Be the change you want to see in the world. ~ Ghandi

Tuesday, January 20, 2015

Reflections on a first medical mission


-Approximately how many patients were served by your team?
-580 patients were seen in the clinic over the course of 5 days.

-What I enjoyed the most:
         -How a team of professionals could come together to serve so many people in such a short amount of time – very fulfilling.
        
-How humbling the experience was, giving me a new level of appreciation for the simple and important things in my life
        
-Learning of the vast cultural differences, but also seeing how we aren’t so different in many ways.
         -Brushing up on my Spanish!
        
-The feeling of fulfillment I had knowing we helped so many people, while also learning and growing so much myself.

-What I enjoyed the least:
         -It was hard to see the extent to which some patients’ conditions had progressed without getting adequate treatment.  It was also difficult to try to manage patients the best we could within cost- and resource-constraints, while thinking of all the labs, tests, meds, follow-up, and therapies that we might treat the same patient with in the U.S.

-What cultural differences I observed:
         -The medical culture is generally quite paternalistic.  Patients are told very little about their diagnoses and treatments are often inappropriate or poorly explained to the patients and families.
        
-Women’s roles within society and family are more rigid, and this can impact their health: for example, they have quite a different culture surrounding birth, including who should be present/assisting and how they assist.  They also most commonly work in the home.
        
-Some of the folk remedies were interesting, for example, one patient mentioned that one relieving factor for his musculoskeletal pain was putting lemon juice on his head.

-One to three examples of “memorable moments”:
1.  My most memorable group of patients were 4 generations of women/girls of the same family.  One day I saw a young mother and her 3-year-old daughter.  The mother had been having occasional seizures for several years, and had never been told what was going on!  The next day I saw the “next two generations up.” I noticed a familial pattern of migraines and neuro issues.  The family sticks in my memory because they were so endearing, and also because even though I couldn’t do as much as I wanted for their more complex issues, they were incredibly grateful (as were all the patients I saw!) for the migraine meds and other therapies that I provided.

2. Watching the sunrise from the roof of the clinic before having breakfast and starting our day, hearing
the roosters crowing (and a turkey joining in, too!), and taking that moment to reflect.  It was a quiet, peaceful moment I had just to myself, before the busy-ness of the day set in.  From up there, you can also see all the patients lined up waiting to be seen that day and it really gives you quite a sense of purpose.

-What impact the medical mission will have on your nursing career:
         -This was my first medical mission, and I have a feeling it won’t be my last!  Here at home, I’ve already benefitted from a renewed perspective and passion for nursing.  Next to that “warm fuzzy feeling” you get from helping those with limited access to care, the biggest takeaway, as an NP student, was the confidence I gained in seeing large volumes of patients with limited resources.  In the Guatemala clinic, I couldn’t always make referrals I might have here, or rely on X-rays and other diagnostic tests to help me make certain decisions; instead, it was back to the basics with my history taking and physical assessment skills.  Furthermore, we had a limited formulary to work with, so it meant working with what we had and being flexible.  It’s amazing how much more confidence I have as a practitioner after working with such clinical challenges.


--Nora Maynard