First Day of Clinical!

"A woman whose smile is open and whose expression is glad has a kind of beauty no matter what she wears."  - Anne Roiphe 

We finally got to start clinical today!!!!  We unfortunately were a bit delayed in starting because Veronica, the head nurse here at the parish, wasn’t able to fit both groups of nursing students in at the same time.  On a typical day, we are sent out to different clinical sites in both the morning and afternoon in groups of two.  We will all rotate between the following clinical sites: emergency department at the local public hospital, Pro-Life Clinic, hospice, social services, midwifery clinic, and home-visits.  In addition, during our last week at Santisimo Sacramento a medical mission will be doing free hernia surgeries for people in the community, so we will be helping with pre-op and post-op care, instrument sterilization, and patient teaching.

This morning, my clinical partner Ellen and I were assigned to do home visits in a nearby pueblo, San Jacinto, with a nursing assistant from the parish, Yackie.  As we walked through the poor side of town, I talked with Yackie about some of the most common health problems – hypertension, diabetes, arthritis, and osteoporosis – that we would most likely assess.  We went to three households to visit four different patients, all of whom receive check-ups once or twice a month.  For each patient we recorded vitals, did a quick physical assessment, went over any medications that they were taking, and just talked with them to see if they had any other problems or concerns. We also helped with their personal hygiene - nail care, cutting hair, and washing their hands and feet.  These may seem like simple tasks; however, the assistance was much needed and much appreciated!  Overall, I really enjoyed the home-visits in San Jacinto; there was plenty of time to incorporate creative, individualized health teaching into the visits and to just get to know the patients and their beautiful families.  Most Peruvians live with their extended family – which tend to be muy grande – because of their close relationships and limited resources.  Another advantage to the home visits was that we were able to assess the living environment of the patients – all of the homes had dirt floors, no running water, and various animals running around. 

I really loved getting to know these two women and their family! 

The woman sitting in this chair absolutely lit up when I braided her hair and painted her nails. Unfortunately, she contracted polio as a child before she could finish her regimen of vaccines. Believe it or not she uses this chair to help her walk.

Erin had some fun teaching third graders English today!

This afternoon, we went to a presentation given by a local nurse on Peru’s public health systems.  We were lucky that our dear friend Felipe was able to come and translate for us; however, we didn’t realize that the presentation was going to be a two hour lecture in a small dark room...Felipe became a bit lazy in his translations as time went on, which ended up being extremely hilarious for those of us that can understand some Spanish.  All in all, there were a few interesting things that I took away from the presentation.  The Peruvian government believes that everyone has a right to health care; 98% of Peruvians have public health insurance and 2% have private insurance.  Despite their universal health care system, there are many flaws in the systems and many problems with the health of the country.  These include the following: a high prevalence of communicable diseases, high infant-mortality, low coverage, limited access to medications (these are not covered by the government), financial insufficiencies/inequities, disordered administration, and limited promotion of utilization of health care services to certain aggregates. To sum things up: there are A LOT of problems with Peruvian public health, which is going to be very frustrating over the next month to witness. 

Always learning,

<3 Lisa

p.s. Shout out to my Aunt Iris: Don’t worry, I have been taking a multivitamin every day!