Blog #2
6/3/12
Hello there, again!
It is so nice to relax on the
weekends and “sleep in” if I can consider 7am sleeping in (well, that is my
normal waking up time at least). We have had a jam packed first week! I have
experienced every emotion possible within this first week of being in San
Felix. Although this is long, read the entire thing. It may change your life;
the story I have to share changed mine.
First, there are a few things that
have become mundane over this period of time and I don’t see changing
throughout the remainder of it. Not saying they are negative things, just
things that will help shape a visual of our time here. Also a few things that
stand out to me:
·
There is no HIPAA- and if there were, we would
be violating a lot! We have been able to take pictures of pretty much whatever
we want along with other things that would be a big “no-no” in the U.S.
·
Nurses don’t wear gloves when giving
immunizations.
·
Panamanian time is a real thing. Time is more of
a (really) rough estimate of when you should be somewhere/ how long something
will take. This does not include opening/ closing times.
·
It rains. A lot. Hard. There will be a car alarm
sounding with any storm. Speaking of alarms, the roosters are ideal alarm
clocks.
·
Every night it is very important to wipe the
bugs off of the bed before you crawl in. The use of a computer when the lights
are out is very dangerous. Without a doubt, you will make friends with bugs.
·
Meals consist of carbohydrates (usually rice)
and a type
of meat (usually chicken). Vegetables are rare. Fruits are mainly
for juices unless it is a plantain. In that case, it is fried and served as a
side. Mmmmh J
YUM! Oh, and a potato salad is a salad?
· A loud bang in the middle of the night is
nothing more than fruit falling off of the tree onto the metal roof.
Some of
the most flavorful and largest mangos I have ever had were obtained this way!
·
Showers will be cold. These are very refreshing
when timed after a run. This is probably something that I will continue to do
in the US.
·
Bug spray should be applied after waking up and
following a shower.
·
Walking. Life is exercise. We have gotten funny
looks while on jogs.
·
Asking someone to translate. Any and everything.
I am surprised that the students who speak Spanish still hang around me and
comply with my requests. Thank god though, I am knocking on wood this doesn’t
change. Signing and gestures are good alternatives when all else fails.
·
The beaches have black sand. I have never seen
this before. They are beautiful; our beach day was much needed!
I would like to next touch on Cultural Competency. I was debating discussing this in a blog for everyone to see (partly out of embarrassment) but I think that it is something VERY important that everyone going into the Nursing field can learn from. Everyone makes mistakes. As a nurse, it is important to find the middle ground between being efficient and taking the time to protect yourself. Making time for ourselves is even something that many of us struggle with in every day life. In the grand scheme of things, life is to be taken moment by moment. You will never get back the time, experiences, or opportunities. Take them. Appreciate them. Some minute mistakes may rob you of time, experiences, opportunities and even a life you may have had otherwise.
Personal protection and slowing
down to enjoy life are two big focuses in my life at the moment. I was made
aware of how much I lacked proficiency in both the hard way. For the purposes
of this blog, I want to discuss the first.
One of the days during our
community clinical experience, my group went to the school to give
immunizations. The six USF CON students assigned to the Chami area gave the
immunizations while the other clinic workers and Jessica (our instructor) did
the paperwork. The entire school was lined up before us for flu shots
throughout the several hours we were there. This equated to about 400 flu shots
to be administered to around 400 elementary- aged students and staff. This was
a great opportunity for practice, regardless of how overwhelming and hot it
was.
We successfully administered the
flu shots for the first few hours. As mentioned earlier, we did not wear gloves
and there were no pre-moistened alcohol swabs. Instead, we used cotton balls
saturated with alcohol. There were also a few differences in IM injection
procedure that the nurses were adamant that we practiced. Instead of holding
the skin taught for a z-track (as we were taught), the nurses insisted that we
pinched the skin, including the muscle. We also were to recap the needles. As
you may know, this is a huge hazard and one reason that most U.S. (if not all)
health care providers now use needles that have safety caps.
As time went on, the task became
more repetitious. It seemed as if the lines of students never shortened. Shot
after shot, we pinched the skin, cleaned the area, injected the vaccine,
applied a cotton ball for blood, recapped the needle, and disposed of it in the
hazard box. Then it happened. After giving a little girl (no older than 7) her
flu shot, I went to recap the needle, piercing my thumb instead. My first
reaction was to grab an alcohol soaked cotton ball and apply it to my thumb.
Realizing what could happen as a result of this incident and affect me from
that point forward, I got nauseas and my face went white. I then lost it.
After informing Jessica, she walked
me back to the clinic at Chami. We then went to the ER in San Felix to receive
prophylactics as a precaution. I won’t go into many more details. However, I
would like to note here that you should ALWAYS report such an incident, as
embarrassing or as dumb as you may feel. Believe me, I was imbued with both of
these emotions alternating with surges of fear. Be responsible. Mistakes
happen. It is how they are handled.
There are a lot more things that I
could describe about this experience and the processes that were taken in
precaution. The most important thing is that my blood tests came back negative
for everything. However, I am not walking away with nothing. I am walking away
with a new perception on priorities and precautions. This is true both in my
future as a health care provider and my personal life, as mentioned previously.
Relating to cultural competency,
there are also a few other things I would like to mention before closing. I never
took to heart how important mastering the skills of a culturally competent
nurse was until I myself was a patient in a foreign country. I speak next to no
Spanish and my nurses and Doctor spoke no English. Nonetheless, their mastery
of cultural competency skills comforted me and ultimately relieved me of the
worry associated with this needle-stick. In the Chami clinic (my first stop),
the nurse used gestures to help calm me down. She helped me with deep breathing
as I was close to an anxiety attack. She also used demonstration to show me how
the odds were in my favor for how little blood could be exchanged in such a
prick. She also was able to assure me (with a little translation assistance
from Jessica) that the girl’s young age was another factor to my benefit and
that this particular indigenous community had a low rate of HIV/AIDS. The
doctor at the hospital, much the same, was very caring and patient. He even
used humor to shake my fear and anxiety about the situation.
In context of this course, there
are 8 special attributes that culturally competent nurses possess. My nurse at
the Chami clinic had a very strong sense of population consciousness. She knew
about the trends of the indigenous community concerning infection rates and how
mothers in the community were checked before birth. She also excelled in
creativity. She was able to communicate with me through a warm touch, gestures,
and demonstration, breaking the language barrier that would have restricted her
ability to care for me.
Overall, this experience gave me a
completely new outlook on cultural competency. I have such respect for the
health care providers that I encountered in Panama and helped me through this
traumatic experience.
Additionally, I hope that me
sharing this story encourages you to challenge yourself to master cultural
competency skills. Coming first hand, it is scary. You can’t judge a patient
for not knowing the primary language of your country because you do not know
his or her situation. Accordingly, you cannot let this be a boundary for
maximal care.
I also want to highlight that YOUR
safety is first. ALWAYS. You are educated to perform procedures a certain way
because it is best practice. No matter where you are or the time constraints,
try and implement these best practice procedures. Share the different methods
with colleagues without imposing. Maybe you can prevent something from
happening to them.
My trip to Panama has been such a
life-changing experience already. I can’t believe it has only been a week.
Thank you for reading,
Chanel
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