Monday, July 25, 2011

Final Thoughts

Well, it’s over. Five weeks have passed faster than I ever imagined, especially in this final week. It’s been a struggle to come up with words for a final post, because many of the feelings I have are indescribable. I will try my best to compile some of my final thoughts.
            This last week has included working in the parish clinic operating room. We had the task of operating on inguinal hernias, and with a team of surgeons, anesthesiologists, and nurses, we successfully finished 36 patients. I was able to place IVs and care for patients in their pre and post-operative states. We were all thrilled to be able to maintain a nurse-patient relationship all the way through surgery.
            For two days of the week, I was able to be interpreter for American family practice doctors in the village open clinics. It was similar to a triage setting, where the patient comes in with their chief complaint, is seen by the doctor, is prescribed medications, and given them in a matter of an hour. It’s marvelous to see the amount of difference a medical team can make in a population group that is ridden with parasites, urinary tract infections, rashes, and flu. It’s been a challenge to come up with simple ways to explain a medical issue, and in Spanish. However, the people are understanding and patient. The week ended with a feeling of accomplishment for everyone on the team.
            It’s still surreal to me that I’m here, let alone leaving this afternoon. Course evaluations were due to Dr. Belknap today, and I laughed a little at the thought that this was for a grade and credit. That thought hasn’t crossed my mind once while here. Nevertheless, I was happy to fill out the evaluation. One of the questions was: name one thing you have learned while on this trip. Of course, I could’ve written a million different things.
            Simplistically, there is much to learn here, and none of it comes from a textbook or a professor. My lessons have resulted from the culmination of thousands of conversations I’ve had and relationships with people I’ve met here. I have identified three specific lessons that exemplify this trip: empathy, humility, and vulnerability.
            Empathy is simply part of the Peruvian culture. It is defined as “the intellectual identfication with or vicarious experiencing of the feelings, thoughts, or attitudes of another”. Basically, feeling what another person feels. Most Peruvians have the same struggles from day to day, and they are each other’s support system in a poverty-stricken life with limited education and health care. I have experienced this through almost everyone I have met, especially patients. Although I cannot even wrap my head around the pain some of them may be experiencing, it is always helpful for them to have someone present through their times of hardship. It is fascinating to me that the Spanish phrase for “I’m sorry”, lo siento, directly translates to “I feel it”. I feel for you. While this may not be literal, it is a personal, empathetic connection with someone that may be more meaningful than just saying sorry.
            I think that the feelings of empathy and vulnerability go hand in hand, because these people are some of the most vulnerable in the world, and they connect to each other through this hardship. There were times on this trip where I have never felt so vulnerable in my life, such as standing on the top of a mountain overlooking a world wonder, realizing that the world is so much bigger than I ever imagined. Or, in the hospice, helping a son prepare to bury his beloved father. It was these times that my feelings of vulnerability allowed me to truly feel for that person in need, and to know that sometimes, simply being with someone is the best comfort for sadness. To quote our professor, Dr Belknap, you can’t connect with a person who is suffering unless you become vulnerable yourself.
            Lastly, humility was present everywhere I went here, with every person I met. I found it to be especially there on home visits, where simply washing someone’s feet welcomed a wave of gratitude. It’s also humbling to witness those at the hospice go through painful, daily wound dressing changes and still have the ability to smile. It’s a beautiful thing, and ironic that such poverty and hardship can create this sense of humility. As Mother Teresa of Calcutta said, “The poor give us much more than we give them. They’re such strong people, living day to day with no food. And they never curse, never complain. We don’t have to give them pity or sympathy. We have so much to learn from them”. From what I’ve seen in Peru, they accept their daily struggles with grace, perseverance, and of course, humility. I’ve only been back in the US a few hours, and seeing the cultural differences is a shock. While this is hard, I know that I will always look back at this trip and think of the wonderful people who make so much out of so little. Thank you to everyone for reading and I hope the rest of the summer goes well!

Saturday, July 16, 2011

The Home Stretch

After our Aggregate Presentation

No class, book, or professor in Nursing School could have prepared us for this week. Day after day, we faced new challenges with people whose hardships are bigger than ours will ever be. In the nursing home, we spent our last day with the women giving hand massages and teaching chair exercises. This place was always a challenge, because there is one nun and her assistant to look after about fifteen patients. Sadly, the people who inhabit this wing are women with extreme cases of dementia. Many of them sit in chairs for hours, a blank stare occupying their faces. It was certainly humbling to be feed them, give them a massage, or simply be present with them.
After the nursing home, we came to our last time with our women’s group, Vaso De Leche. Over the past three weeks, we have been working on our aggregate assessment presentation, to be done for them this week. Our presentation focuses on three nursing diagnoses that fit in with what the women can do to fully reach their potential. They already do so much, mentoring for their communities and feeding the village children breakfast on a regular basis. In these women, we saw strong, confident people with a loud message. However, their voices are unfortunately muffled by a society that condemns women to the home, left without the opportunity to grow. Many of them had their education cut short by fathers who believe that women have no place in the professional world. But, this group goes against the grain.
 They are a voice for education, mentorship, confidence, and teamwork. We diagnosed them with stress, readiness to learn, and a lack of structure within their programs. In the weeks that we have been here, we have given them our knowledge. But no measure of education can be equivalent to what these women have taught us in return. Their perseverance and grace in their daily struggles has given us inspiration to become stronger women; advocates for our peers and our community. We have been so inspired by their inquiry and curiosity, and we only hope that our suggestions and outreach will be taken to heart, from women to women. As relieving as it is to have this presentation and the twenty two-page paper done, we are anxious to see if Vaso De Leche will expand and grow like we hoped it would. Only time will tell.
Finally, it was time today to say goodbye to the hospice. We spent the most time here, bonding with people whose strength has no measure. We worked with Hermelinda, the woman whose leg is consumed by a deadly cancer. She persevered through every painstaking dressing change, even helping us on occasion. Unfortunately, her time here is limited, as doctors have given her a prognosis of four months. Given that she is uneducated, sick, and a woman, no one, including the nurses at the hospice, have told her about her cancer. Due to cultural humility, we have shut our mouths at this Peruvian show of silence, simply hoping that it will change in the future and that she will stay strong through her time left.
A few times on this trip, certain things about Piura have rocked me to the core. None of them were like today. This morning, we lost a patient in the hospice. David, who suffered from complications from prostate cancer and pneumonia, passed away during the night shift. Over the past two weeks, we noticed physiological signs of impending death, such as fluid overload in his hands and feet. But none of us expected to walk into his room during our time here, only to see a white sheet over his body. David was the hospice’s first patient, coming in three years ago, fully able to walk and talk. The hospice nurses, Daisy and Coco, watched him deteriorate to the point of feeding tubes and a complete loss of speech. Today, these nurses graciously dealt with his death, saying that he was a father to them and a dear friend to the other patients. Here in Peru, people do not hire morticians or funeral homes to deal with the body. It is the family, and if present, nurses. So, accompanied by David’s son and the hospice nurses, we changed him into clean clothes and helped lift him into his casket. With Luis, another patient, we watched the car containing David drive away. Luis nodded toward the car, one last goodbye to his friend.
After a few moments, Coco brought us back into the moment. She said, “We are so sad to see him go. But here, there are other patients who need our help, and we will go into their rooms with a smile. Our day starts now.” Her words could not be more true, since we still were scheduled to tend to Oswaldo’s bed sores. Oswaldo is always difficult, because his wounds are deep and his mood is usually depressed. Today was the same, but when we finished, Oswaldo smiled. Somehow, through the daily dressing changes and paraplegia, he still manages to smile. I will always remember that smile as one of the most beautiful things I have ever seen.
Our upcoming final week here will consist of bittersweet goodbyes and work with a group of surgeons. We are to help with intakes in the villages for hernia surgeries, some of us also assisting a pediatric dentist with translating. We are sad to end regular clinical, but also excited about the change of pace. One week left of Marquette Nurses in Piura, and we are hoping to go out with a bang. 

Monday, July 11, 2011

Teaching Project: Done!

           Teaching seems to be this week’s theme. Three of us are to complete our teaching projects over the course of the next five days and we are all to complete our aggregate project on Friday. Today, I taught about women’s nutrition and blood pressure to Vaso de Leche, our beloved women’s group. This is a topic in which they requested information, and I was happy to provide what knowledge I could.
            I decided to conduct my presentation entirely in Spanish. I figured I would be able to say more without having to deal with a translator, and also relate to my audience better. There were about thirty women there today to listen and learn. I split my project up into a few sections that I thought most relevant to what the women wanted to learn. First and foremost, I talked about the basics of nutrition, and why it is important to eat well. Simplistically, people must eat well to feel good. 

            Secondly, I thought it would be important for the these women to learn about the FDA's nutrition programs that we have in the United States. For those of you who don't know, the MyPyramid program has recently changed into Choose My Plate, a demonstration of color-coded portion control. I gave the women hand-outs in Spanish describing the new nutrition guide. 
New FDA Program
       I explained which foods were in each food group and described healthy options. Next, I focused on women's nutrition specifically. When a woman is pregnant, she must consume certain vitamins, such as folic acid and calcium, and I described each and gave food examples. I showed why it is important for women to receive prenatal care and what to eat while pregnant and breastfeeding. 
      My next topic circulated around adolescent girls, and how older women should approach them and their eating habits. When I conferenced with Cecilia, the clinic's gynecological doctor, she told me that eating disorders are actually quite prevalent in the area. Unfortunately, due to shame and embarrassment, girls do not talk about it and the problem is usually left unaddressed. I told the women that it's okay to chat with young girls about their eating habits, and that prevention of eating disorders is important for their future growth and fertility. 
      My focus shifted next to blood pressure and how to control it. The women wanted education on this topic, so I was sure to include the basics of what blood pressure exactly is. The fundamentals of this can be confusing, so I did my best to describe it in a way that wasn't ridden with medical jargon. There's high blood pressure and low, and to keep it in control, diet and exercise must be improved. Unfortunately, stress runs rampant here in Peru, and this is one of the main causes of hypertension. I taught a brief relaxation and breathing exercise for the women to do daily in order to decrease their stress. To conclude, I, along with the rest of the MU nurses, took blood pressures of the group. Many of them wanted to know if their numbers were high or low and had questions about stress management. We were happy to provide answers. 
         In the past, I've normally gotten pre-presentation nerves. However, it's a whole different situation when the speech is in a different language. Luckily, with the help of Cecilia and an online translator, I was able to complete my powerpoint presentation and deliver it smoothly. I'm thankful that I had such great help and that my accidental stuttering over words was kept to a minimum. Overall, I am pleased that the women will take this information back to the villages and share it with others. 

Saturday, July 9, 2011

Concluding Thoughts from Week Two

Our professor, Dr. Ruth Ann Belknap, posed a question for our journals this week: Where have you seen cultural humility this week? None of us were too familiar with this phrase, because it used to be termed “cultural competence”. She explained that when a difference in cultures is recognized, humility and modesty is needed to step back and respect the other culture. Having been in Peru for three weeks now, there have been several examples of this. Peruvians are friendly people, greeting everyone with a hug and a kiss. They are significantly more open about breastfeeding, something kept relatively private in the States. But this week, I started to think of this term on a much larger scale.
Quite frequently, we hear unbelievable things about the healthcare system here. In interviewing the women’s group, we heard some shocking stories. One woman’s husband had been in a work accident and had shards of glass stuck in his back. Of course, insurance covered nothing, a typical situation for many people here in Peru. Initially when they visited the ER, they took out what was visible and rushed him out of the ER. They wanted him to go home as quickly as possible because doctors here simply do not want to be responsible for anything that might go wrong. Ten years later, this man still has shards of glass in his back because there is no care or money to fix it. This is the reason that people here turn to natural medicines and methods. They will avoid the healthcare at all costs.
It’s hard to be silent when a story like that creates so much anger. However, my biggest challenge this week was in the hospice. I always had difficulty with the pressure ulcers; those kinds of wounds would shock even the most experienced nurse. But yesterday, a new patient was admitted, a 31-year-old woman with terminal sarcoma. What lies under her bandages rocked me to my core. We don’t know what happened when she tried treatment down in Lima, but it appears that they tried to scoop the tumor out of her leg. She has an open wound that is the size of my face on the outer side of her thigh. Her skin is completely gone, and she bleeds ceaselessly. She has full visibility of not only this wound, but also the three baseball sized tumors that jut out of her groin. The worst part about this is not the grotesque appearance of her leg or the amount of time it took to stop her bleeding and clean the wound. It’s that the doctors and nurses here refuse to tell her she has terminal cancer.
It’s so hard to not question this, especially when the woman is already in the hospice and clearly has a serious ailment. But, I suppose this is where humility falls into place. There is a time to step back, respect the culture, and just administer the best care possible for this woman’s remaining time. Many Peruvians are very quiet about their own illnesses and the illnesses of others, and this part of the culture has been frustrating for our group. We come from a place where we want to know everything that’s wrong at all times, so we can treat it.
I’m slightly put at ease by the amount of educating we are doing during our time here in Piura. If we teach, then there is more widespread awareness of illness and the ways to prevent it. As the old proverb states, “Give a man a fish; you have fed him for today. Teach a man to fish; and you have fed him for a lifetime”. This rings true in places like this. On Monday, I will teach about nutrition and I am looking forward to contributing to illness prevention efforts. I’ll post more details about my teaching project soon!

Wednesday, July 6, 2011

Trauma: Life in the (Peruvian) ER

      Today, I was happy with the fact that I waste hours watching Discovery Health’s Trauma: Life in the ER. Although, it’s a different experience in the safety of my own home than it is in the actual emergency room. When you throw in the language barrier, it’s a whole different world. I found myself thrown into the procedure room with Meg, neither of us knowing what our purpose was. We soon found out when the doctor started rattling off medical jargon in Spanish. Thank goodness for cognates, because I would’ve been clueless. Soon, after donning gloves, I was given suture scissors to assist in stitching our first patient up.
            Now, it’s slightly overwhelming to see someone’s toe practically falling off, but I had to fight through the temporary lightheadedness in order to maintain my scissor job. I left the ER feeling accomplished, having done something for a change and not just shadowed. The rest of the day was spent with Vaso De Leche, our beloved woman’s group. Marianne and Rachael taught about first aid, something these women desperately wanted to learn about. Taking care of cuts and scrapes is different here in Peru. When asked about what to do to a bleeding gash, one of the women suggested finding a spider web to curtail the bleeding. It’s interesting what people do here with no resources.
            We finished the day with our first interview with the group. They were started in 1993 in response to the bad rains that year. The villages needed help, and these women were there to respond. They began a program that gave the village children a breakfast everyday. Now, the program has grown into something educational for the community. The women get together weekly to learn and to grow. They bring information back to the communities with them, somewhat acting as mentors for the villages. We are thrilled to have three of our teaching projects with them, because they are so excited to learn. Many of them take notes during our presentations. On Monday, I will teach about women’s nutrition and blood pressure. It is so nice to teach people who actually want to learn and are so grateful for your presence. 

Tuesday, July 5, 2011

Week Two Beginnings

      It’s been a strong start for week two in Piura. On Sunday, we visited Madre Del Redentor, the girl’s orphanage. The compound is surrounded by dirt roads and heaps of garbage, but inside, it is a home. The minute we exit the truck, girls are by our sides, grabbing our hands. I am led to the garden, where the girls place a red flower behind my ear, a welcome gesture. We were simply enchanted with the performances the girls prepared for us, traditional dances hailing from the jungles of Peru. Our new friends were so generous and kind, and we hope to return here soon.
With Juliana and Elise

            We began our aggregate assignment yesterday, a large project focusing on one population group. We chose Vaso De Leche, the women’s group, and we are enthusiastic about our plans. We must collect data about the group and then produce nursing diagnoses. We are to write a 20 page paper on this and present to the entire aggregate and parish staff. It’s going to be a lot of work, and it is certainly an adjustment having schoolwork along with daily clinicals. It looks like we have our work cut out for us!
            Today, I got my first experience with working in the hospice. The other girls in the group were able to work here last week while I visited homes, so this was very new. It’s difficult to come up with words to describe the work we do here, because each day and patient is different.
An Average Hospice Room

Today was a concentration on wound care. Some patients here are quad and paraplegics, and have developed severe pressure ulcers. For those in the medical field, they range from stage 3 to unstageable. Unfortunately, this means that they may never heal. One particular patient, Oswaldo, has seven bedsores, three completely covering his backside. We try as hard as we can to care for his wounds and change the dressings quickly, because he has to have this done everyday. It is heart wrenching to see him in this situation, but one of our jobs as nurses is to put on a smile and act empathetically.
            For the rest of the week, we will be rotating in the hospice, ER, and village homes. It’s time to get to work on our project this week, and hopefully the finished product will be successful. 

Friday, July 1, 2011

First Week Conclusion

I’ve always associated flies with things that are dead. They swarm over roadkill, port-o-potties, or even a plate of food that’s been sitting out. Basically, things no one ever wants to touch. Here in Peru, they are everywhere. Of course, the people pay no mind to the flies that inconspicuously land on their furniture, their food, and their bodies. To a foreigner like myself, the flies are more than noticeable, and I swat them away instinctively. Although I’m getting used to it, they are still the enemy.
            To the elderly gentleman sitting in front of his house in his wheelchair, the more than 40 flies swarming around him are merely part of the scenery. The “home visit team”, which consists of Daisy the nurse, Meg, and myself, arrive at this man’s home to do the routine: recording vital signs, a haircut, a shave, and a wash. However, after about five minutes in front of his home, I realize that nothing about this visit is routine. Up until today, all of our clients have been relatively happy, and if sad, consolable. This man sobs whenever we talk to him, and he is barely understandable with his lack of teeth. After a struggle, we understand that he is sad about his inability to walk and the pain in his knees. We try as hard as we can to console him before we begin our work, but it is without gain.
            I’ve never cut anyone’s hair before, let alone someone of the opposite sex. I’ve also never imagined haircutting as a nursing skill, but it is one here out in the community. While Meg washes his feet and hands, I begin snipping away at his salt and pepper hair. I am successful, though I feel like a fool swatting away at the flies that surround us. He continues to carry his sad expression, though smiling once when we tell him he looks “guapo”, or handsome. I carry on, beginning to shave and wash his face. Again, I’ve never shaved anyone’s face before. However, he trusted me, a stranger. I wipe the shaving cream off his face and begin to uncover the lines and wrinkles that have presumably resulted from the stresses of life. I’ve heard people say: stress kills. Here in Peru, this certainly rings true.
            Yesterday, I took a woman’s blood pressure, and it measured up to 170/110. This is extremely high, for those who don’t know blood pressures. Hypertension (high BP) usually results from eating a ton of salty foods, and in America, this is typically the case. In Peru, the hypertensive people I have come across have all been victims of extreme acute stress. This particular woman was so worried about her sick daughter that she became sick herself. This is when my English-Spanish medical dictionary comes in handy, because we need to look up how to say: “You’re stressed out and you need to relax. Just breathe”. It’s stressful when a child is sick. It’s even more stressful when a child is sick and there is no money to cover the medical charges.

            The home visit team and I take these cases as they come. The people here are so willing to listen and learn, and it is amazing to teach. Next week, I will most likely be working in the hospice, and I am ready for the new experience. We will work through new battles and old ones, including the fight with the flies. No matter the temporary struggle, I am always enthralled to work with a culture based on love.

Tuesday, June 28, 2011

Reality Sets In

A woman, age 42, dying of Hepatitis. She is too weak to walk on her own and must be taken care of by her 13-year-old son, who dropped out of school. She has no husband, and no treatment or formal diagnoses to the illness that has plagued her for years. She is at a breaking point, not having eaten for a week.  She is so jaundiced because of her failing liver, so much so that her eyes and face are noticeably yellow. This is where we come in: five student nurses. Our job is simple: transfer her to the nearby hospice, so she can become rehydrated and comfortable. There is a simple request from her: that we all would pray with her before we left. We clasped hands and stood together on the dirt floor, in solidarity with her. She began to cry in the midst of her prayer, a common show of Peruvian emotion towards God. With her rosary around her neck, we slowly helped her into the truck and to the hospice.
The Hospice 
As we took her vitals, we quickly realize how dire her situation is. Not only does she have a deadly disease, but she also lacks the care she needs. Even if she had health insurance, she would be taken to a sub par hospital to receive a low amount of care. If she wanted the right drugs or treatment to curb the Hepatitis, she would need to travel to Lima or farther to get them. This is the reality of so many people here in Peru, where people simply die from preventable diseases. Here’s some food for thought: while 20% of the world’s population uses 80% of the world’s resources, the other 80% only uses 20% of the resources. This rings true in Peru not only with general poverty, but with health care as well.
We only hope that if she is to pass away in the next few weeks, that it is in peace at the beautiful hospice. The three hospice nurses and the Marquette team are working to give her hydration, comfort, and tranquility. Her name is Aurelia, and her 43rd birthday is on Thursday. We plan on bringing her flowers, because everyone deserves a celebration.

First Day

I was assigned to accompany Daisy, a staff nurse, on home visits today. Meg, another Marquette student, and I set off in vans on a bumpy ride to a pueblo, or small village. The desert air here is hot and dusty, and it doesn’t get much better when we leave the city and drive twenty minutes into the outskirts. The only road leading into this particular pueblo is a dirt one, and extremely rough. I learned from Daisy that normally, cars will not come here. If villagers need immediate medical care or general supplies for everyday life, they must walk 40 minutes to town. The nearest school is a half hour walk away, and small children make the trek daily.
To say that these people are poor is an understatement. The thatched roofs and dirt floors are common living conditions for most in the area. Having a concrete floor and a roof that lacks holes is a privilege. The first home we visited was just like this, and had an open fire in the back room to cook with. The smoke filled the living quarters (and our eyes) as we walked through the home to meet the owners. We were introduced to our first patients, a husband and wife with no children. The man, Jose, had arthritis so badly that his knees were swollen to the size of baseballs. Our job was to take vital signs on both of them and assist Jose with daily activities, such as cleaning and grooming. As Meg gave him a haircut, I washed his hands and feet and clipped his nails. Jose and his wife were so grateful for our actions, and their smiles expressed this perfectly.
Washing Jose's hands
Our next home visit was with a woman named Rufina, who had knee surgery and has trouble getting around her house. She was overjoyed with the fact we were washing the caked dirt off her feet and clipping her toenails. It is simple actions like this and people like Jose and Rufina that give heart to nursing. Building relationships with clients is a wonderful thing, and is one of many aspects of nursing that I fell in love with. Here in Piura, people are so happy, regardless of socioeconomic status. I am honored to be working with such amazing people, and I can’t help but think their happiness is rubbing off on me.
With Rufina in her home
Our plans for the rest of the day consist of visiting the Piura’s nursing home. We will probably be assisting them with stretching or any other activity that helps them to get moving. Some of the people can’t feed themselves, so we will be helping them with this as well. There’s so much more to come from a fantastic first day!

Monday, June 27, 2011


Today marks the first day of our community health clinical, although we are still touring the area and the sites that we will be working with. The parish we are staying at is the basis and background to all the work we are doing here in Piura. Sacramento Santisimo is a Catholic parish led by Father Joseph Uhem, who graduated from Notre Dame and has been building the programs here for 18 years. The focus in this parish is tending to acute needs in the community and serving the poor in the area. Their main program is called Family to Family, in which one can sponsor a Peruvian family in Piura for $25 per month. These families come from the surrounding villages, which contain houses made of dirt floors and bamboo walls. The houses have no electricity or running water, and many times, the main income into the household is nowhere near enough to sustain life.
For example, in 2010, Marquette University opted to sponsor a family here in Piura in response to the Community Health Nursing Program. This family contains a father, a mother, and their three small children. The father of our Marquette family is a mototaxi driver, a job commonly seen in these types of families. Although mototaxis are a common way of transportation in Peru and the jobs are available, our “father” does not make enough per day to maintain and support his family. Most of his income goes to the mototaxi company, not to him. The Family-to-Family program at Sacramento Santisimo has given this family and families that are similar food packages to help maintain everyday life.
Along with the food packages, the parish provides several programs for the families that tend to basic needs, such as healthcare. There is a clinic within the parish that is very often visited by the community.  The Marquette Nursing students will be working at this clinic many times during our visit here. Some of the other clinical sites we will be working with are the hospice, Vida Nueva: Drug Rehabilitation Center for Men, Vaso De Leche: Group for Women, and many more. I will work to expand on these sites as we visit them.
Marquette Nursing with the Gentlemen of Vida Nueva

As a group, we felt a calling to Vaso de Leche, the group for women.  They spend their time making breakfast for the children in the villages and spreading the knowledge they gain at the parish with their communities. We spent an hour with these women today, and we all felt that this was the aggregate we would want to concentrate on. I am scheduled to do my teaching project with this group of women, and I am ecstatic about it. During our time with them, the women expressed their excitement about us being there and us sharing our knowledge. They called us hermanas, or sisters, and we immediately felt at home.
With the Women of Vaso de Leche

As nursing students, we are always asked to teach in clinical. In fact, one of the main roles of the nurse is to teach, so the patients can advocate for themselves. Here in Vaso de Leche, we were fortunate enough to hear what our clients actually want to learn. I truly feel like we will make a difference with this group of women. We will help to make their group into something so substantial; something that the community can join and grow with.
I am teaching about the importance of nutrition and how food can affect health, such with blood pressure. I will complete this project two weeks from today and I am attempting to give it in Spanish to better relate to my audience. The women also requested information about first aid and infection control, and these topics will be taught by all of us as a group.
Tomorrow is the first day that we will venture out into the community to give care. We will go out from the parish in scrubs at 9 am to our clinical sites, mine being the nearby villages. I am to give home visits to the community tomorrow, and I am so excited to finally begin my role as a public health nurse here in Piura. 

Saturday, June 25, 2011

Introduction to Peruvian Health Care

      We arrived in Piura early this morning to a welcoming crowd from Sacramento Santisimo, the parish compound we are residing at. They were so happy to see the second group of Marquette students. As we drove through the bustling streets of Piura, I felt like I was headed home, especially after a long week of staying in a different bed every night. The hospitality of the staff at the church is fantastic, and we immediately felt comfortable within the compound walls.
            Right away, we were taken on a tour of the public hospital in Piura. The nurse showed us the surgical areas, where they mainly perform basic surgeries, such as laparoscopic ones. If one would need a major surgery, such as one for the heart, they would need to travel to Lima. In the hospital’s emergency room, there are many components that are similar to those in the United States. There are two observation areas, one room for pediatrics and one for adults. Next to these rooms are the triage area and the trauma room, which contains one bed. There was a large supply of medications in this room, all of them labeled in Spanish, which will certainly be a challenge later. In Peru, medications are not as modern as they are in the US. They are still kept in ampules here, which are glass containers that need to be shattered by hand. The drug would then need to be drawn up with a filter needle and then drawn up again with a regular syringe. In the US, there is more access to supplies, so this process has been shortened with most medications.
     In our time here, we will be working with the ER nurses, and the first group of MU student nurses have reported giving shots and placing IVs on their first day. There is complete independence of students here, especially the Peruvian student nurses. I look forward to this exposure in the coming weeks. We begin formal clinical days on Monday, and we are scheduled to visit Vida Nueva, the drug rehabilitation center for men.  For now, we are settling into our new home and beginning new friendships!

Thursday, June 23, 2011

Almost in Heaven

I battled with the right words to begin this blog post, but I realized that words cannot do justice to the experiences of the last 24 hours. I will do my best to explain the day’s activities, but I should let the readers know that my words can never correspond with the feelings or sights I experienced.
 The day began at 5 am with a walk through Aguas Calientes, a small mountain town just outside of Machu Picchu. The air was chilly as we boarded the bus that would take us into history. Being surrounded by the Andes is quite the thrill, especially because the cloudy mist covers the grassy, lush mountaintops. Standing at 5 foot 4, I’m used to feeling relatively small. However, in a place where the surrounding mountains stand at 12,000 ft on average, I felt like an ant staring up at the rest of the universe.
 As the bus tumbled over the gravelly, winding road, the Huayna Picchu Mountain was slowly uncovered, unveiling over 500 years of history. Sprawled out at the base of Machu Picchu and Huayna Picchu mountains is the great Inca civilization that was hidden from the Spaniards and the rest of society until 1911. Due to earthquakes, only 60% of the buildings in Machu Picchu are completely original, but the pure genius of the Incas shines through the architecture. The Incas had great respect for the Sun, and Machu Picchu’s layout is based on this culture. We were lucky enough to be there the day after the Winter Solstice, the biggest celebration in the Peruvian and Incan calendar.
On this day, the Sun shines at certain points within the Incan temples, and this reflects their worship and respect. For example, the Incan sundial still shows the exact geometry of the twelve-month calendar, corresponding flawlessly with the sun's rays. Also incredible, the stones within the Machu Picchu buildings are built in a trapezoid shape to enhance strength and durability. It amazed me that the Incas were able to build ramps to transport these 20-ton stones, let alone carve them into trapezoids. We spent the first hour of our tour gawking at the incredible sunrise over Machu Picchu and learning about this incredible civilization.
As a group, we decided to take on the task of climbing Machu Picchu Mountain. This is a relatively new hike for tourists; most opt to hike the Huayna Picchu Mountain. Knowing that it would be a 3-hour trek, we set off up the mountain. After a few minutes, I knew this would be a significant challenge.  At some points in the hike, I was literally climbing up the slate rocks and struggling to make it to the next flat platform, my heart pounding.  We hiked up 10,000 ft, and there wasn’t a single step that I didn’t think about stopping. By the time I stepped on the summit, I was overcome with a feeling of invincibility. If I could climb this mountain, I can make it through anything. The view was nothing less than worth it. I was left breathless, but not from fatigue. It was the beauty of silence and the freshest air filling my lungs that left me speechless and moved to tears. If I reached my hands up, my fingertips would have touched heaven. I truly believe that completing this adventure can change a person for the better, and I would recommend it to anyone of any age. Just bring sunblock. J
I am now currently in Lima awaiting the plane ride to Piura. We finally will begin our Community Health Clinical, and I am so excited. I am ready to fall in love with the people of Piura all over again, and this time, be able to give them basic health care and education. Stay tuned, this is still the beginning!

Monday, June 20, 2011


The first leg of our Peruvian adventure has begun! We arrived in Cusco early this morning and are currently in awe of this place. Culture is rich here, where women still dress in the traditional mountain garb. Babies are carried on the back, swaddled in wraps painted in the rich Peruvian pattern of colors. It feels like we have travelled back in time to ancient Incan custom. The streets are lined with hectic markets chock full of meats, fruits, and citizens working hard to make a living. For many of us, it is the first time travelling to a poverty stricken country, and it is quite the spectacle. However, the  poverty here is not what catches the eye. It is the unconditional kindness of the Peruvian people, and all five of us have experienced it already in one way or another. Peruvians are never afraid to pass along a smile to a stranger, which can raise the spirit of any weary traveler. They have even been patient with my broken Spanish, which is slowly, but surely getting better.
    My tripmates and I are sojourning in a local hostel, close to Cusco's Plaza De Armas. Tomorrow morning we will scale Machu Picchu, the great world wonder. I am hoping to see a llama tomorrow, and I will certainly post a picture if I should be so lucky! Stay tuned, the adventure has just begun!

Wednesday, June 15, 2011


In three days, five Marquette University Nursing students will begin a much-anticipated journey. We have known about our placement in this Community Health clinical in Piura, Peru since November, and now, it's finally real! Meg, Marianne, Rachael, Maria, and I (Chelsea) will be flying out of the US on Sunday morning to explore Cuzco and Machu Picchu before undertaking our month-long clinical. Here's a snapshot of our schedule:

June 19-20: Travel to Cuzco
June 20-23: Galavant around Machu Picchu
June 24: Fly to Piura 
July 24: Home

   I can't wait to share our adventures here! Our clinical is six days a week and includes working in the hospice, home visits to nearby villages, and work in the local emergency room. On top of all that wonderful nursing work, we all have put together individual teaching projects to present to the various population groups that we will be working with. But, there are more details to come relating to our clinical endeavors. 
   For now, I'm extremely enthralled with the fact that we will be acting as public health nurses in Piura. I travelled to Piura in 2007 with my high school, and upon leaving, I absolutely knew in my heart that I would be returning again. Fate led me to Marquette's College of Nursing and with a little luck, I was accepted into this program and will see Piura again, but this time, as a future nurse. I, along with my tripmates, are so excited to be serving this beautiful community. Stay tuned for more entries and pictures! 

Much Love,