 16 hour workshop split into two days and ultimately attends one birth for credit for the class. Thereafter, for the program, it is our (me and the other 20-30 birth companions) responsibility to provide support to moms who continuously call into the resource line with due dates as cloase as next week to January '09. Through the summer I was fortunate enough to sign up for a number of births. This means that I make a prenatal visit and meet mom, discuss her birth plan and comfort measures and ultimately attend the birth. I witnessed 8 miracles born! What an extraordinary experience to have; literally watching and helping a family be born. As a birth companion, it can be stressful. With birth, there is no timeline. Babies come when they are ready and they have no care for your schedule. Plus, they take their time! Especially for first time moms whos average labor is >24hrs. The program has been a wonderful resource to numerous Baltimore area moms, and eye opener to me and all in all a wonderful experience to help families through such an intimate and life altering event. Wedding week, in my case, was all about damage control. My year and a half of planning was pretty thorough, but there seems to always be those unforseen/unanticipated changes; the aloof bridesmaid the month before the wedding, the absent mate that changed my well planned room assignments, the caterer who called on Thursday before the Saturday wedding to remind me to pick up the food warmers (a task I formerly knew to be under the responsibility of 'caterer'). There didn't seem to be enough time to do all those last minute chores. I worked 12 hour days both Sunday and Monday. My maid of honor and Dans best man and other good friends all arrived in DC on Monday night, all within 4 hrs at 3 different airports; I made only one pickup that day. Tuesday I had a 3 hr NCLEX review at the hospital and left early to pick up my parents and sister and head up to Baltimore for dinner and a tour ( my twin hadn't seen the city nor my place of schooling). By the time we got home, my MOH (maid of honor) and friend had collected my other sister and her significant other from the other airport and my whole family was in one place for the first time in what seemed like years. Wednesday found us around town verifying flower orders, setting up hair appointments and making up a calendar and phone number handout for parents and the wedding party (I'd gotten so many phone calls...What's the deal for Friday?, Where do you need us? What's so and so's #?). Wednesday was also our night out; boys played golf all day then headed to Baltimore for an Orioles game and barhopping while I met my girls at the Melting Pot and had a great night of fondue and later, drinks at the sketchy bar down the street. Thursday my girls worked hard to bake the wedding favors (chocolate chip cookes) and everyone else had the day off. My family headed downtown to ride up the Washington Monument, most everyone got to go on the monuments by moonlight tour and Dan and I got to go on a date. The first thing we did at dinner was...sit...quietly. We just sat for a few minutes and then...caught up with eachother. It seemed like it had been forever since I last saw Dan and I felt like I had lost the man I was about to marry. It had been two weeks of craziness; the first week both of us working hard to get caught up and actually ahead for the time we'd be gone and the last week because of family and friends were in town...we barely saw eachother these days because we were both trying to wrap things up, spend time with everyone who flew in and running errands to pick stuff up for the wedding. Friday we headed to the reception site to set up tables and chairs and the girls and I went for our pedicures and manicures. We all had lunch at the wonderful Korean grill resaurant and then headed to the rehearsal and rehearsal dinner. I had planned enough time for a quick nap, but alas, things run over and we only had half hour of down time between the two; just enough time to shower and dress. And finally, wedding day! I slept alone in an empty apartment the night before the wedding and called up my girlfriend for an early morning walk. I met my family and friends at their guesthouse and had time to just sit and relax. I started hair and makeup around 11, the photographer arrived and we were all dressed and ready for a pre-wedding photo shoot by 2. At two-thirty we headed to the church...I wasn't nervous or scared...just relieved. I was so happy to finally be marrying this man, having everyone that means so much to me around and looking forward to a relaxing honeymoon and not having to plan a wedding anymore. The wedding was beautiful; flowers phenomenal, emotional in all the right places, funny where it was supposed to be and really just...well, perfect! http://www.flickr.com/photos/aldobrown/sets/72157605766599616/ Sitting in my last day of NCLEX review at the hospital, I think these 8 weeks have been quite an experience. On the cardiac care unit at this particular hospital, the ratio is generally 2 or three patients per nurse. I was very lucky to work with a number of different great nurses on the unit as my preceptors and learned as many tidbits of medicine that I could. I can't pinpoint the single most important one, but here is a list of the things I learned. 1. Relationships matter-when pharmacy likes you, you get your meds; when you work well with your coworkers, you get help, and overall teamwork is necessary. 2. Clinical skills- all those skills I learned in school and practiced on mannequins I've now done on the unit; suctioning, packing wounds, inserting catheters, IVs, NG tubes, hanging and giving meds, and assessments (all under the careful watch of my preceptors, of course). 3. Documentation- if it's not documented, it's not done...we've heard it so many times in school, yet it's so important. Sometimes it's not a big deal, like when you have a stable patient and it's his/her temperature...but other times it's critical...did that patient get his/her last insulin injection?...Important. All in all, my summer externship program was a great learning experience. For those students coming in, I highly encourage you to do it on your break, not necessarily for money (it's a little...not a lot), but to practice those skills, learn differnt ways of organizing and get more patient time. Wednesday, June 04, 2008 9:09 Culture is what Dan calls it. While my friends spend their weeknights studying, Dan and I take the old guys out for baseball, go to dance lessons or enjoy a date night. While my classmates wisely use their Saturday evening before finals to understand cardiac heart failure, I'm out watching De LaHoya tune up on Forbes. Some days I think of our outings as silly and excessive, but when we go out, I feel glad to live a balanced life. It's hard to find that balance, though. As a typical type A who attends JHUSON, I'd love to have time to do 110% of the studying; to get A's in all the classes...but I have a life outside school. I have to have a life outside of school. So I make sacrifices; I study on the train, I squeeze in workouts between classes, I eat on the run and I have to be satisfied with the grades I get. Dan, too, makes sacrifices, he wakes up at 5:30 to drop me at the metro, sleeps with a pillow one night a week when I have to stay up in Baltimore for clinical and supports me totally dispite my crazy schedule. One day during my spring break, I headed up to the Maryland board of nursing to obtain my CNA (clinical nurse assistant) license. I went equipped with my transcript, two passport photos, a money order and the CNA application. Feeling like I was going into a third world country where you get what you need only when the person on the other side of the window is having a good day, I humbly offered my papers and hoped to be successful. A few weeks after my classmates (due to using my time planning a wedding instead!), I got off 7 applications to 7 different units in 7 different hospitals for any of the open summer externship programs. Within one day, I got a call back from one hospital in DC and interviewed the next week. Most of the externships include 8-9 weeks working full-time on a specific unit with about 4 hours of that being classtime going over differnt topics or reviewing for the major test (NCLEX) we all do before becoming registered nurses after completing nursing school. I, unfortunately, did not get that first job and after a few weeks of no calls, I started to worry that I may have to look elsewhere to find a summer job. Then, at last, my number one choice hospital called and as always, things worked out. So now, after 3 weeks of being out of school (during which there was more wedding planning...of course) I am now sitting in orientation with 15 other nursing students looking forward to a final year of school; but first, the summer externship program. We are sitting rhough lecture after lecture on hospital policy, nursing benefits, what we'll be doing during our shifts, a tour of the hospital and eventually, at the end of the week, we'll practice some skills we already learned in school. My fellow externs are from all over, Howard County, Salisbury, community colleges and 3 of us from Hopkins. We're going all over the hospital; CCU, ER, OR, and most to mother/baby (seeing as this hospital is one of the main baby factories in MD). My manager is wonderfully open and flexible with my crazy schedule and will be working me and one other in 3 twelve hour shifts and making up the last 4 hours one day a week in class with the other externs. It will be an interesting summer and I really look forward to being on a unit, having a little (just a little) more autonomy and using and hopefully cementing the skills I've learned in school into practice. My weeks are crazy. When school is in, it's tough to find a spare second to do much of anything. With a lot of planning, a lot of effort and quite a lot of time management, things work in my life. I wouldn't say that I am a typical student. Most of my friends at JHU are single, mid to later 20s somethings, living alone in Baltimore. They attend classes just like me then either go to work (many have community outreach workstudy positions that help Baltimore City in some way), or go home to study/cook/chat on the phone/socialize/whatever. Sometimes I envy them for their life of living in the town where they school, for not having to commute nearly 4 hours a day, or not having a house to run, a relationship to maintain, a mortgage. But then I look at my fiance and am happy that I have him and that we have such a blessed life. Monday through Wednesday I am at school and physically in class from 8am to 12:30. Now, four and a half hours of sitting in a class may not seem that hard to you, but believe you me, when D.Aschenbrenner (the lady who actually WROTE the pharmacology book) is smiling at you the way that she does and going through drugs like there's no tomorrow, it's tough work to keep up. Or, trying to follow zanny L.Taylor as she literally plays out fluid passing through nephrons and demonstrating exactly where UTIs hit. As I've said before, these instructors are the best of the best and they expect the best of the best from the JHU student. Noone gets by here just by coasting. Thursday and Friday we will be in the wards. Half of my class has just switched from OB and are now entering the unknown psychiatric wards across Baltimore. We know not what to expect; the only advice given us is, "grow thick skins." Thanks, that's helpful! I was lucky to get one of the only night shifts, from 1-9pm and look forward to my "sleeping in" mornings (yes, I consider 7am sleeping in!). I'll be getting home around 11 on these nights and then it will be up on the 11:30 train with those few short hours before sleep and travel used to work out, pack lunch, run errands and study. Saturday and Sundays are my all day cram days. I generally take a little time to get the house in order, shop for groceries and plan the weekly meals before really sitting down to go through all the notes for that week. I have the habit of writing out notecards for all of my classes. It's a lot of work, but it seems to be the only way I've seen to get the information into my head. Usually Dan doesn't mind me working so much because he's doing the same himself. In real estate they always say "while the rest of the world works 9-5, we work 5-9," fitting time in with clients when they themselves are off. Not to say D. doesn't work during the day, he's spending that whole time finding houses, scouting them out for his clients, trying to match that perfect house with the perfect clients and then aligning everything so the offer comes in with a good price that makes everyone happy. No easy feat! And, of course, he holds houses open on Sundays so I get my mandatory 3 hours of hard working quiet study time in on those afternoons. Then finally, if D. doesn't have any more appointments, we enjoy a quiet dinner together and a little bit of well deserved quality time together playing cribbage or just vegging out in front of the TV. What does one do on a full week off from school? Well, if you're me, you plan a wedding. Spring break marks the break between the first seven weeks and the second seven weeks of the term. This term I took 4 required courses and am taking two electives. My required classes are Pharmacology, Pathophysiology and both Psychiatry and Nursing the Childbearing Family. The last two are broken up so I took OB first and now am starting psyc next. OB was wonderful; it was a whirlwind of woman, fetal and neonate health information. We covered all the development of the fetus, the growing and changing of the mothers body and the normal and problematic states of the newborn. On top of this class, we also had clinical. Clinical was a blast. I had a wonderful time on both the labor and delivery and postpartum wards. The first day we were running from place to place on the L&D ward and it pretty much continued through my first 3 weeks. Then we transitioned to postpartum and it was an interesting shift from caring of laboring mother to caring of hopefully a well mother and neonate. And my first day on the postpartum ward I had the incredible opportunity to care for a very good friend of mine. She had had a beautiful baby girl in the morning and was just transferred up to my floor when I came on... what a gift to be there for their first day as a new family, it really was such a privilege. Pharmacology and Pathophysiology is kickin' buns hard. Both classes are so much information over such a short time; so many drugs and so much physiology that goes behind it. My instructors continue to be top notch and help from friends and the support of my fiance lets me get in as much studying as I can while I continue to do relatively well in class and clinical. Then, of course, there's real life outside of school. I am still commuting and still trying to live my life even though school overwhelms me at times. On Feb. 17th Dan and I ran our second marathon in Austin. We'd been training for 5 months, going out in rain or shine during the winter months to run our long runs on Saturdays starting in our town just outside the DC border, heading NW to Bethesda and down a the wonderful Capital Crescent Trail to Georgetown in DC and back up through Rock Creek Park. Twenty three miles total and we did it twice before actually running the marathon! The marathon was so much fun and I’ve sworn off marathoning for the rest of my life (or at least until next year when I forget how much it hurts). Austin is a very hip town and Dan and I enjoyed a much needed break from work and school to get in sync again. And finally, the wedding; I put off planning anything for when I have a little bit of time. Well, with school, marathon and generally trying to run a house and stay on speaking terms with my fiancé (oh, we also just purchased our first home...!) sometimes important stuff has to be sacrificed. Wedding planning is pushed into the nooks and crannies of my daily life; phone calls to set up appointments with DJs here, emailing with the photographer there, a quick hello at the florist and that’s about as much as I can handle in a day. With one week off, I crammed it in. The florist, the photographer, DJ, caterer, invitations, websites and dress shopping…all of it in one week taking a little time to study here and there. Now that school is back in, it will be another 7 weeks before I’ll have any time to dedicate to planning and hey, that’s okay with me, everything always works out in the end and at the end of it, I have Belize to look forward to! Babies, and babies, and more babies! Oh my gosh, how fun! This is the first week of the second semester. Second semester at JHU means we have two rotations of clinicals, each lasting 7 weeks. I opted to do OB my first rotation and psych my second...Whew-hoo, babies! Yesterday was our first day at the hospital. First off, I commute. This term, I commute three days, 1.5 hrs one way, 2 hours back...it's fine, I love it, it gives me much needed time to read/study/sleep/catch up on House M.D. Two days we are in the hospitals; lucky for me, this time I got a great location. I'm at a hospital that is just 4 miles from my house in Takoma Park, a quick half hour bike ride (if I so choose to freeze off my fingers and toes) or 12 minutes driving. Awesome! Not only that...it is a baby factory. I am at one of the top hospitals which help moms give birth to the highest number of babies in the state...and I have a wonderful clinical instructor. So, yesterday we got the orientation stuff; fill this out, sign that, here's where supplies are, yaddah, yaddah, yaddah. Today was baby day. First off, I helped with a cesarean...mom had an abnormal situation (placenta gravida) which made it necessary to do a section. Then I helped mom #2 push through a vaginal birth and mom #3 was another cesarean. In addition to helping mom, I got to do what those in OB call "eyes and thighs"; the erythromycin for the eyes and Vitamin K for the thighs. It was my first shot to a human and I think I got through it just fine...I was a little nervous, but hey, that little sucker isn't going to remember it anyway and he's crying already! I also got to watch a spinal, an epidural, learned to read "the tape" of the fetal heart rate, found a fetal heart rate and put in a foley catheter...all in one eight hour shift. I think my classmates will be sooooo jealous! So, in an attempt to keep everyone up to date, I failed. In this blog, I'll just list what I'm up to... 1. Marathon training- yes, Dan and I have decided to do another marathon. We'll be in Austin in February running our buns off. Training got kicked off when we did the Baltimore Half Marathon in October and we've been adding miles ever since. Today was 20 miles and whew, was I hurting! Here's a picture of me in an ice bath after the run...ow! 2. Registering for classes- It is that time, already! I've decided to take the OB clinical first so I'll be learning how to help catch babies as well as giving them their first shots. In addition, I've decided to take a couple courses that struck my interest...opposite though they may be...Death and Dying and Birth Companions. D&D I assume will be about how to help people through the process and make it everything they would want and Birth Companions is just that, learning how to be there and be helpful to a soon-to-be-new mother. 3. Social activities-School is obviously not just for learning, I've made some great friends and in the last few weeks, with the holidays and all, I've tried to get more social. This can be a bit tricky seeing as I live an hour away from most of them, but my friends seem to be working with me and they come down to hang out when I ask. Last weekend, Dan and I held our 2nd annual Christmas Party where we had our guests contribute to our Christmas tree by decorating their own ornament and hanging it for us. Next week, after finals I'll do my first ever attempt at building a gingerbread house. 4. Wedding Planning-Now, this is a handful. Dan and I have set our date (late June) and we have a few things going for us. Christmas break will be the big planning and coordinating time, and probably the last one at that. Spring market is pretty heavy for a buyers agent in this area and I'll be bogged down with classes until just before the wedding, ahh! 5. Finals, of course! It's week 14 and finals are coming! My last week of class ended on Thursday and I'm working through the weekend to get on top of the piles of notes I have (literally piles- I rewrite my notes on note cards and taking a ruler, I have nearly a foot of note cards!). So, off I go, enjoying the last week of class before the craziness of wedding planning, holidays and travel. My best to you, Kathy In my last blog I wrote about my classes, but how does that relate to time? Well, for starters, I'm in class three days a week, one day in clinical and one day off. Monday I'm in class from 11am to 7:30pm with a one hour lunch break. Wednesday and Thursday I'm in class from 9 and 8:30 until 5:30 with a 3 hour break on Wednesday and a one hour break on Thursday. Now, that may seem like a lot- yes, it is, but the classes are mostly so interesting with so much information that by the end of it you wonder where the time went. Friday is my day off where I run around Takoma Park frantically trying to catch up on the errands I haven't been able to do because I'm in Baltimore all week. I commute. From just outside DC to Baltimore. It takes exactly one and a half hours, door step to door step, in the morning and typically 2 or 2.5 hours getting home in the evening. I walk or get a ride to the metro, metro to Union Station, take the Marc (a commuter train that runs from Charm City to DC), and finally a shuttle that drops me one block from the School of Nursing building. Coming home, I spend more time because the shuttles don't always move on time and sometimes my timing is off for the train. Do I like to commute? Well, mostly, yes, I do. I spend my time reading and catching up on notes, time that most of my peers lack because they have distractions when they read at home. I, on the other hand, can do nothing else but sit (well, maybe sleep, which I do sometimes), but mostly I read and it gives me a good environment to do that. Also, Dan got me an ipod so I can zone out and on those occasions when I'm just too burnt out on reading, I download a TV show and can watch that (isn't technology great?). Anyway, back to the schedule. Tuesdays are game day. We head to the clinic and practice all that we've been learning in class. Mostly just the assessment stuff (read: noninvasive). We take vital signs, get histories, talk with our patient and observe the nurses. Right now we're in a rehab center with lots of stroke patients who are working with physical therapy to learn how to walk again. I've also had the opportunity to go on rounds with the wound care team where I got to see numerous bedsores in a number of different stages of recovery. It's all very interesting and eye opening. I love time with my patients though; I've been very fortunate to have very welcoming and open patients willing to help me learn on them and with them. I just signed up for classes for next term, it looks like I'll be doing my labor and delivery rotation just in time to catch all those spring babies! Kathy Wednesday, November 07, 2007 4:50 It's a Monday evening only two weeks post midterms and I should be studying. I'm now in my first semester as a nursing student at the renowned Johns Hopkins. It gives me great pride to say that I go here and truthfully, it made the work all worth it; the caliber of instruction, the hand-on learning, the accepting, reassuring and nurturing attitude of everyone as high up as the dean down to any admissions or office personnel is wonderful. The staff get our pictures and memorize our names in the off chance we stop by to say hi and ask a question! What more could you ask of a school? Currently I'm in six classes: Principles and Applications, Foundations of Nursing, Trends and Issues, Issues in Aging, Health Assessment and Community Outreach. P & A is about learning all the basic skills of nursing, the rationale behind them and how to actually do them (i.e. IV's, injections, vital signs, catheters, etc.) Foundations is about learning the basics of a nursing thought process, coming up with diagnosis, working on interventions and ways to implement them. T & I is working through the problems we have in the nursing profession, be it not enough money in health care, how to treat everyone equally, recognizing the shortage of nursing and what that will mean for us young nurses. Issues in Aging is learning about the elderly population; normal and abnormal developmental changes and how to best communicate with elderly patients. Health Assessment is learning how to do a complete physical, learning the what's normal and what's not so that when we get a sick patient we can assess their symptoms and figure out what's wrong. And finally, Community Outreach is learning about the greater Baltimore City outside Johns Hopkins. Learning what the problems are (drugs...lots of them; Baltimore is the heroin capital of the world), how to address them, how we can help and how to protect ourselves. Well, that's all for now!
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Renee: Accelerated 2009. I just KNOW my experience of getting a Land Cruiser out of a rising creek using only 4 oxen will come in handy at the School of Nursing someday...I'm just waiting for my moment to shine!Although there are several interesting aspects to the Hopkins Student Nurse Relief Corps trip to New Orleans this year, I thought one key point was extremely relevant to anyone thinking of going into nursing. I am going to start off letting you know that I am purposefully keeping some parts of this blog a little vague as to not have it turn into a political sermon. Also, keep in mind that the Lower Ninth Ward was not the ONLY area affected by Hurricane Katrina, it is simply the only city affected where I have family, and the only neighborhood where I grew to know some of it residents. The Hopkins Student Nurse Relief Corps spent one week in the Lower Ninth Ward in New Orleans over Spring Break. We worked and lived at Lowernine.org (check it out online) and partnered with Touro Infirmary, Lower Ninth Ward Clinic, and St. Anna’s Mobile Clinic. I was able to spend time with the people at Touro and L9 Clinic. Darren, who works at Lowernine.org had survived Katrina by sitting on his roof for four days with no food or water, only to then be rescued to a nearby bridge, still with no food or water and 500 other stranded neighbors. After Katrina, he returned to the Lower Ninth and began cleaning, plowing roads clear of debris, trees and even a dead body or two left behind. His story was similar to others that we heard. Patricia, an RN, returned home quickly after Katrina and opened her house into a functional clinic (again, check it out – http://www.l9whc.org/). She and another RN began to provide healthcare free and then later with a minimum fee to residents slowly returning home. At first most of their patients were construction and demolition crews, now a steady influx of long-lost friends and neighbors walk through their doors. While in the Lower Ninth Ward, I met person after person who never questioned returning home after the hurricane. No matter what you believe politically, after meeting the people of the Lower Ninth, you cannot deny that these neighbors came home to a warzone, pulled up their bootstraps, held their neighbors hands, and began to rebuild their homes, together. Volunteers from all over come to help out, but you can tell the spirit of those who call L9 home is what keeps the efforts going. As I recounted some of these stories to friends, I picked up on their sense of loss, as if the stories they were hearing were depressing, and they felt sad for these people, felt sorry that these residents ever had to endure this experience. And that is SO NOT what I got out of my week with the men and women and children of New Orleans. I know this is rambling, and by now, youre thinking “How is this related to nursing?” So here’s the link, as promised. Surveys have shown over and over again that nurses are the most trusted profession. They are allowed into the most intimate moments of the patients and their families’ lives. Pediatric nurses, Oncology nurses, Hospice nurses, all have stories of a patient who was terminally ill but promised to live until their next birthday, until their daughter got married in the spring, until their husband graduated from his masters program… and those patients lived just as long as they promised and not a day more. You could view it as a pity that this person ever had to endure the pain of losing their mother, the agony of a miscarriage, or having to overcome a narcotics addiction to save their family. But I do not view it in such dim light. My life if mundane compared to what most of my patients are going through, and I am honored to be allowed in and to be part of a strength that only presents itself in the most dire moments. It is this strength that is more beautiful than anything else in the world. And you, as a nurse, get a backstage pass to see this wonder on a regular basis. so I was leaving the hospital friday afternoon, after having worked 2 days with THE BEST PATIENT EVER!!!! She was a tiny old lady from abroad (yes, I know where she's from, but Im sure saying so violates a HIPPA thing). I had helped her take showers, I had suctioned her trach, I stuck her with needles, I gave her tube feedings. I hung out with her equally awesome older sisters, and taught her daughter how to do tube feedings and trach care at home. I had SERIOUSLY bonded with this family. So Friday afternoon rolls around, and Im not gonna see these people again, so with a room FULL of her extended family, I got a little emotional and thanked her for being such a wonderful patient and that I REALLY enjoyed working with her, and it was awesome to see such involved loving family, blah blah blah...I mean, I REALLY laid it on thick. She weakly lifts her hand up to her throat and presses on her bandaging (as per doctors orders) to speak, and Im thinking "here it comes, she's gonna say an emotional Thank You, or she's gonna tell me Im the best that's ever been, or she's gonna say how awesome of a nurse i'll be someday" and literally I am holding back the tears of emotion... the entire room is silent... and she says, softly in a hoarse voice, using ALL of her energy:
"The trash in the bathroom is full" ... and this last hilarious impression she left with me, simply solidifies her as the best patient.
Yes, the accelerated program at Hopkins is difficult. Yes, nursing is difficult. However, not once in this school, have I ever felt alone. That may seem like an obvious statement seeing as how every morning over one hundred fellow classmates rush into the main lecture rooms, and there is ALWAYS a line during class break at Me Latte, but that is not exactly what I mean. Any time there is a computer glitch and your final paper disappears into oblivion, or anytime you click 'Submit' and instead of the screen telling you your score on the online quiz, you get an error page or you're kicked back to the Honor Pledge page, anytime you completely go blank on how to study for that first exam in a class and find yourself in your professor's office having to "discuss" your grade... EVERYONE, and I mean, EVERYONE here at the School of Nursing has consistently bent over backwards to help the students. Melinda Rose has sent me emails over the span of a month, searching and digging for current masters students or alumni who have done exactly what I want to do... just so I can ask them "Are you still alive after doing your masters full time and working full time?" Kathie Reese has walked me through a basic dosage calculation problem, as I stare at her blankly... not giving her much to work with. Mindi Levi and Patty Wilson have worked with me for over a month to get my work hour paysheets and signatures in order, no doubt wondering how this could be such a source of confusion for me. And the most recent reason why I love this school, and essentially the purpose behind this post: My dad went into the hospital over a week ago for a heart attack, and during a routine cardiac cath procedure, had another heart attack on the table. His lungs filled up with fluid, just like Laura Taylor said they would in Pathophysiology. He became short of breath, watched the medical staff around him become panicked, he yelled out a quick "Come on, boys! Tighten up" before they rushed him to bypass surgery. Mom and dad are in Richmond, VA, a quick 3 hour drive, 4 hours if you take Route 301, 2 hours on 301 if youre worrying about your dad. I could drive home that night and be with mom while dad was in surgery, but I would most definitely miss clinical hours... which incidentally this school nails it into your brain that you MUST NEVER MISS CLINICAL... EVER... unless you, not a relative, YOU, are dead. So with trepidation, I called my clinical instructor, Germaine, and told her the story, said I would try to make it back for the second day of clinical, which she promptly responded with "Renee, if you need to miss Friday as well, that's completely understandable." I didn't entirely believe her, and on the 2 hour drive back to Richmond that night, I had come up with several alternative plans for how I was going to finish my BSN/RN degree. I could move home for a bit, maybe dad and I wouldnt argue so much if he gets percocet after this surgery, Im SURE we could live together just fine. I'd go to some nearby community college and finish up MedSurg and the rest there... what a lovely little jaunt I had into Hopkins, so sad it's surely over. But Germaine was serious, and Meg Bernstein was in on it too. Arrangements were made for me so that I was not super behind on clinical hours, and there was no mention of having me pack my things to move back to Richmond. Everyone was simply concerned about the health of my dad and welcomed me back to school with open arms. Instructors and course coordinators were helping me the entire time. And today, I found a card in my student mailbox, from an awesome classmate, Amber Robbins, sending warm wishes for me and my family. Thanks Amber, and Thanks School of Nursing. Thanks for making me feel loved during a major time of stress. Incidentally: Dad's doing fine, he was in the hospital for a grand total of 12 days and is home now. Valuable lesson learned: When something goes wrong in a medical procedure, remain calm for the sake of the patient... you never know what they'll remember, even after 4 days of a propofol coma. Asleep in bed at 11:30pm (what's a nightlife?), the phone rings. My high school friend is calling... odd because we talk so rarely between work and school now. "Hi Renee, what are you doing?" "Sleeping." "Really? Wow, its early." "Yeah." "Well, anyway. I have a question for you." "Uh huh." "My dad shattered his knee cap on Friday. They managed to basically put it back together, but now he's got something like a drain in it with a little baggy thing attached to it. And tonight, my mom called and said that my dad has a fever, like 102. But she gave him advil and now its like 100. What do you think is going on? Do you think something major is going on, or do you think its infected??" "Is your dad have any other problems besides the fever and obviously pain around his knee?" "No." "Its still a little early to tell whats going on. But if he's able to tolerate the fever and it doesnt spike up in a short amount of time this evening, let him ride it out. It is flu season and he might just have a mild fever from getting a cold or something, in which case, the fever should break during the night. If he wakes up tomorrow and he still has a fever, call the doctor and go in to see them. A fever typically means theres an infection of some sort going on, but its hard to tell from just two temperature readings whats going on. If you're mom is able to, have her check the injury, especially any incision sites for redness and heat, like abnormally hot to the touch. Swelling too, but that may be harder to tell since his whole knees probably swollen. Did your dad take anything for the fever?" "Yeah, advil." "Okay, well. Keep in mind that fevers can be good. If this infection is mild and bacterial, a fever can help to cook and kill the germs. Also his lowered temperature might have been skewed by the advil. Its like if my thermostat in my apartment were broken. My heaters are all going full bore and its SO HOT in the place. So I open the windows and let in the freezing cold air... my apartments temperature reading will be lowered, and Ill feel better, but it doesnt fix the problem that my thermostat is on crack. So just watch out for anything else weird like nausea, vomiting, lightheadedness, sweating or anything NEW or different." "Okay, Thanks Renee. I was just all wound up and couldnt go to sleep yet. Hearing that made me feel alot better. Go back to sleep." "Uh huh, and send me an email or something tomorrow to let me know how it worked out." So thats all fine and dandy, except that I was so sleepy and out of it, that I thought I dreamt it all the next morning. Only to see on my phone that my friend DID call and an email was waiting for me to say that her dad's fever had broken during the night and he was as hunky-dory as any man could be after shattering his knee cap... and oh, it wasnt a drain, it was some nifty coolant cyclical thingie. This posting was just a reminder to all my fellow classmates who are PINING for this semester to be over and may be feeling a little worn out, wondering if ANY of this information is sinking in or not... well, it is. Let's just hope my future patient's call me while Im sleeping. =) The patient in one room violently vommitting, while a staff member asks "Are you having any abdominal pain?" The patient with such horrible alcohol detox shakes that she can barely initial the consent form. The patient that snears at you for even having the nerve to ask her if she's interested in getting tested for HIV today. The swarms of police men surrounding the trauma room with the latest admission. The 50 year old on 15 medications. The Physicians Assistant that avoids your eye contact, although you're not sure why. All of these smalls upsets are part of my every Tuesday. And again, I love this job. I was sitting at my desk thinking that I really would not rather be anywhere else. I like being in the ED. It's exciting to hear the physicians review hyperkalemia with the resident (too bad the resident had not taken pathophysiology with Laura Taylor or he would not have needed the review); it's exciting to see 5 people go running down the hallway to the newest critical trauma. Its exciting to see teaching staff and guest speakers from last week's classes come strolling through the ED, I try my best not to be a nerd, although all I want to do is yell out "Hey remember me?! You spoke in my class last week? I asked that question... and... and... you said it was a great question! Remember? Hey! Can I do research under you? You know, since we have a connection. I work in the ED, you walk in the ED. Hmm? Yeah?" I love explaining to curious nurses where they themselves can get free HIV testing, and how often they should be doing so. I love it in the ED, but I am occassionally reminded that it is still a scary and traumatic place for a lot of people. On the way back to the office, I walked past a father, holding a small child, surrounded by police, social workers, doctors and nurses, all of them asking the dad questions about "did anyone see her fall? has this happened before? when was the last..." while his child in the trauma room across from them screamed and cried at the top of her lungs. You get into the swing of things at any job, but here, you frequently get reminded that this is not "just another day" for the patients and their families. Im sure there are a million other professions with less stress, less emotion, less drama and more pay... but for some reason, again, I would not want to be anywhere else... And now, thanks to Dan Sheridan's class last night, I know for sure that I do NOT want to be a Medical Examiner. Sorry such a long time between posts, next week is less busy, I promise to update you all then. Hope you had a great Halloween! My ultimate goal is to eventually become a Nurse Practitioner with a regular group of HIV positive patients with whom I can monitor meds, CD4 counts, viral loads, overall health and any counseling needs. Last week I started my new job in the Johns Hopkins Emergency Department, where I try to test AS MANY patients as possible for HIV using the OraQuick test (it looks like the Q-tip and the Pregnancy test had a baby). So far, the job entails hours of spending quality time with patient's gums... there are more toothless people in Baltimore than you would expect. The testing doesnt require a lot of dialogue, its pretty simple: "Hi, My name's Renee. Im one of the HIV testing counselors here. We just want to let you know that Johns Hopkins offers FREE HIV testing to ALL of their ED patients. You would get your results back while you wait. Can I interest you in being tested today?" What Im really saying though is "Hi, My name is Renee. Im a wide-eyed naive nursing student, who only has an inkling of what youre in here for. And Hopkins offers free testing to ALL patients so dont be scared, no one looked at you and said 'THAT ONE! TEST HER!' But while youre waiting for someone to patch up that right leg that seems to be torn off, and remove all those shark's teeth from your abdomen (cause I cant really help you with that) Would you like to be tested for HIV? Dont worry, I have brochures for ALL possible outcomes! And please please please dont be HIV positive because I havent given a positive result yet, and that sounds super scary." Suprisingly most patients must not read into it that deeply, because most say yes to being tested, typically get regularly tested and are less scared of their results than I am. My stomach is in knots the entire shift. HOWEVER... I absolutely and profoundly LOVE this job. I cant contain my excitement when a patient has questions about HIV for me and I LOVE seeing people fill out their surveys on what risky behavior they have and whether or not they consider it a risk of infection. I love the little old ladies, practically asleep from waiting so long in the ED, giving me a one-eye-open BAD look when I ask them if they are a Male-To-Female transgender. I especially love that now in clinical, I have NO problem walking into a patient's room and introducing myself, because, afterall, at least in clinical, Im not going to be asking them if theyve ever traded sex for drugs. And considering the ultimate goal here, this is a teeny tiny little baby step... in the right direction. Today in clinical, yes again a rich source of blog material, I performed a maternal assessment post-partum while being supervised and critiqued by my clinical instructor. I knew the basics, starting with heart and lung sounds and rates, and moving on to Breasts, Uterus, Bowel, Bladder, Lochea, Episiotomy, Homan's and Emotional state (Thank you, BUBBLE-HE). I spent a few full minutes on each key note, poking and prodding and asking the mother questions about how her BUBBLE-HE feels. "Does it hurt when I press down on your abdomen directly above your c-section incision?" "Oh it does?" "Oh you say you just gave birth yesterday? Well please bear with me, I have to find your uterus... oh, and Im new at this, so I REALLY have to push hard to make sure Im not feeling a bladder or perhaps a lost jar of peanut butter." "Okay, all done poking your abdomen. Is there anything I can get you before you leave?" "Well, your order says here that you cant receive Motrin for another 3 hours." "Im sorry I didnt make that out. You were grimacing while speaking." "Would you like me to massage your abdomen to help with the pain?" "Ma'am there's no need to yell 'NO!'" JUST KIDDING! As a sidenote with a touch more of reality in it: Thank you to my clinical instructor for waiting until we were outside of the patient's room to inform me that I do not need to perform a FULL *** exam for post-partum purposes. Apparently the purpose is NOT to detect *** cancer! Thanks also to my patient who put up with me performing a 5 minute boob massage.
The first semester was a complete and total blur. Sorry to say that, all you new students. When I went home for summer break, friends and family would ask if I enjoyed nursing school. To which, I would respond "I don't know. It's all going way too fast for me to decide if I like it or not." Summer semester was composed of respiratory assessments, EKG leads (both physical and the direction of the current), older adult falling statistics, epidemiology and learning how to wipe an older gentleman's bottom three times in two hours. None of those experiences really sealed the deal for me. The topics were interesting, but it was all just way too new for me to get my head around it and form an opinion. This is now my second semester, and by no means has the program slowed down at all. I am required to study, know, apply and practice FAR more than during my first semester (which my professors are extremely willing to point out to us). However, this semester, the basics are clicking in my brain and I am able to focus on more detail (a double-edged sword in itself). I have straight-cathed a liter of urine out of a woman, three hours after she just had a vaginal delivery, I have already learned about beta-blockers, the dangers of free-floating ribosomes and some of my friends have even seen electro-shock therapy in depression patients. I have no doubt that this semester will drag me through the mill and that I will come out battered and bruised. Yet, this semester I can already say that "Yes, I like nursing... I actually REALLY like it."
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I think it’s pretty funny that as nursing students, we start giving a nursing diagnosis to everything. Here a few that I have made up in the past couple weeks while talking with some of my fellow classmates: - Fatigue related to studying effort as evidence by falling asleep during class and baggy eyes.
- Imbalanced Nutrition: More than Body Requirements related to inability to cook food b/c we’re always in class and the professors are always giving us candy and sweets after exams aeb weight gain of 20 pounds in one semester.
NOTE: These nursing diagnoses should not be applied to every nursing student and, if diagnosed, interventions can be completed promptly and problems should be cleared within one or two days. :D
On a better note, nursing diagnoses that we see more often include: - Effective thought processes r/t physiological changes aeb being able to complete a head to toe assessment on assigned patient, give medications and actually know why giving them & achieving an A on Adult Health Nursing exam.
- Self-confidence related to assurance and assistance from peers and professors.
If not understood now, once you are a nursing student, you will COMPLETELY understand these diagnoses.
Now back to studying for my Peds exam… HAPPY HALLOWEEN!!!
Hi all! My name is Beverly. I’m a Traditional BSN (first degree) student here at the JHU School of Nursing. I graduate in May 2009….very soon, which I’m pretty excited about. Sooooo…I’ve been meaning to blog actually for the past YEAR now and I now I finally have a chance to. Since everyone has missed out on many of the things that happened during my first year of nursing school and my 1st seven weeks of my 2nd year, I think for some of the blogs, I’ll add a random flashbacks or event, as you may call it, of the past year. So a little more about me… I was born and raised in Baltimore. During my first two years of my undergraduate program, I attended the JHU's School of Arts & Sciences at the Homewood Campus (I’ll refer to the Homewood campus a lot since I still live near the campus and have a lot of friends that attend the School of Arts & Science and the School of Engineering). I was originally a neuroscience major, but then by the end of my freshman year, I decided to go into nursing. I considered nursing throughout high school but I didn’t really think about it until after some of the experiences that happened during my first year of college. I knew I wanted patient interaction and wanted to affect lives. I could do that as a doctor, right?! No, not exactly the way a nurse does it…. You can do all that, but I realized it’s the nurse who has the most affect on patients' lives. It’s the nurse who knows the patient and how they're feeling. It’s the nurse who is just there to listen sometimes. That’s what I want to do. I want to affect lives on a more personal level, not just from writing a prescription and doing a couple of assessments. One thing that really made me make my final decision on nursing was working with Hopkins Organization for Pre-Health Education's (HOPE) Project Prevent, which is an annual health fair in the Park Heights area of Baltimore where agencies offer FREE health services (i.e. lead poisoning, HIV/AIDS testing, etc.) to the surrounding neighborhood. It was a great experience where I got to meet so many people from the community and just have a one-on-one conversation with them. A lot of them have a bad perception of the people who work in the medical field due to experience, but when they saw that an African-American going into the medical field was helping them, I saw that they began to change their perceptions…just in that day. It is definitely a great feeling just to know that someone thinks differently…just because of something you said. Diverging from academics, I also have a social life (and yes, you can be social while you are at the Hopkins) and I am very involved in groups and organizations. I’m really outgoing, as you can ask anyone who knows me pretty well. I enjoy just being in the presence of other people (I’m SUCH a people person). Random fact, I am random. I think randomness is what makes life interesting…and that’s how I make a lot of new friends. I’m President of the Black Student Nurses Association. We’re just starting off on a clean stale so we’ll be up and going with events and activities soon. I’m also still involved in some of the Homewood groups too. I’m a part of the Mentoring Assistance Peer Program (affectionately known as MAPP) and I was on the Student Admission Advisory board, working with the Admissions office with recruiting, blogging, and talking on the message boards on the main JHU website. I still help out when I have a little time on my hands. I’ll talk more about MAPP and BSNA in other blogs. There’s sooo much to say! By the way…nursing students CAN get involved in activities at any of the Johns Hopkins campuses. I know many students who have joined groups there. Here’s a link to a list of the activities: JHU Organizations Check into ALL the links because there are many things that you can do. I just joined a cooking club last week (but we'll see how many times I can actually make it to a meeting). I know a few people at the School of Nursing who have joined Capoeira …if you don’t know about it, that’ll be something interesting to look up. To finish, there is ALWAYS something happening in my life. This is where I begin to share it with you all. :D
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Conclusiones
Posted August 10, 2006 3:41 PM Hola… Since many of you have long anticipated this most current blog of mine, I am very happy to report that life is good here in Baltimore and that although many of us are a bit sad that the summer months have flown by, it has been a good one!!! Firstly, an official welcome to the new kids of SON who have already finished their summer courses and are now on vacation - and anticipatory welcome to our new mates starting up in just a few weeks. This summer has proven to be a brilliant learning experience for me; I have just finished a summer internship at Johns Hopkins Bayview hospital and will remain there throughout the course of the year as a “Nurse Associate”, a fancy Tech but brilliant nonetheless. There were a hand-full of us in the same program as well as many other of our buds working in various hospital and healthcare settings throughout Baltimore and the US - not sure if anyone went abroad for the summer? I think the general consensus was that our summer jobs in these particular settings made what we had learned the previous year at SON finally make sense, at least to some degree. Aside from work there has been some traveling, some tubing down rivers, the WORLD CUP!!!!!!!!!!!!!, an occasional mojito/margarita - sometimes one of each… Good times. So to all of 2007 coming back to SON for round 2, and to our new friends starting year one and those returning from vacation, safe travels and we’ll see you in Sept. ~ Ciao ***** Spring Fever
Posted March 5, 2006 4:31 PM Friends, Greetings once again from lovely Baltimore. It has been a good long while since my last little blurb. Actually, I think the last time I blogged was at the beginning of the semester. I have been slacking as a blogger, which was brought to my attention a couple of days ago by the lovely miss Minette, a fellow blogger who apparently has “one-upped” me with her latest blog posting. With that, here I am, blogging once again to tell you all tales of life at the SON. It has been pretty crazy around these parts as most of us have been condemned to books and massive amounts of studying and writing papers and care plans - fun stuff! But, we are all making it through and only have one more week until freedom. A badly needed and much anticipated spring break awaits us all. This semester got up and busy from day one and has been a fairly challenging one. All in all, not too bad heading into the final stretch of the first half of the semester. I am in the process of finishing my psychiatric mental health rotation, which has been beyond interesting to say the least. After break, labor and delivery…this should prove to be a very unique experience and I am pretty excited about this next rotation because I do not really know what I am getting into. That and one of my best buddies from home just had a baby girl last week - now I get to have a glimpse of what his wife and he probably went through. So what’s going on with all of you? How are you doing? Kind of feel funny writing things down and telling you about life here in Baltimore and SON and not having any reaction from the “audience”. Maybe that’s a good thing, not really sure. I wanted to send a hello to all of the accepted students that I recently had the pleasure of meeting. Seemed to be a very cool bunch of people, hope you enjoyed the trip. Feel free to send a hello and any questions you might have - promise I’ll be better at responding to your emails than I have been catching up on my blogs. With that, I leave you. Must share some of this time with my pharmacology book. Be well, take care and I’ll be sending out another email sometime soon…most likely from beautiful sunny and warm Massachusetts! Ciao ***** Winter Vacation
Posted January 17, 2006 5:47 PM Friends, I am still on vacation and this is a very strange feeling, having been on vacation now for about 5 weeks. No complaints, it has been wonderful. Just returned this morning from a trip out to Santa Barbara, CA visiting my sister. If you have never been able to take the time to check out this part of Cali, well the entire state…better yet the entire west coast, it is certainly recommended. The roads are amazing, tucked into the cliffs overlooking a Pacific Ocean so immense - it was fabulous and all I could do was watch with envy as countless motorcyclists engulfed the 101 on every kind of bike imaginable. Great trip; I think I have a better understanding why my friends in the program from Cali are very excited to get back to Cali and indulge in the nursing world, California style. So this is my second blog - no sure how I am doing with this blogging thing. Attempting to still figure out what it means to be a true blogger, but hey, if you all are enjoying this I can keep it coming! The countdown has commenced, 5 days + a little bit and ticking until our second semester begins. I mentioned that it has been strange to have had this enormous block of time off, and it has quickly passed as we all knew it would, but know I am staring at 5 days of freedom before it all happens, again! And not that it is a bad thing…I think many folks are excited to see how a full out clinical rotation, 16hrs a week, will be and how the last semester of their SON career will finish up. But the very badly needed break that has so quickly left us will certainly be missed. Well then, I hope this one finds you all doing well. To the friends of SON still on break, enjoy! See you all very soon. Ciao! ***** 4 months in a flash
Posted December 31, 2005 10:05 AM I think I had forgotten how quickly the time passes when assuming full time student status once again…4 months in a flash! Hard to believe that my first semester has already come and gone. My section finished up its last final December 16th and it was certainly time. All in all, a great semester and I think it is safe to say that we were all certainly ready and needing this break. Back home here in Massachusetts with family and friends, thus far, a very nice and relaxing break. Had a chance to get down to NYC before the Christmas holiday and walk around the city. I also have a quick California/Baja Cali west coast trip planned with my sis before we get going Jan 23rd on semester number two. To all who get a chance to read this, Happy Holidays and a very safe and healthy New Year! To my fellow mates @ SON, enjoy the remainder of your break. Look forward to seeing you all in 2006! Ciao. ***** Coming Soon...
Posted December 21, 2005 12:18 PM To tide you over until I make my first post, here’s some info about a program that I’m involved in at the school. Programa Salud works with Baltimore’s Hispanic population. Check out this article in our school magazine, Johns Hopkins Nursing, to learn more about the program: The Language of Healing
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For your viewing pleasure
Posted Sunday, June 3, 2007 2:41 PM At long last, here's a link to some of the photos from our Haiti adventure. Click the following link to see Meghan's top 277 photo picks... and remember that these are just a fraction of the photos we took!! http://picasaweb.google.com/mebodkin/MeghanSTop277PhotosFromHAITI 
***** Day 6, Holistic Care
Posted Sunday, June 3, 2007 2:35 PM We had an early start this morning in an attempt to stretch out our last full day in this incredible country. Uncle Marion, our host’s uncle, led us on an herbal walk. At age 81, he is quite the character and can identify the “miracle” plants that cure anything from kidney stones or prostate cancer to upset stomach or worms. Two of the students ordered and received special teas for their respective ailments – we have our fingers crossed for them! Today, we walked much of Jeremie as we made final trips to many of the sites of our week’s work. We spent our morning huffing and puffing up the mountainous terrain to the Missionaries of Charity where we did health education to about 40 children. Jessa, the germ, wowed the children as she danced around to explain where germs live and how washing hands, covering for coughs, and brushing teeth will help keep germs away. A giant soap, giant toothbrush, and a giant hand whisked the big germ away. This health lesson was quite the spectacle, but as the Sisters do not allow photos to be taken inside the compound, our descriptions will have to suffice. Just imagine Jessa with Groucho Marx glasses and a hot pink feather boa – wouldn’t you be afraid of “germs” too?? Teaching through song reiterated the message and the children enjoyed playing decorating ‘healthy teeth’ with stickers and crayons. Afterwards, we crossed the breezeway to the men’s side of Missionaries of Charity. These men live at the complex for hospice care. Patients include both the old and the young -- from diabetic amputees to cachectic and frail victims of unknown maladies. We spent our time massaging their sore muscles and tired bodies. Often, it felt as though we were simply rubbing their bare bones. As we made our way down the rows of metal beds, the men began to line up for their massage. Those who are well enough to sit outside came in and lay down, awaiting their turn with the nursing students. It was an act of the most basic nursing care and reminded us of the sheer power of human touch. The men showed their appreciation through their smiles, their relaxation, and the light in their eyes. Making our way across the street to the women’s hospice care center, our patients were no less grateful. The women had heard that we were at the Missionaries of Charity compound before our arrival, and the ones who are able waited for on the porch benches. What started out as hand massages for the women turned into full body rubs, as each directed our attention to other weary body parts that needed massaging – feet, temples, backs, and even bellies. When they had finished with their massages, the women went inside for a craft activity. We had brought along colorful plastic beads, and giggles filled the room as the women made bracelets for themselves and for their bedridden fellow patients. To have something extraneous, something out of the ordinary, and something of beauty – this was extraordinary for them. Once again, the power of touch and individual attention proved amazing. Working at the Missionaries of Charity was the perfect way to end our week in Haiti. Providing holistic, basic care was exactly what the patients – and we – needed. There’s a lot to be said for medical advances, for expensive drugs and technology. But in an area like Jeremie, where much medical care as we know it just isn’t available, a return to basic, low-technology nursing proved quite effective. The activity was intensely moving for both patient and student nurse. If the experience alone wasn’t enough, the Mother Superior at the Missionaries of Charity of Jeremie gave each of us a medal to express her gratitude. They are small medals of Blessed Mother Teresa of Calcutta, which have been touched to her tomb in Italy, making them very special for believers. “Blessed” is the first step to sainthood in the Catholic Church. After our last meal at Place Charmont (a very un-Haitian dish of pizza, complete with ketchup sauce), we went out on the town with our translators, FanFan and Moondi. Even our fearless instructor Beth, who had been laid up since Thursday after a “spectacular” fall down the rained-on steps of the dining area, trekked down the mountain in the dark to “Oasis,” where we enjoyed a few last (cold!) Prestige beers and danced in the dark bamboo-curtained club. Early the next morning, we loaded up our bags and headed back out of town. Our luggage was much easier to manage this time, as much of what we had brought was donations to leave in Haiti. Arriving at the airport, we waited for about an hour for our puddle-jumper plane to come, and then we took off from the dirt runway and were gone. The plane ride allowed us a few last spectacular views of Jeremie’s beautiful landscape -- an incredible end to an incredible week. Though our trip was short, it made quite an impression on all of us. We learned so much about public health nursing, about cultural competency, about humility and humanism. Even after returning to Baltimore and resuming our usual activities, a part of all of us remains in Jeremie. ***** Day 5, Plan C
Posted Thursday, May 10, 2007 11:51 PM They say the hardest part about public health nursing is getting to the patient. Case in point: today we just couldn’t get there. We had planned to cross the Grand Anse, the river that shares the name of this region, to conduct our final adolescent health fair. Mother Nature had other plans. The rain that fell throughout the night caused the river to rise too high for our snorkel truck to cross. Clad in our classic white and blue uniforms, we dispersed out across the muddy, rocky, pot-holed “roads” of Jeremie. Team 1: Out to downtown Jeremie to the Aka-1000 mill to see how protein enriched flour is made which is distributed by The Haitian Health Foundation to combat malnutrition in women and children. Team 2: Hopped in the back of a van with Sister Sophie, a nurse midwife from India, to provide prenatal care in a mountain village. Oddly, they crossed the Grand Anse using a bridge. They screened mothers using a high-tech portable sonogram and a tape measure. Team 3: Who says there’s no “I” in team? Our lone ranger braved the language barrier with an “English translator” to a village heath post where local midwives convened for their monthly educational session reviewing postpartum danger signs and contents of birthing kits provided to them containing clean razors, gloves and other various supplies necessary to ensure a safe birth. After our tasty lunch of granola bars and trail mix, we reconvened in the afternoon to observe primary and prenatal care in various settings. At the Center of Hope, directed by a German national, prenatal care was facilitated by Haitian and Cuban physicians and nurses and students assisted with counting fetal heart rates and measuring gestational age with a measuring tape. Meanwhile, across town at HHF, patients, dressed in Sunday’s best, braved the heat and their own discomfort, to seek care. Patients waited in the halls to be seen with a range of ailments such as toothaches, malaria, gastric pains, STDs, arthritis and hypertension. Health care concerns prevalent in the United States were echoed with Haitian care providers such as patient adherence, availability of medicine and concern for the price of receiving treatment. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. As hard as it is to get around Haiti, everyone manages to get here. From India, Cuba, Germany, Canada and our very own charm city. Practice in global health nursing presents itself with barriers related to culture, language and training. Our time in Haiti has demonstrated that passion for providing care transcends political, economic and language obstacles. Somehow, we all understand each other sharing laughs and hiccups in translation working to empower a community. ***** Day 4, We are lovin Haiti more...
Posted Thursday, May 10, 2007 8:23 AM Waking up this morning at the top of the hill overlooking Jeremie the skies were dark and it was quieter than usual, even less humid, and even a little chilly? Running up the mountain, the roads, so filled with pot holes that the pot holes have pot holes that the ruts are roads unto themselves and the footpaths wind their way through the road. The roads were strangely clear today, everyone preparing for impending rain. After our breakfast among the flowers and trees at the top of the mountain we pile into the old school land rover and head down the mountain for whatever adventures Haiti brings today. We get dropped off at the Center of Hope, a maternal waiting home and treatment center for children with Kwashiorkor’s (a malnutrition disease when children don’t get enough protein). The maternal mortality statistics in Haiti are staggering (1 in 17 women) so the Center of Hope is one more way to try to help bring these statistics down. At the Center of Hope after a tour and orientation to the center we split into two groups – half of us going to the pediatric health education and vaccination area and half of us working with the amazing nurses (and one doctor) who were doing post partum and some pre natal visits. Though the nurses we were working with are “only” LPNs, they do some amazing work assessing diagnosing and educating the patients. I think all of us are struck here by the possibilities of the nursing role that we have seen. The nurses in the health education and vaccination center were equally adept in their work riling up the crowd of over 50 women and their children who show up for education according to age for nutrition and baby care. We all feel pretty confident in our abilities at administering vitamin A, oral polio and DPT to squirming babies under the tutelage of the Haitian nurses. We also had the unique experience of meeting some doctors from Cuba who are part of the Cuban government’s outreach to other countries. They are in Haiti, as they are in other countries around the world, giving medical care, aiding health institutions and training local doctors. The Cuban doctor who spoke with us was amazingly humble in her expression of her work and her desire, the goal of the entire outreach effort, to work in a culturally appropriate way that would aid Haitians to be able to meet their own health needs without outside assistance. Humility was in fact the theme of the day – after getting stuck in a phenomenal rain storm that only lasted for a bit, we went to visit Eve Rose. As we arrived at her house we tromped up the steps to be met by little children, many many little children, who kissed our hands and wished us Bon Soir. Eve Rose runs, far beyond an orphanage, a home for children, a spot of grace. She has 75 children of all ages who are clean and healthy orphans, those who no one else wanted, but Eve Rose’s heart envelopes them all and the sense of pervading calm and kindness is profound. We played with the children, we toured their home; we held them, took pictures of them and then in a surreal moment that can only happen in Haiti, only in Jeremie, the children assembled their band of discarded instruments and played. From what was discarded something beautiful emerged and in the shining faces of the children playing and the littler ones clapping, it was hard to believe that this was not a family … somehow of 75. After clapping and cheering we felt obliged to return some bit of entertainment and led the troop back down to their courtyard playground of cinders. We sang our new favorite health song (Bon Sante – Good Health – sung to the tune of Father Abraham with crazy actions … it’s a long story). Every single face broke into a smile as we danced together and sang together; taking turns one American song for one Haitian - a cultural exchange, a human exchange transcending our lack of Creole. The culminating moment was when the children sang an American hymn about lifting up the name of the Lord – the spirituality that Eve Rose professes evident in the way the children help each other little paired with big and vocalized in both Creole English to not a dry eye in the humble courtyard. Humbled we could only say thank you and after hugs and kisses and pictures and writing down the words to songs we knew to add to the impressive repertoire the kids already know. Humbled we are seeing in Haiti immense need tempered by immense kindness – from the malnourished child who offers us a seat, to the nurses who wade to meet us in the middle of the linguistic divide, to the people who open their homes and hearts to us, to the Cuban doctors who are giving free service to a people not their own, to our host who has made this her life’s work, to Eve Rose whose family numbers over 400 orphaned children finding a home in hers and grows with child she plucks from the street and each heart that is touched by her family. Humbled, every one of us would be happy to not get back on the plane on Saturday for at least few more days in Haiti to offer whatever help we might be able to offer, and yet humbled to know that it wouldn’t be enough, but that it would be accepted as if it were. ***** Day 3, Do you miss us yet?
Posted Tuesday, May 8, 2007 9:53 PM We have experienced more in our first six hours today than most people in America experience in a lifetime. The day began with traditional Haitian pumpkin soup, and then we took a land rover down the bumpy mountain to the Haitian Health Foundation, where we were introduced to the KOMBIT program. This specific model of intervention is the only one of its kind. However, it is not widely implemented, despite great results, due to its expense. The health workers from KOMBIT showed us an entertaining and informative skit, including a ‘pregnant’ man and hand-stitched uterus and baby, courtesy of our very own Sara Groves. Afterwards, we got to experience downtown Jeremie for the first time. The market was a sensory roller-coaster, complete with smells of drying fish, flies swarming raw meat, and fruits of every color being sold from every available ground space. Our pictures will soon follow… The next event was visiting the Missionaries of Charity orphanage and hospice. The children in the center are not all orphans – many actually have parents but their parents are unable to care for them. The sisters there only take in the sickest children and so the children we saw were severely malnourished and the evidence of kwashiorkor and marasmus were all around us. This was definitely one of the most heart-wrenching experiences so far. It was extremely hard not to cry in front of the children as we rocked the babies or played with the toddlers. Thankfully, we get one more opportunity to work with the children and the hospice this Friday when we come back and do our health education. One of the last amazing sites of the day was the weekly ferry boat that transports hundreds of Haitians from Jeremie to Port-au-Prince. The boat should only really hold about 300 people to be safe, but today it was packed to the brim with about 800 people, livestock, and produce. Sometimes people will even row out as the boat is leaving and climb on as the boat is sailing away. More to follow…Stay tuned! - Team Haiti Twa (3 in Creole)
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Homeward Bound
Posted Monday, April 30, 2007 12:33 PM Hello Everyone, My last week in the UAE finished on great notes. I ran up Jabel Hafeet with a marathon-running friend I met from South Africa. 7 miles up to the top - and it was up! Because of the heat we left at 5am. The top of the mountain is jagged, but an extensive hotel was built at the top as well as an incredible palace placed on one of the peaks with a man made walk way out to a gazebo that is hanging off the edge of the mountain. What a sight! I was also showered with generosity from friends who took me out to see last minute places that were a must do before I left. I had a really great time and am glad for the opportunity. Thanks for tuning into my blog and for the comments. I hope to touch base with you all soon! Looking forward to the adventures ahead! Chao ***** To the East Side
Posted Sunday, April 15, 2007, 6:10 AM Greetings Everyone, Last week was a mix of different experiences. I shadowed the nurse supervisor whose job it is to keep the hospital's bed capacity organized and problem solve. It was interesting because I was able to check out all the different units of the hospital. Some of the units were similar to what you would find in a US hospital, but others a little different. They have one unit here for chronic care patients, young children born with abnormalities that will not live without ventilator support or constant care. The next couple of days I spent working on labor and delivery. Here the L&D unit is run primarily by midwives. The unit was very welcoming and I had a great time. Some of the birth stories I was a part of are quite something, a story perhaps for later. Hard to believe my clinical experience is nearing its completion. Really one week left! I will be back to my unit, female surgery for that week I just returned from a trip to the eastern shore of the UAE. There is a small strip belonging to UAE that intersects Oman whose borders contain the northern part of the peninsula and the southern part of the Arabian coastline. I went to a small town called Khorfakkan. I have been trying to get here for some time, but there are no buses that travel here, taxis are expensive and organized trips are how most people go and I was trying to avoid that route. I met a woman on L&D who was going with an organized trip and encouraged me to come. She was going to smuggle me on as a cast away. They were leaving the next day. My transport was not completely working out so why not. Well, we did get caught, but easy to ask forgiveness then permission as they say and I made it to Khorfakkan. It was worth the effort of getting there! Rocky, jagged mountains border the coastline here towering high above the village. The mountain ranges are immense and show the feat it must have been to get a road through them! Walking along the beach I scanned the mountains and could pick out small rock fortresses here and there. It kind of reminded me of Lord of the Rings scenery. The unfortunate landscape was the HUGE cargo ships that were coming into the eastern side of the bay where a major operation of unloading, cranes, all sorts of stuff was going on and taking up a large area. Power lines also travel along the mountain side, how they got them up there must have been a lot of work! They can almost always be viewed from wherever you are. Kind of too bad they didn't put underground wires in since this infrastructure is fairly recent. As a cast away I enjoyed lovely meals and luxury of staying in a hotel. I met some really great people. Many from South Africa and heard some very interesting life stories. The beach that runs for several miles and consists of Khorfakkan’s city center is public and was a full of locals. Tents were set up, barbeques on the beach, lots of badminton and cricket. It was very festive. Sally's friends took me under their wing and we all had a really great time! Off the coast I could see many ships dotting the horizon. The weather was beautiful and the water refreshing. On our way we stopped at an outdoor market that lined both sides of the road with hundreds of vendors. Lots of fresh fruit, mangos, pineapple, dates, grapes... and corn on the cob, steamed or roasted. Plants of all kinds, essentially sitting in green houses and a plethora of carpets. The corn was quite good, can't pass up corn on the cob! and I stocked up on fruit. Its back to Al Ain for a couple more work days and then off for some final adventures. Thanks for your comments, it is great to hear from people! Cheers |
***** Late Night Entry
Posted Friday, March 2, 2007 1:35 AM Good Evening Friends, Sometimes I feel like I am on an outward bound course in some respects: the group dynamics, learning, growing and seeing new things together and in different ways. Tonight we had a fun time talking about where we are coming from, little tidbits and a few embarrassing moments....funny stuff, had to be there:) Now I find myself typing away, while the rest of the gang have found themselves a bed and gone to sleep. I went solo today to the Center of Hope where I worked with a great Haitian nurse doing HIV consultations and ante partum exams. I learned a lot and got some practice at finding heart beats and measuring fundal heights. Speaking French would have been helpful so I could have understood more of what the nurse was saying to me and the patient, but heck we did alright. Noah, my interpreter where are you?:) I guess I should start practicing my French a little more. In the afternoon I shadowed the doctor at the HHF clinic. Saw all sorts of things, lots of high blood pressure and scabies. He was quick and often knew right away what the patient had, but also asked me what I thought. An eye opening experience to add to the many others. Like our trip into the mountains yesterday. Three of us were lucky enough to catch a ride with Katy, a doctor from the states who is building a clinic in the mountains. We went with her to some remote villages to do a resource assessment by talking with several of the village leaders. I was amazed by how rocky the high mountain villages are. The Toyota truck we were driving took them with stride, but a flat tire seemed inevitable! The folks we met were very welcoming and we heard perspectives from a lot of people. Katy always asked as her final question, if you were president what three things would you do? Any ideas? Consistently the answers were 1. clinic 2. roads 3. schools Keep in mind that none of these villages have electricity, running water, toilets. Tomorrow three of us head back into the mountains and across the big river (good thing we have land rovers with their long air filter stacks!) to go to a health clinic with some of the HHF health agents. All the best |
***** A Beautiful Sunday! (Emily G. is Off to Haiti!)
Posted Sunday February 25, 2007 9:14 PM
Hello Everyone, Thanks for checking out my blog! Today was a full day that started off with an early morning walk by myself down the hills to town. The roads are impressively steep! People were out, on their way to church and the sun had begun to get warm. And fresh orange juice and fruit for breakfast!!! We made our way from our gorgeous place that we are staying to the orphanage where we helped the nuns feed the babies and played with the young ones. They were all so excited to see us. The site, of all these children was pretty shocking. I would like to go back and spend some more time there, just to give them some attention means a lot. The nuns have their hands full with all the children and babies in cribs that fill the whole room. Just changing diapers and cleaning up spit up seems to have them running around non stop. We walked from the orphanage to town to fetch some supplies at the market. The chicken feet were tempting, but I decided to bargain for the papaya instead. A lot of flour, rice, beans, bananas. The sun was really hot, it must have been in the 90's today. Luckily the group put on a gracious supply of sunscreen and a stop for a glass of coke got us all on track to continue our walk. We took a bumpy trip to the beach in the afternoon. Great waves!! It was so fun and really warm. Tomorrow we begin our work. We are meeting with the Haitian Health Foundation in the morning and then heading out to a village an hours drive away to give our anemia presentation and do screening for anemia, blood pressure, tetanus shots to the 200+ girls who are coming. So far So great. I hope you are all well and I hope to get a chance to write again soon! Chao
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Sanibonani!
Posted Monday, June 26, 2006 4:51 PM Sanibonani is the plural form of Hello in Zulu. This is my first blog entry on this or any site, and I have a lot to say about my experiences as a student at Johns Hopkins University School of Nursing. I have to start with my most special experience here. Well, the experience wasn’t really here, but the result of being a student here. I was selected to participate in the MIRT (Minority International Research Training) Program, which provides training experiences abroad to students interested in minority-focused research. This program is funded by NIH and has affiliations with universities and research institutions in Australia, South Korea, Israel, England, Sweden, and South Africa. I was thrilled to have the opportunity to participate in research at the University of Kwa-Zulu Natal (UKZN) in Durban, South Africa! I’ve always wanted to go to The Continent, and to go there for such a lengthy stay (3 months) and as a part of a special cause made the experience even better than I expected. My research there was focused on developing communications against adolescent substance use and abuse. My specific role was to develop focus group guides for health workers in the communities so that researchers at UKZN would have input directly from the target audience, allowing them to create the most effective campaign possible. I’ve been working on different research projects at Hopkins since 2002, so I had some experience, but doing research in an unfamiliar culture required many skills that I had not yet learned. I’ve always enjoyed learning about new things, and the faculty and staff at UKZN provided extensive learning opportunities on and off campus. I was able to travel to Johannesburg to meet with the Director of Research and Development at Soul City Communications. Soul City uses research to develop literature, television shows, and radio broadcasts with the goal of promoting healthy behaviors and lifestyles. I observed UKZN’s undergraduate community health nursing students plan and implement impressive community health interventions in Durban communities. I attended the 2nd South African AIDS conference in Durban during my very first week there. The list of awesome educational experiences goes on and on. In addition to the research experiences, I greatly enjoyed being immersed in African culture. I was there with 2 other Hopkins students and we made friends with several Zulus and Xhosas who showed us around and allowed us to experience Africa in a way that tourists wouldn’t. We went to cookouts, parties, concerts, malls, the beach, family dinners, and just hung out. Being in South Africa was an experience I’ll never forget! In fact, at the end of my trip my boyfriend came to visit. We went to Cape Town, Zimbabwe, and Zambia - and he proposed to me at Victoria Falls in Zambia!! I’m so glad that Hopkins provided this African experience. I have a really busy summer ahead of me. One of the faculty at UKZN forwarded me a Call for Abstracts for the Sigma Theta Tau International Nursing Research Conference in Durban. I wrote an abstract, with help from my friend Safiya, Cultural Competency in Nursing Education to Facilitate Effective Healthcare , and it was accepted! I’ll be going back to Africa in early August to present this work. Once again, JHUSON is supporting my travel and my interest in research! I’ll even get a course credit for developing the presentation. I took a course this past spring, Communication Strategies for Health Education and Health Promotion, and the Professor is helping me to incorporate the relevant strategies from that course. I can’t wait to go back to Durban! As soon as I get back from South Africa I’ll go straight to Florida for the National Black Nurses Association’s annual conference. I am presenting there too. This presentation, Breastfeeding to Reduce Health Disparities from the Cradle to the Grave, is the result of my work on an NIH-funded research study to support low-income breastfeeding. During the training for my position on the Breastfeeding Support Team I learned about all of the amazing benefits of breastfeeding. For example, research shows that breastfed babies are less likely to become obese, have less incidences of diabetes, lower rates of hypertension, and lower rates of asthma - to name only a very few benefits. I realized that these were some of the same diseases that disproportionately affect the African-American community. So, if more people breastfeed there will be better health outcomes across the lifespan. While I’m at the conference I’ll be promoting JHUSON and recruiting potential students since Hopkins values diversity and the different perspectives people bring from various backgrounds. Okay, I didn’t mean to write so much for my first entry, but I’ve had so many great experiences during my Masters program! Next time I want to discuss the classes I’m taking this summer and the activities included in their requirements. I also want to talk about my two new jobs. I’ve been a Nurse for almost 7 years now and I keep discovering new and exciting roles and opportunities. This profession provides so many options and they are all very rewarding. I look forward to sharing more of my experiences soon. Take Care!
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 The NICU
Posted Sunday, July 08, 2007 5:54 PM
I love working in the NICU (Newborn ICU). It’s a lot of fun. The nurses are great, the babies are cute, and there’s a nice variety of patients that move through the unit. But one of the most common comments that I get when I tell them I’m working in the NICU is, “it must be so hard to work there.” I don’t see it that way. Granted, it can be very difficult working there. You see so many babies that are so critically ill, that it tears at your emotions. So many of them are barely hanging by a thread, require intensive care and life-saving techniques. They’re on ventilators, heavily sedated, hooked up to machines, and have tubes coming out of every open patch of skin and orifice. And the sad reality is, for the ones that are so sick, some of them do not ever get off the vents or heavy sedation. Personally, the hardest part is watching them lay there and struggle against the ET tubes, knowing that they won’t ever be free of them because the parents want everything done for them. It’s not that I want them to let go, but I hate to see their suffering prolonged. All life is precious, but it is the quality of life that is most important (in my opinion). So it is hard for me to see some of these kids that are not progressing, not getting better, and their parents want everything done. The parents don’t always understand what it takes to keep the child alive or what it will mean for the infant. Sometimes it’s better to just let the baby go. But just as they might not understand what is going on or what the prognosis is, we don’t understand what it means for the parent to keep the child alive. What it comes down to is a difference in values. For me, simply existing isn’t living, and it is hard for me to watch a child with no prognosis or chance to be off a vent, yet kept alive without any quality of life. But working in the NICU isn’t all sad. Most of the infants do very well and get to go home to their families. They’re amazingly resilient. It’s a matter of helping them get better. Over the weeks, you see them get stronger, gain weight, and learn to bottle feed. The parents come in to hold and feed their children and see the pleasure in their eyes. You can hear the excitement in a mother's voice when she hears her son “graduated” from an isolette to a crib. These are things that overcome the sadness of some of the other children and make the work worth while. And the best part is when you pick up a crying child and they calm and fall asleep in your arms while holding your fingers in their small hands. Actually, the best part is when they’re sleeping quietly in their cribs and stable so that the alarms don’t go off every minute haha And the coolest thing in the NICU is that you can save a life one foot flick and poke at a time ***** A rookie mistake
Originally posted: January 28, 2007 at 2:47pm It’s kind of scary sometimes when you think about someone’s life is in your hands when you’re at the hospital. Especially when it’s your turn to give out meds. We’re supposed to check and recheck, and then recheck again. And after you think you were being so careful and meticulous about them, you find out you might have done something wrong. It’s scary to think about making a mistake. The other day I was giving meds. I checked them on the orders, made sure I had the right drug, the right dose, right route, right time and the right patient. Then I checked compatibility because I was giving an IV push, along with hanging other IV piggybacks. And I thought everything looked good. So I gave my meds, my IVs, and my IV push. A little later I went to look up some of my meds for the next round. For whatever reason I went back to the IV meds I gave and checked compatibility again. One of them had “caution: variable” meaning the reactions with the two could potentially be incompatible. It’s a terrifying feeling. Your heart just drops. You feel the blood run from your face. You get nauseous. And then you just wish you didn’t wake up this morning at 545, because sleeping in and missing clinical might be better than accidentally hurting your patient. What do you do? What can you do? I went to my nurse and I told her what had happened. We checked the IV compatibility on Micromedex and confirmed what I saw. We checked the patient (who was fine, no changes), and then I went to talk to my instructor. I was ready to get sent home, to fail clinical, drop out, and then go back home to figure out what to do with my life. Maybe live on the beach in a grass hut? I know I was exaggerating and thinking too far ahead, but when you’re panicking and unsure of what to do, your mind goes in every direction at once. So when I talked to my instructor, I showed her what I found and waited for judgment. And luckily, the meds were compatible. I didn’t mix meds incorrectly. I didn’t almost hurt my patient. And thankfully, my instructor knew what she was doing and wouldn’t let us make these kinds of mistakes. So as annoying as it might be sometimes to wait to give our meds with our instructor, there are benefits to it. Sometimes it’s necessary. Maybe some people are perfect in everything they do and never make mistakes. I’m not one of those people. I think sometimes we are driven to do everything so perfectly, that little details need to be exact, and then find ourselves missing something really big because we’re too into the little things. Or maybe it’s the pressure that we put on ourselves to do everything exactly and correctly, that make us miss something so obvious. And as scary as it is, at some point we’ll make a mistake. Hopefully something bad doesn’t come of it. All we can do is try to do our best, not scary ourselves into being the most perfect nurse ever, and make ourselves think about what we’re doing. If you have a question or unsure of something, just go ask. If you don’t feel comfortable doing something, ask someone to help. I was lucky, really really lucky. It could have been a lot worse. But as students, we don’t have all the answers. We’ll make mistakes. And the best thing we can do is learn from them. So if you don’t already know, phenergan doesn’t go with Ringer’s Lactate (my patient had KCL). But make sure to double check! ***** Awkward Communication
Originally Posted: October 21, 2006 at 8:34pm Last week I attended the wedding of my older brother in California. It was a beautiful wedding and I was so excited to get away for a weekend. We had a three day weekend and my brother was nice enough to move the wedding date to accommodate my travel considerations so I didn’t have to leave in the middle of the party to fly somewhere like I did for my oldest brother’s wedding. I like weddings. It’s a celebration of love. And there’s a lot of good free food. I’m always for good free food. But one of the things I hate about weddings, particularly if you’re the youngest unmarried brother of the groom, people are bound to ask you annoying questions like “when are you getting married?” it’s one thing when family asks you that, because that is the eternal question any family member or close family friend will ask anyone unfortunate enough to be single. But what I don’t like is when a complete stranger comes up to you and asks you that question. Of course it’s to be expected, but I find it awkward and a little insulting at times. I don’t know you, and I probably don’t remember your name, and you’re asking a really personal question. It’s rarely, “are you seeing anyone special right now?” no, it’s straight for the jugular, “when are you getting married?!” Is it right to naturally assume someone is coupled? What about those lonely singles out there? What about those who aren’t allowed to get married? Maybe we don’t need a big party or a wedding to celebrate the love that we have for one another. Maybe I’m a little touchy about people asking me about my marriage prospects. For some I replied with “I can’t get married until the laws change” and would smile and watch the confused expression cross their faces and perhaps a dawning of understanding. Most of the time when I was asked by strangers I just said “Not for a long long time” and made a V line for the door. I wouldn’t wait for that look of pity and the condescending “you’ll meet someone someday…” I don’t like having to explain myself all day long, and I shouldn’t have to. Those questions make me feel horrifically awkward, and I’m sure the other person feels just as awkward too. I say we dispense with awkward questions, and not bother trying to talk to complete strangers haha no I’m kidding… for the most part. But I guess this has been the week of awkward questions. People have been coming out of the woodwork with them, and I’ve been asking them also. I’ve been getting the, “so… you’re a male nursing student… how’s that working out?” and the “so you really wanted to become a nurse, not a doctor?” questions and it gets on my nerves quite a bit. And perhaps I am not the most socially adept person and I might have fallen asleep briefly during some our therapeutic communication lectures, but how do you answer those questions? How do you not get offended by the negative connotations and not want to pull out your hair in frustration. I’ve always tried to not put much stock into what other people think or say about me, but it doesn’t mean I don’t get annoyed or feel awkward. I’m not saying I never put my foot in my mouth and ask awkward questions. My face still becomes red with embarrassment when I’m asking a postpartum woman how her hemorrhoids are doing while she’s laying on her side and exposed with myself and my instructor examining her ‘roids (although I’m thinking that she’d feel more embarrassed than I would be). I still feel my ears get warm and the hairs on the back of my neck rise when I know someone is going to say something that will offend me. But I try not to let it eat away at me. And it still bothers me sometimes when people make ignorant judgments about me or others for the decisions we make for ourselves. But I guess it’s something I’ll have to learn to deal with and not get too worked up about. People will offend you whether they mean it or not. It’s usually it’s innocent, but unfortunately, it’s part of the job. No one said it would be easy. It takes a really strong person to be a nurse. It takes dedication and discipline, a thick skin and the ability to take the abuse, and the knowledge when to accept it and when not to. And it also takes a strong will to not smack someone when they say something stupid and offensive. We do it because we care. If we were in it for the money, we’d be doing something easier. If we wanted recognition and fame, we would have chosen a more glamorous job. But sometimes the benefits outweigh the difficulties and the headaches. When a patient sincerely thanks you for your help, or when a fellow nurse praises a male going into nursing, then it’s worth the abuse, the irritation and the indignity that sometime follow the job. It’s about being proud of yourself for your work and loving who you are. It makes those hard questions a little less awkward and easier to answer. Maybe I’m still trying to get used to these questions. Maybe someday when someone asks me one of those nurse related questions I won’t get annoyed or feel like I have to explain my choices all the time. And maybe someday when some stranger asks me at a wedding when I will be getting married, maybe I’ll tell them the laws finally changed and that my partner and I have the date for sometime next year. Sorry folks if this entry was a bit scatterbrained, it’s a scatterbrained time. It’s late, I’m tired, and I like to kill as many birds with one stone. I wanted to celebrate my brothers wedding, send a shout out to the LGBT community at school (I missed the lunch last week because I was too hungry to wait until 1230 to eat and wanted to go to a ER/transplant nursing meeting), talk about some of the difficulties and rewards of nursing, and emphasize the importance of therapeutic communication. We need to learn talk gooder and avoid the awkwardness!
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 Why Nursing?
Originally Posted Thursday, March 15, 2007 1:51 PM
Hello Friends, It has been a very busy couple of months and now that the Medical Surgical clinical rotation is over we are moving into the next rotation, (Pediatrics). We have been immersed in the JHUSON relentless academic marathon and in a few short months (4), the student journey ends and a new path is blazed as new nursing grads, and licensure examinations. Personally, the nursing school experience has been quite the adventure, yet rewarding on many levels. Another student asked me the other day if I would go through nursing school again, my first reaction to her inquiry was to question her on the type of medications she was taking and if any adverse side effects such as, “delirium” was being experienced. I compare the nursing school experience to military boot camp or similar academy/educational type programs. This process is demanding, emotionally, physically and mentally and you ONLY want to live through it once. The experience at times, feels as though you JUST cannot do one more push-up, run one more mile, take one more exam or write one more care plan. Then a remarkable thing happens, you find the inner strength to push through the challenge and propel yourself forward with the confidence that you persevered and gave it your very best. I believe that perseverance and resilience is what propels us forward and strengthens us during times of difficulty. It is only through personal or a professional challenge that one is pruned, tuned, strengthened wisdom is gained, regardless of previous historical successes. Pushing through nursing school whether the timeline is 14 months, 21 months or three years requires heart, determination, resilience, faith and intelligence not to mention the undeniable belief in the purpose of your journey. I have traveled the world as a member of the armed forces, worked in situations that would probably have shocked the faint of heart and have been in the right place at the right time to make a difference in the lives of others. I have held numerous positions of leadership throughout my careers and worked long hours in critical incidents that I cannot even begin to accurately capture through this blog. I have treasured those experiences, valued the memories and nurtured the friendships through the years. I am often asked by individuals, WHY NURSING? With all of your career successes why would you give that up to attend school and start a new career with its own unique challenges? I admit, it’s a fair question, my response is simple. Success is not always measured by money, status, power, credentials, I have had money (had... is the operative word), great career successes and power. Success to me is doing the one thing that you would love to do even if you were not paid a single dollar. The purpose of the journey, any journey regardless of your background, sex, culture. socio-economic status in regard to choosing a nursing career is as individualized as a fingerprint. The essence of nursing and the common commitment of "standing guard" for others is grounded in ... not what is gained but what is given. It is not a rubber stamp reflection of a job; nursing is immersed in commitment, hard work and passion for people. Why Nursing? The following is just one example: I have one story to share that occurred toward the end of my Med-Surg rotation. It was toward the end of our seven week clinical rotation and as usual we were all on a non-stop marathon of care plans, exams, quizzes and yes hours and hours of studying. I did what we all did on a weekly basis. prepared diligently for clinicals, gave 110% total nursing care with every assigned patient and survived at times on sheer determination, reserve energies and lack of sleep (PRN basis) to push through the long hours and manic moments of care plans, clinical preparation and project deadlines. One particular week was especially difficult for me after receiving some untimely outside personal news. I continued to push through the distraction and provide 110% best patient care possible while remembering that regardless of my personal outside concerns, my patient and their nursing care was first and foremost. The long clinical shift ended and I drove home exhausted. I struggled with my fatigue both emotionally and physically. I pondered the question,” did my efforts today made any real difference? The personal and professional sacrifices to attend nursing school and the choice to start a new career did not seem as CLEARLY defined for me on that particular day. I continued to draw strength from my faith, and from my inner convictions to continue pushing through regardless of what I was “feeling” although my fatigue and life’s stressors were clearly working against me. (I thought, I could have money, status and work a regular 8 hr day what am I doing here jumping through all these hoops). I proceeded on with the rest of my week pushing through to meet deadlines and task completions. (Living on caffeine and tasty food bars- always ask for the nursing student discount). The following week while reporting to my clinical site, a letter, addressed with my name was waiting for me on the hospital floor, below my name was written, Johns Hopkins School of Nursing Student. My first reaction to this letter was, “Great, it’s another bill…financial accounts has forwarded this to my clinical site…this is special”. (Financial stressors are without question a reality during nursing school education) I proceeded to open the letter, and discovered it was written by my assigned patient from the previous week. The patient I had cared for on the day after receiving some difficult news and wondered if my nursing actions and efforts really did make a difference. (It did) The letter touched my heart and was written with such genuine gratitude and expressed beautifully written words related to the positive impact made by my direct nursing care received on that particularly difficult day. This patient expressed through a full one page letter the positive impact of her care and the difference that it made for her in her hospital experience. Her fears were eased and her comfort level improved related to the recovery and healing process of her condition. The words at the end of the letter simply stated,” You made a difference in my care and you are going to be great nurse, thank you for always going above and beyond to take care of me, you have made a perfect career move and have a great sense of humor. (WOW) I could not believe the timing of the letter. The tears rolled down my face as I folded the letter, placed it in my pocket and realized that all my sacrifices, struggles and challenges through nursing school was not simply an academic exercise but a living example of touching lives and making a difference even when we do not realize the impact. I will always keep that letter to remind me of regardless of our own personal circumstances and challenges in life; we do make a difference in the lives of others if we allow ourselves to embrace the gift of selfless giving. It is in those moments when we continue to give our best even though we feel as though we have nothing left to give, something marvelous occurs. We touch lives! The art and science of nursing is merged in moments that sometimes takes us by surprise and reminds us of how truly privileged we are to care for others, and to hold the sacred title Nurse or in this case, nursing student. Touching lives IS a tapestry of our successes how that is measured is as unique as the individual fingerprint. We do make a difference each day in the lives of others and after all isn’t that the essence of why we have chosen such a challenging yet rewarding career. Pushing through the difficulties is what provides value to our journey and adds appreciation for what lessons were learned along the way. I would like to thank those who have written me e-mails in regard to this blog site and although the day gets quite busy, I may not always get a chance to respond but be assured they are read and they touch my heart and are greatly appreciated. Thank you! Congratulations to those who have been accepted into JHUSON, great job! Take care and thanks for visiting the site. ***** Inspiration
Originally Posted: October 1st, 2006 at 12:08 pm Hello Friends, The first sets of exams have been successfully negotiated and like all things in nursing school as soon as you finish a project, care plan, or preparing for an exam; you look up and another list of deadlines and preparation must begin for another quiz, exam or patient care plan that at times seems as close as your next breath. Timing, organization and pacing yourself is key for survival to prevent feeling “overwhelmed”. You must always take time out for yourself to keep school in perspective. Imagine swimming underwater for periods of time, coming up for air to take a breath and diving back underwater, propelling yourself forward until you stop to take another breath… you quickly ascertain your position relative to your surrounding, continue heading in the direction of your intended destination and at times are unexpectedly inspired and awed by the beauty of the water world you find yourself involved in. This weekend I was so inspired... not by the creatures of the sea, but by some of the most incredible and amazing people who are part of the legacy and tradition of the "Alumni Association”. These women and men are graduates from the JHUSON ranging from past graduating classes dating as far back as the 1940’s to recent graduates. I had a few hours on Saturday to volunteer and help with their annual Alumni Association breakfast and lunch and I must say…I was a bit tired from a long week of exams, studying, evening clinicals and writing care plans. I had to force myself to get up early on Saturday morning…but I committed myself, so I slowly moved toward my car (the pep in my step was a little lagging) and drove to the hotel with a cup of coffee in my hand and humored by the lack of traffic on a Saturday morning in downtown Baltimore (most likely these folks were still sleeping). As I positioned myself near the door to their function (my volunteer role) wearing a lab coat to primarily identify myself clearly as a student, I began greeting the alumni who were entering the ballroom for their breakfast and could not help but feel their enthusiastic energy. I was awed at the sight of these remarkable women and men who ranged from the ages of 91yrs to twenty something. They proceeded to file past me, greeted me with a smile and many of them stopped to engage in a few minutes of conversation. Their sharing of accomplishments, experiences and pride of being part of the JHUSON nursing legacy was evident by their grace, poise, humor, intelligence and incredible warmth and positive energy. From current Nurse Practitioners to the aged and retired nurses, they each shared personal stories about their experiences from the war to present day nursing with energetic animation that captured my attention and inspired my soul. I looked around the room at one point and just took in the energy from this collective group of amazing individuals who each one in their own right has contributed a part of themselves and continues to influence the art and science of nursing. As I embraced their energy and laughed at their stories, I could see the passion and love for nursing in their eyes and it moved me because it was so genuine and unmasked. It was part of who they were and it propelled them forward….seeking out new challenges and never settling for the status quo. As I finished my duties and prepared to leave, I assisted an older retired nurse (70-80 yrs) to the bathroom facilities. As we briefly talked, and laughed about needing a map to find the bathroom in the hotel, she stopped, turned to me and said,” Do you like nursing so far?”
I responded honestly to her inquiry and stated ” I do love the clinicals, but you remember what it was like sludging through Nursing school-your always immersed in something. With a sparkle in her eye, and firm grasp on my arm she said,” Yes dear, I remember, but always know even in the hard times, you will touch the lives of people and in time you will make your own contributions to nursing”. She continued, “I am old and have not been active for many years but my hope is that students like yourself will follow in our legacy and never forget the nurses who have gone ahead of you and left their mark…you must do the same.” I said “Yes Ma'am, I will always remember.” I thanked her for her words of wisdom said good-bye, told her to take good care of herself and walked toward the elevator. I stopped for a moment to turn in her direction …she was gone. Our brief encounter was inspiring to me and yet so simple in its transaction. I am glad I had the opportunity to meet her even for just a few minutes ….she was more than an alumni attending a function she was a nurse and a genuine soul with over sixty (60) years of experience, working with patients and impacting lives. With that spark in her eye and genuine spirit she did what she has probably done throughout her entire nursing career….touched a life, left an impression and kindled inspiration in someone she had only briefly met. The energy from the morning event carried me throughout the day and when at times I feel as though I am running low on energy and can’t bear the thought of studying another 3-4 hours on a subject….I will remember the spark in her eye and that genuine soul who has blazed a trail and continues to propel herself forward. I would encourage all students who have the opportunity … to get involved with the alumni association, it is a remarkable group of people that not only have gone through the gauntlet of nursing school education but who continue to impact the field of nursing today on many levels and fronts. Their kindred spirit, historical legacy and passion are energies that never waivers and their light is never extinguished. What a wonderful career we have chosen! ***** Academics and the “rite of passage”
Originally Posted: September 16th, 2006 at 6:30 pm Hello Friends, The monthly calendar reflects midway through September and we are now progressing into the third week of clinicals and exam periods. The Nursing school experience is just that…an “Experience”. The “right of passage” is the maneuvering through each semester and one step closer to meeting the personal goals of graduating and entering the professional field of Nursing. The passage is marked by at times straight paths, but more often by winding and challenging roads that each student must negotiate to move closer to that finish line. The perseverance of pursuit is in the spirit of completion and the reality of the “schoolhouse environment” is merely a right of passage that will allow you to eventually be part of a profession that is special, unique and often challenging. I as most students have been challenged, frustrated, and at times edified by my experiences thus far. I can pass close friends in the hallways and know by the look on their faces what kind of day their having. Nursing students become very adept at picking up energy (negative or positive) with each other and can empathize as only a collective group can that share similar experiences within the same environment. Each semester and each clinical is progression toward the next higher level of learning. Having the opportunity this summer to work with some excellent Emergency Room / Trauma Nurses solidified the balance between school (the means) and working in the “real time” world of nursing (the valued end). To keep your eyes on the prize even when your sunk under for a week or two (as a friend told me once) is to understand the “right of passage” and know that the value of each person going through this process will have something special to offer and contribute to the field of Nursing. The science of nursing is only partially complete if the spirit and heart is lacking the passion. The passion comes from what it already in place, but is pruned and tuned by the struggle and frequent challenges from just being in nursing school. To my friends who read this blog and who I know are struggling getting back in the groove of the fast paced academic tempo here at the SON, be assured your in good company and persevere, we are almost there. Sometimes it is all about the journey that gives us strength to rise above the challenge and make our own mark when the time is right! Take care and thanks for visiting the site, I will see you around Campus! For those readers who are reading this and who are not yet in Nursing School but thinking about it….my advice to you is… the journey is worth the pains of passage….so take the risk and jump in with both feet. You're in good company, believe me.
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 We're leaving for Haiti!
Posted Thursday, February 22, 2007 6:18 PM We are technically leaving for Haiti today. Very exciting. So exciting, in fact, that I can't sleep. Since it is very late at night, or very early in the morning depending on your perspective, I'll make my entry brief. The Haitians have many sayings, or so I have been told. There is one that I came across, in preparing for this trip, that comes to mind- Ou we sa ou genyen, ou pa konn sa ou rete (You know what you've got, you don't know what's waiting for you). That is exactly how I feel at this moment, knowing that whatever I have learned to this point, whatever experience I can bring with me, whatever good intentions I carry, whatever I have packed in my luggage- that is what I have right now. Will it be enough for what is waiting? I hope so, but I think not. I am slowly understanding that this is why I have come to JHU SON, for these moments and these opportunities. I've come here to work with exceptionally talented and passionate people. I am here to find out what is waiting. So, fellow nursing students, please keep us in your thoughts and prayers if you have a moment as we fly tomorrow. I have the feeling that this will be a very memorable trip. Arrival Posted Sunday, February 25, 2007 8:45 PM I have never been a fan of the window seat; in fact I have been known to avoid it at all costs in favor of the aisle. As luck would have it, I've been assigned to the window on every flight so far. As we flew into Miami, I was mesmerized by all of the lights. It reminded me of an enormous motherboard, all the neatly divided sections, and the buildings that look like capacitors. The night in Miami was an adventure in itself...yay for HOJO (to be read as mild sarcasm) . The highlight of the night was waiting for the "free" shuttle at the terminal with 20 check-in bags and 10 carry-ons and at 11:52 pm, being told via phone that the shuttle is not due to arrive until midnight by the shuttle driver, who is was about 20 feet down the way, just waiting for the clock to strike 12...Comedy! When we flew into Haiti, I think what struck me most were the mountains. Anyone who has read Mr. Kidder's book will recognize the Haitian proverb - Mountains beyond mountains. I always took it to be somewhat metaphorical, like the mountains are the challenges we face in our lives or the hardships we endure and then overcome with hard work and perseverance. But when I saw the mountains, felt their commanding presence, I realized that these are real, tangible mountains that people do physically climb, every day. It sounds so obvious, but it is very daunting to see the mountains beyond when you have not yet climbed the first. Our arrival and not-so-rapid departure from Port-Au-Prince was a lot to process all at once. I am still in the process of processing...We are now at Betty's oasis. I feel like I am staying at the Swiss Family Robinson tree house. We have finally arrived. Tuesday Posted Tuesday, February 27, 2007 9:50 AM It is early in the morning on Tuesday and the cocks are crowing, but that doesn't mean much since they literally crow at all hours of the day...and night. It's been a very powerful experience thus far. I find it hard to write sometimes because it is frustrating when you can't find a key on the keyboard to express Haiti. Yesterday, we got to see the Haitian Health Foundation in all of its glory. There is really good work being done here, and it provided a much-needed reassurance that things can change for the better- especially after our visit to the Sisters of Charity on Sunday. I had never held a baby suffering from Kwashiorkor's before, and I had never seen so many children bombard complete strangers begging to be held. And they were still smiling. Yesterday was a long day, but very good. We attended the HHF orientation and then took a walk to the hospital proper. It was unlike anything I had ever experienced (like much of the trip thus far). The smell of illness was thick in the air as we wandered around the barley functioning wards. It did not feel like a place of hope and health and that was difficult for me since I have always known hospitals back home to be held to standards of quality and centers of healing. Even hospitals in disrepair that I have seen in America cannot compare to this- We talk of bed making procedures and blood pressure protocols and sterile dressing changes, but all of that seems like luxury here. The day continued on with an hour long car ride on a roughly forged road through the mountains to a village where we would conduct our first Health education day. All fourteen of us were packed into a land rover, like sardines except probably a little tighter than that. The landscape was beautiful, that of a tropical paradise, with the Grand Anse River following our progress. Small shacks and towns lined the road as we passed. And throngs of children, being released from school, flooded to road with the bright colored uniforms. Each of the many schools had their own unique outfit, designed specially for their program. Haiti is a country of colors, all around, all very bold and bright. Lime greens and bright blues and yellow. Tons of kids, all walking to who knows where. Ferme Posted Wednesday, February 28, 2007 10:25 PM We had been walking for about 20 minutes, up a very rocky road. I chanced a glance back and was met by a mob of little children. They had been let out for recess as we passed the state school along the road and had followed us in our journey to Ferme, all in their bright blue uniforms sure to keep a safe distance. They quieted each other, stifling giggles as they investigated the strange visitors to their remote home in the mountains. But smiles are contagious and pretty soon our silent entourage was transformed into a giddy following. We walked a little farther and came to another school up the way. It was a private school, Protestant. The children there were also being released for recess and suddenly we were surrounded. So many beautiful, happy children. The school was a single room, a concrete building with wooden beams and very small. Dr. Katie informed us that this would serve as the site for her first interview, and our guides led us back to meet the school director. He was a 27 year old, well spoken Haitian man with very kind eyes. We observed that interview and several more before taking our leave and continuing on through the village. We stopped next at a small house, a two room shack with a tin roof, and were welcomed by a man and his small son, who hid behind the doorway still sporting his school uniform. The small room was bare save a calendar on the wall and a chalk board. We conducted our third interview of the day, it was a resource assessment trying to determine the level of "buy in" towards a new clinic that Dr. Katie hopes to build on a plot of land known as Gatineau. She travels on foot to 17 remote villages in the mountains above Jeremie, speaking with members of the community about their health concerns and what may come. The clinic will be centered on curative care and promises to bring much needed medical services to 30-40,000 people otherwise cut-off from medical services. Rachel, EmG and I were able to accompany Dr. Katie as she conducted this slew of interviews. When the interview was done, we were offered fresh coconut milk, straight from the coconut, and fresh boiled eggs. It was the most touching and meaningful show of hospitality I have ever received. I watched the man's son climb the tree and cut down the coconut. They shaved it with a machete and gave us each one to satiate our thirst. It was so refreshing. We left Dr. Katie to her interviews and were shown around the rest of the village by our guide, Tijan. He pointed out the vegetables and flowers that were grown, the animals that were kept, and the market. We were greeted everywhere we went and did our share of greeting. Finally, we were led back down the road to the larger state school, a concrete and would structure divided into two rooms. The benches had been removed to allow for the large focus group/town meeting Dr. Katie would facilitate to engage the community and get them on board with the project. Children, throngs of children all wearing bright yellow uniforms, refused to leave the school even after dismissed. As we waited for Dr. Katie to arrive, we were invited to sit at the front of the room and ALL of the children sat in front of us, staring intently, waiting for something to happen. They were so cute, just staring at us as if we were aliens. It was a little unnerving. In an attempt to break the ice, I stood up, pulled out my camera and took a picture. Then, I turned the digital LCD screen around so they could see...that most definitely broke they ice. I was mobbed by giggling, chatty, excited children all wanting to have their picture taken, all wanting to see the screen. It was incredible. Once that was done and we had a mutual understanding of good intentions, we returned to the familiar game of sit and stare, still waiting for Dr. Katie. So, Rachel and I did what any other reasonable aspiring nurses and lovers of the arts would do in a similar situation- we sang Frere Jacques (this song is specially dedicated to my dad!)! And the kids knew it!!! They sang for us, we sang for them, and then we all sang together and it was such a high! So much fun. When we were done singing, as if on cue, Dr. Katie came walking down the path and everyone was excited because she is well known and seemed to be well liked among the community. The meeting went very well, everyone had insightful things to say and comments to add. One of the clearest messages that came through was the frustration over a legacy of broken promises. I hope, for the sake of all involved, that Dr. Katie and her team are successful with their clinic, because the people are in desperate need.
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 6:33pm and counting
Posted Thursday, February 22, 2007 9:32 PM It's 6:33pm and there's still so much to do! I began this week with a whiteboard full of tasks - all accompanied by little boxes, just waiting for that satisfied checkmark to show it had been dutifully completed. Less than 24 hours before the plane leaves the tarmac and how many of those boxes have been left unchecked! Just another familiar mantra of nursing school... However, to put it into a little perspective on this otherwise petty concern, soon my clinical group and I will be in Jeremie, Haiti. As we've been preparing for this trip I've had several moments to briefly reflect on what this experience may be like - and how things may have changed since the last time I set foot on that small island. Traveling to Haiti during my freshman summer of college in 1999 was the first time I had been outside of the continental United States. What a culture shock it was to set foot on the soil of Port-au-Prince, just outside of an airport thronging with unfamiliar faces and tongues, and gaze out onto the cityscape. This was my first encounter with a developing country - and it left a permanent impression. At the time I was traveling with a medical mission accompanied by nurses, medical specialists, and interestingly enough, my father. We witnessed great beauty - and great destruction - in the landscape we traveled during those brief weeks in 1999. I was amazed at how people could work so hard, in such challenging circumstances - with so little. I tentatively sampled a bit of goat meat offered by a generous hostess in a mountain village. I struggled to assimilate clumsy high school French into the richness of Creole - and failed - and I made many "small" friends along the way. The outstretched hand of a 5 year old and the sparkling smile that accompanied it became familiar - almost comforting - but I couldn't help but feel a bit uncomfortable about my role in this land so different from the one I had grown up in. That trip served as a chief source of inspiration to pursue nursing practice and public health. The nurses I was with at the time and I theorized that the work we were doing there was only a band aid on a much greater need. I later came to understand that this kind of thinking has a name - in Peace Corps circles it is called "sustainable development" - in nursing, I have come to learn it is called "health promotion". In later years, once I became a volunteer, I often thought about Haiti and what I'd seen in Port-au-Prince, Cite Soleil, and the mountain villages that seemed so precariously perched atop the steep ridges that gate the island. Now that our public health nursing clinical group is preparing to go back - this time to a different region with a slightly different mission - I wonder not only about what will have changed there, but also what will have changed within me. Either way, I am so incredibly thankful for this opportunity, for my clinical group-mates (who are an awesome, accomplished, and inspiring bunch), for our instructors (an MPH student with previous experience in the Dominican Republic and a doctorally-prepared public health nurse who spent all of last year working in this Haitian community) and for the many generous donors and supporters of this trip who have made it - and the work we are about to do - possible. Sorry for being so long-winded - but another checkmark down! Chat with you all in Haiti! How Much for a Chicken Foot? Posted Monday, February 26, 2007 12:56 AM It has been a long but beautiful day. I was so heartened to see Haiti again – in fact, there were several of us, crammed hip to hip in the back of the Land Rover, who breathed a literal collective sigh of relief – perhaps release – upon finding ourselves in this incredible country (either back or for the first time) and doing the work that we love. Mostly I think we were high on laughter – and the intoxication only worsened with every pothole the vehicle struck. Perhaps I should say we had split-second lulls between the periodic launches from the benches upon which we were perched. We skipped right through Port-au-Prince and onto a “puddle-jumper” as my uncle would call it, and into the hilly but gorgeous region of the Grand Anse, where we landed on a white strip of runway in the city of Jeremie. This area is so – well, it appears thriving compared to what I last saw in Port-au-Prince. Perhaps it’s the greenery and the rural location, perhaps it’s my memory. Either way, it’s encouraging. The people here are still beautiful – they smile and nod and greet you – “Bonjou!” upon encountering you on the street. This morning everyone was wearing their Sunday best in church and the way that they take care of their clothes they make the look GOOD, even if they really aren’t. Today was the first Sunday of Lent. We chose to visit l’eglise of the Sisters of Charity, a Catholic relief organization here in Jeremie, for their Sunday services. Little did we know that today would be an extra special fete for both the season and the third anniversary of their church choir. The inside of the snow white cement meeting house was bedecked in wedding decorations that had been converted into streamers for the celebration. The house was packed. The sermon was in French, mixed with Creole, and very focused on the holiday – particularly the fast. It was strange to hear this community leader speak about the importance of fasting, especially spiritual fasting, to an audience of men and women who probably had one to two small meals of rice or beans a day, if anything at all. There was a tiny little girl from the choir – she was maybe 8 – who stood at the church’s microphone and narrated along with the choir. She implored God to look out for those who are starving and suffering – not her community – but “others” of the world who are in need. They were praying for those who were truly suffering. I sat and watched in awe. It definitely gives you perspective - not only on one's own situation, but how the people of Haiti can also take real pride in themselves and their ability to help others as well. After the church we returned to a paradisiacal villa to grab a quick breakfast before heading down to the Sisters of Charity, an orphanage and recovery house for impoverished infants whose parents can no longer care for them – either out of need or because of the child’s illness. Nuns care of many of these little ones – I can’t describe how their faces lit up as they greeted us at the door. We handed out crayons and coloring sheets and sat with the toddlers as they showed us their fine motor skills and played or explored with every pocket, hat, purse or pair of sunglasses they could find on us. After these ones were called to a hot lunch of rice and peanut sauce, we retired to a room of approximately 15 bassinets, flaked white paint outlining each one against the dimness. Inside each of these bassinets was a small child - they were in varying states of health and nutrition (or malnutrition). Many had obviously been kwashiorkor babies, others had apparent CP or MR – and many if not all seemed to have suspicious lesions, especially on their hands and extremities – congenital syphilis? Fungus? We weren’t exactly sure. But we fed them – or at least attempted to. The little one I chose to assist was unable to make eye contact me and his spasticity seemed to prevent any hope of his consuming the rice and sauce that I offered. It was very frustrating to see a little one such as this – so tiny and frail, and yet, so totally unable to benefit even from this small gesture we were attempting to provide. I can’t imagine how the nuns who worked there managed to see to the needs of all of these little lives every day. Apparently some of the parents come back to reclaim their children after they’ve recovered, and most of the staff are trained nurses or midwives. Nevertheless, the work they have is daunting. But the experience for us, even in its brevity, was very rewarding. This experience also brought to mind some comments made by our host last night about the varying degree of sustainability in projects launched here in Haiti. It looks like Haitian Health Foundation is really interested in building the infrastructure of Haiti’s health care delivery system, and I’m excited to learn more about the organization and its health agents. I won’t bother you all with a summary of the market we visited in the afternoon though it was fun to weave about the stalls, skipping over mud puddles and exploring the chicken feet section while steering well clear of the cleaver in the midst of separating them from the rest of the bodies. We had a good time, though the oranges are still bitter and one must definitely bargain for a deal. The day ended with meeting one of our translators for tomorrow (another big day) and packing over 300 individualized hygiene packets for the young women we will be screening tomorrow. The work went quickly – probably because it was a lot of fun – and I know I learned a ton today that will help me both now, and I hope, in the future, though the word “humility” comes to mind. Good night and thanks for reading the blog! Comments to us are welcome! Roosters crow at all hours Posted Tuesday, February 27, 2007 9:41 AM Just a quick post before breakfast - yesterday was full but wonderful. We started off the day at HHF, hearing about the incredible project they've begun here - I can't go into all of the details but suffice to say this is the most impressed I've been with an NGO in a long long time. They have community buy-in and have made a tremendous dent in the cases of pediatric pneumonia, as well as several other illnesses, through their efforts. And most of the work in the field has been carried out by community health workers, which to me - having that continued active participation, monitoring and evaluation, is just astounding. The hospital we toured afterwards was actually much more than I had expected, in spite of the obvious needs. Then we headed off on another bumpy mountain road towards the village of Moron (pronounced, "moh-roahn") where we hosted the first of our health and hygiene fairs for a veritable mass of teenage women who had been recruited by their community health workers to participate. They laughed at our skit (thankfully - though not surprising considering how ridiculous, in some ways, our actions must seem to them given the language and cultural barriers), and they sat their stoically while I gave them their tetanus shots. The girls were screened for heights/weights, BP, hemoglobin level, and tetanus. Upon successful completion of the stations they each received a bag - full of donated supplies such as washcloths, soap, shampoo, and perhaps the errant bottle of toothpaste. Their smiles were also beautiful, and I marveled at how well they composed themselves in the face of uncertainty (many had never had a BP cuff around their arm before and tetanus shot does not translate too well in any language to girls of 15 years). We were exhausted by the end but having screened between 120-180 girls, we were very happy. The health workers who work with the women also looked on - it was nice to know that when we referred the girls for low blood iron or blood pressure, they'd be there to follow up. All in all a terrific day - plus we got to tour the hospital, a bush sugar distillery, and Sant Lespwa! Now off for another trip! Quick post
Posted Wednesday, February 28, 2007 9:35 AMQuick post before we head out - my body aches from the bumpy car rides but its better than walking those roads all the way home! Yesterday was another amazing day. It started out with a demonstration of the "KOMBIT" home-based life-saving skills - we watched Haitian animators act out normal deliveries - and when something goes wrong - and how they and their villages mobilize to save the lives of women in distress without the help of emergency medical services like we have in the States. Their testimonials about times when women in their villages were actually hemorrhaging and they acted quickly to save their lives were really moving - and it gives one a sense that the project here is really working. After that we headed back over to the orphanage to play with the children and do a skit on hand-washing. Imagine us singing (best we could) in Creole about the way we wash our hands with dozens of toddlers - all ages. They were adorable and seemed to get into it (at least the older ones who are in that "pleasing" stage). The younger ones were just happy to get to play around with some balls and pipe cleaners we brought and I'm sure we were once again an amusing site for all. A few of us (me included) then got to hop across the street to a hospice run by nuns that caters to women who are terminally ill or otherwise ostracized from their families. We came armed with stickers and nail polish and before you knew it we were having a "spa day" - cutting their fingernails (badly needed in many cases), painting their toenails and adorning their fingers, faces, arms, and pretty much anyplace else they wanted with stickers. They seemed truly happy to have us there - and the nun was a bit relieved herself as she had recently arrived from India and - in response to our fledgling greetings in Creole and French - asked, "Um, do any of you speak English???" The day wrapped up with another health fair - this time in Marfranc. We were a bit more organized this time - things went smoothly - and seeing as how we identified several girls with very abnormally high BPs and low Hgb (6.1 in one case), I think we did something valuable - of course this was all possible thanks to the health workers who set it all up and without them and the infrastructure of HHF we might simply be on a tourist journey. Its really been brought home to me how important it is for those who wish to help here to partner with agencies like HHF - so you're building the services rather than reinventing the wheel and then picking up and leaving after a couple weeks. On the way back into Jeremie we stopped by the wharf just in time to watch an over laden boat with Haitians literally hanging off the sides of it begin to pull away from the pier. The thing didn't really look seaworthy for a swimming pool, much less the 12-19 hour journey to Port-au-Prince, but that's okay. They seemed content to ride the waves on what could only be described as a tin circus afloat (so many colors and people and animals and packages, etc)...apparently our host (who is also an anthropologist) has made the same journey so I guess it’s possible. OK others are waiting so I'll go - thanks for checking out the blog and please comment if you wish! a really bad road Posted Thursday, March 01, 2007 12:28 AM So today we took a really really bad road up a really really really steep hill (like my English major skills?). This road led to Laferme (or perhaps Ferme - we were never quite clear on the name of the village). Anyways the trip renewed my faith in development work. We accompanied an American doctor who is in the process of completing her MPH and starting a clinic in a very remote region of the mountains to a series of focus groups and interviews she is conducting as part of her capstone project in the School of Public Health at Johns Hopkins. Got to practice my translation skills as we struggled to keep up with the Creole. I couldn't blame the men and women she interviewed when they responded to her favorite question - "What would you do if you were the president of Haiti to improve the country?" - with "ROADS!". The roads here are truly unique - much much worse than anything I ever saw in West Africa - partially I think because all of the villages are perched on the sides of steep mountainsides and when it rains I can imagine the rivers that form down in these natural gullies. The Land Rovers we've been using seem to be able to negotiate just about anything - from washed out bridges to gulfs in the pavement that look like bomb blowout sites from old black and white pics of WWII. It’s not uncommon to view the skeleton of an old rusted Kia truck and other vehicles that couldn't cut it and now find themselves part of the flora and fauna that accompanies these miniature riverbeds. Before leaving the village they sent a child of about 8 scurrying up a 20+ meter tree to cut down fresh coconuts for us. We drank the milk and used a natural spoon to scoop out the tasty white interior. Then - miracle of miracles - they produced boiled eggs with sea salt! I had hardly touched my own packed lunch and my stomach was already full. I would say I was surprised by the generosity but so far it has been the norm here. The rest of the day was more of the same - a large community meeting with 150 pairs of young eyes peering on (the children refused to leave) and then back down the road we came... 2 hours of rocky bumpy crevices. The other former Peace Corps volunteers and I agree - kudos to anyone who could get a Trek up those things! I probably would've walked. Haitian medicine Posted Friday, March 02, 2007 8:51 PM First allow me to apologize for being a day behind - but hey, its Haitian time, right? Anyways yesterday was another exciting adventure into the mountains - this time to Bigarade where there was another "poste". This was something similar to the prenatal screenings/vaccination campaigns we used to do in Peace Corps out in West Africa, except that HHF seems to take a more comprehensive approach. Once we arrived at the village we scaled a steep hill where a hastily-constructed (or so it appeared) thatch-covered pavilion awaited just above the cemetery. (Cemeteries here are above ground, much as you see in places like New Orleans where concrete tombs encase the caskets and one can easily see the reasons for such superstition surrounding the dead as it looks like many could simply pop the top off of their tombs and greet you as you walked by). Our guide assured us that having the clinic on the grounds of the cemetery was only a problem at night when Haiti's zombies and other spirits are known to roam the forests. There were already scores of women and babies awaiting us patiently on the hill - in spite of the chaos each seemed to know his or her place in line. We started out with BPs and weights until the rest of the Haitian team arrived, and then it was prenatal checks, pediatric evaluations, syphilis and anemia tests, and baby-weighing. Many of the women are hard to get a good stick on - their hands are already so callused from years of rough labor. One of the Haitian health workers pulled me aside because I speak French and sat me down at the pediatric assessment table. Pretty soon I was filling out comprehensive assessment forms as mothers presented their babies - some just a few months - others already a couple of years old, and sought guidance. The health workers have been trained to recognize signs and symptoms of certain pediatric ailments common to this area - pneumonia, anemia, malaria, typhoid, etc. Upon finding a probable case they'll consult a standardized book of treatments and then refer the woman to a nearby pharmacist (set up on a rickety card table under the shade of some trees), who'll give them enough medicine to tide them over until they can seek primary care at the clinic or hospital. We were having a grand old time assessing these children - some with common colds, others with what appeared to be more serious cases of pneumonia or malaria - when the health worker handed me a pad of white paper. His question was simple, "So what do you want to write for this?” "Whoa!” I said, snapping back into Nurse Practice Act mode (not to mention student nurse mode) - "We can't write prescriptions. That you'll have to get one of your people to do". It took me back to the days in Mali when people assumed that because I was a foreigner and had some schooling I was obviously capable of diagnosing and prescribing just as you would see a family nurse practitioner or general specialist do. Not that it isn't one of my goals, someday, but still. Luckily there were others who were able to step up to that task and in the end I'd like to think our assessments (really, the assessments of these lay health workers), were able to catch some of the more serious but treatable cases of pediatric illness which otherwise might have gone untreated until much graver circumstances intervened. With people so isolated and high up into the mountains, it’s easy to see how a case of pneumonia might not necessarily warrant a trip all the way down to the city if you didn't have a bona fide health worker giving you the official okay to make that investment. It’s really quite a system they have - and the people, as always, were terribly gracious and kind. Today was spent at the actual Haitian Health Foundation - we observed as one of their doctors - a man who actually came from the city of Jeremie before getting his medical degree - treated the endless streams of people young and old who arrived on the doorstep of HHF seeking what they knew to be some of the best medical care available in this region of the country. Patients were treated with respect - it was quite heartening to actually watch the doctor lock the door to the office when performing an exam or asking sensitive questions - and the people had infinite patience. He's a diabetes specialist, and I was surprised not only by the number of cases of diabetes and hypertension he treated today, but the fact that in a country with such poverty where electricity is a luxury - much less refrigeration - Diabetes Type I patients manage to survive and even thrive! We saw a broad range of conditions - his office actually reminded me of something akin to an American community hospital ER - and those who couldn't pay were often sponsored or taken care of in other ways. All in all, I think I'm going to leave with a better impression of Haitian medicine (at least the medicine and nursing practiced by this project) that I ever had coming in. Well its dark now - the sun is setting and the ocean is growing mistier in the distance - so I think I'll go for now. But keep checking for more updates!
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 Packing and other things Posted Thursday, February 22, 2007 at 12:08pm I should begin this post with a disclaimer that I am the worst packer ever. Ask anyone in my family, and they will definitely tell you the same thing. That being said, I hate packing. I have run all over town purchasing needed items for this trip. From cans of tuna and bug spray to sandals and bandanas, you name it, I probably have it...at least I hope I do. Needless to say, despite thinking that I have everything that I need, I am sure that I will inevitably forget something. Oh well...as long as I remember my mosquito net and my bathing suit, I'll be ok. But enough about packing. Let me introduce myself since you will be reading my blog. I'm a senior in the traditional program. I graduate May 16th at 9am, but who's counting. I'm from Los Angeles and came to nursing school so I can eventually work with Doctors without Borders (MSF). This trip to Haiti will be my first time in a developing country, and I look forward to finally having such an experience. After graduation, I will be moving to San Francisco and hopefully working in UCSF's emergency department. So about this trip now. I will be in Jeremie, Haiti for 9 days. It's me plus 7 other nursing students, 1 MPH grad student, and 1 clinical instructor. It's a great group that works well together and still manages to have fun. While in Jeremie, we will be conducting various health fairs with orphans at several orphanages and adolescent girls in an after-school program. We will be screening for anemia, providing tetanus shots, and taking vital signs. We also plan to do some entertaining teaching projects, play with the kids, and be silly. We will also visit a hospice and a clinic in the mountains that requires a 1.5 hour hike to get to! Expectations: I honestly don't know what to expect. I've heard and read up about Haiti and the work we will be doing, but it's one thing to read about it and another completely different thing to actually be there. I hope that my fluent French comes in handy. Overall, I am super excited. I think it will be a great experience and hopefully reinforce my desire to go into international health. Alright, well enjoy my blog and thanks for reading. Feel free to post comments back. As a first time blogger, I would appreciate any feedback. I will try and write daily, electricity permitting. Ciao! Random thoughts Posted Monday, February 26, 2007 9:39 AM It's 6:45am and I'm in the common eating area waiting for breakfast of Haitian oatmeal and seasonal fruit. I have a view that overlooks the ocean. There are trees all around me and various brightly colored plants. There are noises of roosters, dogs, and my personal favorite...cows. The sun is shining through these trees and there is a slight breeze. Could I ask for anything more? There are so many sights and sounds to take in here in Jeremie that I'm afraid my eyes and ears can't do it all. Nothing that I have read has prepared me for this. We spent an hour in town yesterday between the market and the general store. People were making kissing noises at us and asking why 11 white women were parading through town. The market was huge...so many different vendors and smells. Rice, beans, chicken feet, fruit, veggies...really anything you could possibly want. I didn't buy anything because although my French has come in handy, I doubt I could bargain with a Haitian woman. I just observed and managed to walk through the maze that was the market. We then went to the beach and were surrounded by UN troops. My Dad would be happy to know this. The troops are here to keep the peace, but Jeremie is so peaceful that they spend their days at the beach working hard on their tans. They are from Uruguay so they are already pretty tan to begin with. There were also some Cubans there having a dance party and showing off their volleyball skills. As we were leaving the beach, I was proposed to by one of the Cubans...and a gynecologist at that. I turned him down though. Anyway, breakfast is here and then we are off on our first health fair day. I'll try to blog later. Pack it up, pack it in Posted Tuesday, February 27, 2007 9:23 AM I've realized that in the few blogs I've posted, I've failed to talk about transportation. One of my favorite things that we've done since being down here, aside from the beach, the market, feeding the kids at the orphanage, doing a health fair for adolescent girls, and walking all over town, has been the land rover car rides. Now I know what SUVs are really made for. All 10 of us, plus a driver, plus some translators pack into a land rover on a daily basis. It's a highlight of the day because the roads in Haiti are pretty awful. They only cement areas where if it rains it could be slippery, meaning up steep hills. So the majority of the roads are bumpy and we are basically going off-roading. People are flying around in the back bouncing up and down...you get to know your neighbor really well. We've had some long drives too and I appreciate the fact that my bottom is quite padded...if you know what I mean. These drives have given me a great glimpse into the Haitian countryside. We drove for an hour yesterday from downtown to this town called Moron (not sure about spelling). We drove along the grand Anse River where people were bathing and doing laundry. The road is narrow, but somehow cars and motorcycles and pedestrians all manage to coexist. The driver honks his horn around turns to people know that we are coming around the hill. It's also like a turn signal. As we drove through what appeared to be the middle of no where, we kept on seeing lottery stands every few miles or so. It seems strange to find lottery booths where there is nothing but sugar cane fields. The area right outside Jeremie where we were driving is so incredibly green. There was a sugar cane refinery too where two cows would walk around in a circle which caused tings to churn and juice out the cane which then drained into a large vat which then went into a storage room to ferment. The smell from the refinery was pretty awful, and it wasn't the cows. Anyway, I realize this has become a novel so I will go. Thanks again for checking out my blog and for commenting. Off to more adventures today! Butterflies Posted Wednesday, February 28, 2007 9:30 AM Yesterday I learned that I have creative talents that I was not aware of. For example, I can make a butterfly from a pipe cleaner. I might have made about 30 yesterday. I handed them out to the kids at the Sisters of Charity (Mother Teresa's organization). I then went across the hall to the men's ward and did the same thing. Now going over there I didn't think that these older men would really want or care about my butterflies, but that was not the case. Each one smiled and said thank you. I just think that no one probably ever visits these men. They are somewhat forgotten in their ward, so we made their day by stopping by. We also played with the little kids, which is quite an arm workout as every one of them wants to get picked up and thrown in the air. And of course I comply. Even the big ones that I really shouldn't be picking up, I just can't say no. We also blew bubbles and played. I am slowly but surely getting over being a germ freak...that's right I said it. While the others gave the women pedicures, I went into town with 2 other people to get some cokes and some bread. I was able to negotiate with my French and acquire all that we wanted. AS we were walking back to the women's house, we saw UN troops drive through town in their tanks. They of course slowed down near us and waved. We are quite a sight to see in town. Then we saw an accident, which was bound to happen sooner or later as there are no traffic lights, no priority given, and the motorcyclists don't wear helmets. After this man slide out of his bike with his wife, he went up to the man on his bike that caused him to slip out and started punching him. All the while, there was a cop watching all of this. Eventually the ambulance came and hopefully all is well. We went to another health fair and this time it was more organized. These girls who we thought would be anemic actually have more problems with high blood pressure than with anemia. It's quite surprising actually. On our drive back into town, we stopped at the pier to watch the boat leave for port au prince. I have never seen anything like this pier or boat. Words can't even describe what I saw. This boat was packed, overcrowded really and piled high with supplies, wood, and people. It's a 14 hour boat ride from Jeremie to Port au Prince. I can't even imagine riding for any length of time on this boat. The pier was packed as well with vendors, people waiting to board, and just people. Once you see these pictures, you'll understand. People were jumping on the car while we were in it taking pictures of the sights. It was quite exciting. Alright, well today I'll be at Haitian Health Foundation. I was placed there because the doctors all speak French and so I can actually talk to them. I will also be translating for another student. It should be another exciting day! Thanks again for reading. Ciao. Why I went into nursing Posted Friday, March 02, 2007 9:47 AM On Wednesday morning I spent 4 hours at the Haitian Health Foundation clinic and essentially rediscovered why I went into nursing in the first place. This clinic is amazing, but more so, the nurse that I spent the morning with is amazing. If I can be half the nurse she is, I'd be happy. As a French speaker, I was placed at HHF for the day with another student. The nurse would speak to me in French and I would translate to the other student. That alone was pretty exciting. Again, so glad my parents spoke French in the home. We saw such a wide variety of cases it's hard to remember them all. In 4 hours we saw 25 patients. We observed pap smears, a dressing change on a woman with end stage *** cancer, scabies, fungus, pneumonia, wax buildup removal, cervical cancer, allergic reactions, etc. Even though we saw that many patients, their consultations did not seem rushed. The nurse gave them all her undivided attention. She was completely independent in her consults, having the power to write prescriptions on the spot. She only referred 1 case to the Dr because she didn't know what it was. I want to work in a clinic like that eventually. I think I definitely need to become a nurse practitioner and I definitely need lots of experience. I think that I need to work in an emergency department. So Wednesday basically reinforced this and am I excited again for what the future holds for me. It was an awesome day that was much needed.
Packing and other things Posted Thursday, February 22, 2007 at 12:08pm I should begin this post with a disclaimer that I am the worst packer ever. Ask anyone in my family, and they will definitely tell you the same thing. That being said, I hate packing. I have run all over town purchasing needed items for this trip. From cans of tuna and bug spray to sandals and bandanas, you name it, I probably have it...at least I hope I do. Needless to say, despite thinking that I have everything that I need, I am sure that I will inevitably forget something. Oh well...as long as I remember my mosquito net and my bathing suit, I'll be ok. But enough about packing. Let me introduce myself since you will be reading my blog. I'm a senior in the traditional program. I graduate May 16th at 9am, but who's counting. I'm from Los Angeles and came to nursing school so I can eventually work with Doctors without Borders (MSF). This trip to Haiti will be my first time in a developing country, and I look forward to finally having such an experience. After graduation, I will be moving to San Francisco and hopefully working in UCSF's emergency department. So about this trip now. I will be in Jeremie, Haiti for 9 days. It's me plus 7 other nursing students, 1 MPH grad student, and 1 clinical instructor. It's a great group that works well together and still manages to have fun. While in Jeremie, we will be conducting various health fairs with orphans at several orphanages and adolescent girls in an after-school program. We will be screening for anemia, providing tetanus shots, and taking vital signs. We also plan to do some entertaining teaching projects, play with the kids, and be silly. We will also visit a hospice and a clinic in the mountains that requires a 1.5 hour hike to get to! Expectations: I honestly don't know what to expect. I've heard and read up about Haiti and the work we will be doing, but it's one thing to read about it and another completely different thing to actually be there. I hope that my fluent French comes in handy. Overall, I am super excited. I think it will be a great experience and hopefully reinforce my desire to go into international health. Alright, well enjoy my blog and thanks for reading. Feel free to post comments back. As a first time blogger, I would appreciate any feedback. I will try and write daily, electricity permitting. Ciao! Random thoughts Posted Monday, February 26, 2007 9:39 AM It's 6:45am and I'm in the common eating area waiting for breakfast of Haitian oatmeal and seasonal fruit. I have a view that overlooks the ocean. There are trees all around me and various brightly colored plants. There are noises of roosters, dogs, and my personal favorite...cows. The sun is shining through these trees and there is a slight breeze. Could I ask for anything more? There are so many sights and sounds to take in here in Jeremie that I'm afraid my eyes and ears can't do it all. Nothing that I have read has prepared me for this. We spent an hour in town yesterday between the market and the general store. People were making kissing noises at us and asking why 11 white women were parading through town. The market was huge...so many different vendors and smells. Rice, beans, chicken feet, fruit, veggies...really anything you could possibly want. I didn't buy anything because although my French has come in handy, I doubt I could bargain with a Haitian woman. I just observed and managed to walk through the maze that was the market. We then went to the beach and were surrounded by UN troops. My Dad would be happy to know this. The troops are here to keep the peace, but Jeremie is so peaceful that they spend their days at the beach working hard on their tans. They are from Uruguay so they are already pretty tan to begin with. There were also some Cubans there having a dance party and showing off their volleyball skills. As we were leaving the beach, I was proposed to by one of the Cubans...and a gynecologist at that. I turned him down though. Anyway, breakfast is here and then we are off on our first health fair day. I'll try to blog later. Pack it up, pack it in Posted Tuesday, February 27, 2007 9:23 AM I've realized that in the few blogs I've posted, I've failed to talk about transportation. One of my favorite things that we've done since being down here, aside from the beach, the market, feeding the kids at the orphanage, doing a health fair for adolescent girls, and walking all over town, has been the land rover car rides. Now I know what SUVs are really made for. All 10 of us, plus a driver, plus some translators pack into a land rover on a daily basis. It's a highlight of the day because the roads in Haiti are pretty awful. They only cement areas where if it rains it could be slippery, meaning up steep hills. So the majority of the roads are bumpy and we are basically going off-roading. People are flying around in the back bouncing up and down...you get to know your neighbor really well. We've had some long drives too and I appreciate the fact that my bottom is quite padded...if you know what I mean. These drives have given me a great glimpse into the Haitian countryside. We drove for an hour yesterday from downtown to this town called Moron (not sure about spelling). We drove along the grand Anse River where people were bathing and doing laundry. The road is narrow, but somehow cars and motorcycles and pedestrians all manage to coexist. The driver honks his horn around turns to people know that we are coming around the hill. It's also like a turn signal. As we drove through what appeared to be the middle of no where, we kept on seeing lottery stands every few miles or so. It seems strange to find lottery booths where there is nothing but sugar cane fields. The area right outside Jeremie where we were driving is so incredibly green. There was a sugar cane refinery too where two cows would walk around in a circle which caused tings to churn and juice out the cane which then drained into a large vat which then went into a storage room to ferment. The smell from the refinery was pretty awful, and it wasn't the cows. Anyway, I realize this has become a novel so I will go. Thanks again for checking out my blog and for commenting. Off to more adventures today! Butterflies Posted Wednesday, February 28, 2007 9:30 AM Yesterday I learned that I have creative talents that I was not aware of. For example, I can make a butterfly from a pipe cleaner. I might have made about 30 yesterday. I handed them out to the kids at the Sisters of Charity (Mother Teresa's organization). I then went across the hall to the men's ward and did the same thing. Now going over there I didn't think that these older men would really want or care about my butterflies, but that was not the case. Each one smiled and said thank you. I just think that no one probably ever visits these men. They are somewhat forgotten in their ward, so we made their day by stopping by. We also played with the little kids, which is quite an arm workout as every one of them wants to get picked up and thrown in the air. And of course I comply. Even the big ones that I really shouldn't be picking up, I just can't say no. We also blew bubbles and played. I am slowly but surely getting over being a germ freak...that's right I said it. While the others gave the women pedicures, I went into town with 2 other people to get some cokes and some bread. I was able to negotiate with my French and acquire all that we wanted. AS we were walking back to the women's house, we saw UN troops drive through town in their tanks. They of course slowed down near us and waved. We are quite a sight to see in town. Then we saw an accident, which was bound to happen sooner or later as there are no traffic lights, no priority given, and the motorcyclists don't wear helmets. After this man slide out of his bike with his wife, he went up to the man on his bike that caused him to slip out and started punching him. All the while, there was a cop watching all of this. Eventually the ambulance came and hopefully all is well. We went to another health fair and this time it was more organized. These girls who we thought would be anemic actually have more problems with high blood pressure than with anemia. It's quite surprising actually. On our drive back into town, we stopped at the pier to watch the boat leave for port au prince. I have never seen anything like this pier or boat. Words can't even describe what I saw. This boat was packed, overcrowded really and piled high with supplies, wood, and people. It's a 14 hour boat ride from Jeremie to Port au Prince. I can't even imagine riding for any length of time on this boat. The pier was packed as well with vendors, people waiting to board, and just people. Once you see these pictures, you'll understand. People were jumping on the car while we were in it taking pictures of the sights. It was quite exciting. Alright, well today I'll be at Haitian Health Foundation. I was placed there because the doctors all speak French and so I can actually talk to them. I will also be translating for another student. It should be another exciting day! Thanks again for reading. Ciao. Why I went into nursing Posted Friday, March 02, 2007 9:47 AM On Wednesday morning I spent 4 hours at the Haitian Health Foundation clinic and essentially rediscovered why I went into nursing in the first place. This clinic is amazing, but more so, the nurse that I spent the morning with is amazing. If I can be half the nurse she is, I'd be happy. As a French speaker, I was placed at HHF for the day with another student. The nurse would speak to me in French and I would translate to the other student. That alone was pretty exciting. Again, so glad my parents spoke French in the home. We saw such a wide variety of cases it's hard to remember them all. In 4 hours we saw 25 patients. We observed pap smears, a dressing change on a woman with end stage *** cancer, scabies, fungus, pneumonia, wax buildup removal, cervical cancer, allergic reactions, etc. Even though we saw that many patients, their consultations did not seem rushed. The nurse gave them all her undivided attention. She was completely independent in her consults, having the power to write prescriptions on the spot. She only referred 1 case to the Dr because she didn't know what it was. I want to work in a clinic like that eventually. I think I definitely need to become a nurse practitioner and I definitely need lots of experience. I think that I need to work in an emergency department. So Wednesday basically reinforced this and am I excited again for what the future holds for me. It was an awesome day that was much needed.
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 Jason, PhD Program
Originally Posted: December 14th, 2005 at 4:24 pm Hi all, As my first official posting, I thought I would share a little about the life of a primary care nurse practitioner (NP) around the holidays. 1. Stress is an inevitable part of all positions at this time of year - it’s just that for the NP its your job to manage all that stress - leaving little time for your own. 2. Paperwork seems to be the only present that is being given - and it’s the gift that keeps on giving! 3. Since clinic is closed for some of the holiday, you attempt to squeeze in twice your usual case-load in the week before you head for some holiday respite. (See #1 above) 4. All the gains you have made with your patient’s weight, lipid profile and dietary modifications before the holidays turn into new years resolutions after the holidays. You know, “I resolve to return to my diet and to loose those 15 lbs so that my cholesterol, waistline and NP return to their usually pleasant disposition”. 5. And finally, when it’s your time to rest and clinic is closed- you open your free “family” clinic when you arrive home, because Aunt Sally’s BP is high, Uncle Joe’s sugar is acting up and of course your grandfather needs his Viagra refilled. All the best for a wonderful holiday season! Jason
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 Shaundrea, Traditional Class of 2006
Originally Posted: May 4th, 2006 at 10:58 am I just finished my leadership rotation this Tuesday. I really enjoyed my experience I got to work on developing a variety of skills including physical assessments, patient suctioning, IV insertion, wound care, EKG monitoring, blood administration, blood draws and culturing, urinary catheter administration, burn care, the list goes on and on. I am glad that I was able to have a clinical experience on the neurology floor. In this specialty area you have to be really good at noticing subtle changes in each patient’s condition such as changes in: pupil response, mental status, in the patient’s musculoskeletal system, etc. I think this experience has really helped me with my ability to pay attention to detail. Wednesday, I completed my very last assignments for the nursing program!!!!!!! I turned in my last clinical log for my leadership rotation and I completed a presentation for a computer course that I am taking. WHAT A RELIEF! No more quizzes or test, no more care plans to write, no more presentations or group projects. (Until grad school that is.) Well there is one more test coming up soon……….The NCLEX (Ahhhhhhhhh). I am taking a review course to prepare for this test in a few weeks. But I am going to try to clear my mind for the next few days and just reflect on the fact that I have completed the nursing program here at Johns Hopkins University!! So what is next for me? Well I am going to take a break from school and work (I know I am getting advice to just go ahead and get my master’s now, but my brain is so fried, right now I just feel like a I need a little break) But I am going to go back to school and get my masters hopefully in a year or two. Somewhere in the near future I hope to have a family with a few kids (that would be nice). But…… for now I just want have some fun. I start my new job in June. I hope to be able to go on a mini vacation between now and then preferably to a beach or nice island ( Yeah that would be nice too.) Oh yeah we just had a pinning ceremony this Tuesday too. It was actually very nice. It was great to see everyone together. It made me realize that I am really going to miss all of my wonderful classmates that I have a gotten a chance to meet and to know during my time in Baltimore. Well, congratulations to all the May 2006 grads I wish you much success and blessings in all that you do and will accomplish!!!! ****PS: As you all know the Senior Class did a fundraiser back in February to raise money for the Marion D’Lugoff Endowment fund. Pease take a moment to visit the site listed below to learn a little more about Ms. D’Lugoff and also to find out how you can make a donation to the endowment fund. http://www.son.jhmi.edu/experience/give
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