History in the Making - Michelle (Mickey) Guerreo

 The stethoscope give-a-way was by far the biggest hit. We took it back to basics for the nurses, and we can tell that it was really useful information for them. During the Respiratory sounds lecture, we taught them how to wear the stethoscopes and use them to assess heart and lung sounds. Most of the nurses had never used a stethoscope before. It was amazing to see the change that came over the nurses when they realized they were going to receive the stethoscopes they were practicing with.

Vietnam is still very much a Communist country, control and permission comes from the top and trickles down. The nurses are on the bottom of that chain. They need permission to do anything. Right now, their job is to wait for orders to be given to them, and do not make any patient care decisions without contacting the doctor first, if that doctor is wrong, or prescribes the wrong drug or dosage, the nurse is still responsible to carry out his order and dare not question it. The nurses are not seen as intelligent enough to perform physical assessments or interpret test results, only doctors carry out those types of tasks.   In a code situation, you will see 4 or 5 doctors and no nurses.Also, the Vietnamese people take very long lunches during mid-day; the break is about 2 hours, and all work stops. The hospital halls are empty, and family members can be seen outside the patient rooms cooking and enjoying meals together.

There is a strong family presence in Vietnam, family is required to provide bed linen, patient clothing and meals. There is even a building on campus to house the family of patients that are in a visiting hour restricted unit like ICU.

I have never had to give a speech before, and I spoke twice at the opening and closing ceremonies. The heads of the VN government were there, as well as respected American physicians like the past and current President of ACEP and IFEM. Also, the weather in Hue during spring is usually sunny and warm; while we were there it was neither. Each day was wet and cold!

Touring Hue Central Hospital, the hospital version of a CNO gave us a very up close tour. I found it important to see the area and real life experience of the VN nurse. I met with many patients, doctors and family members, and heard the patients’ stories. We even got to see the Vietnams' first heart transplant recipient. I met a patient in the ICU who spoke perfect English, and he held our hands and thanked us with tears in his eyes for our presence and helping the hospital.

 One of my favorite experiences was during the nursing conference. We were given two English speaking VN physicians to make sure our content was being translated correctly. During one of the days, a conversation during the “Tubes and Lines” lecture broke out into a full blown conversation between these two doctors and the nurses. I was amazed. It was history in the making. The nurses voice was being acknowledged in a way that we hadn't expected. They were sharing information on an equal level. To me that was the most amazing break through.

~Mickey Guerreo

Michelle (Mickey) Guerreo, RN was our fourth scholarship recipient in 2011.  MIckey will graduate with her BSN in September. She has been an ER nurse at a 60 bed inner city Emergency Department for seven 7 years, and the night shift charge nurse for two of those years. Prior to being a nurse, Mickey worked as a unit coordinator in the ER and post-op units. Mickey is passionate about, and dedicated to Emergency Nursing. She is active in her hospital community, as well as her local and church community. Mickey travels to Vietnam for three weeks, once a year, to lecture on Emergency Nursing and procedures. In 2011 she was the Co-Chair of the Vietnam EM Symposium and organized the whole thing. It is her travels that have prompted her to advance her career. Her goal is a Masters in Public Health.

WORLD MALARIA DAY 2011

About half of the world's population, are at risk of contracting malaria, especially those living in developing countries. World Malaria Day 2011 is a time for examining the progress made towards malaria control and elimination. Progress is being made but there is still much work to be done. We at ONAAT salute everyone engaged in the admirable goal of erradicating malaria by 2015.

                 Read below an excerpt from "T-Girl" by Sue Averill, a real-life story of the price malaria extracts. 

"She came at the end of another hot humid day when even a sip of water instantly erupted onto our skin as sticky smelly sweat. We’d learned if you don’t drink, you don’t sweat, although the nurse in me wondered how our kidneys were faring. With an exhausted sigh and stretch of cramped muscles, I finished my line of 100 patients in the crumbling structure of Kakata Internally displaced Persons (IDP) Camp and glanced toward the entranceway. There was a thin, ragged child lying unconscious on a straw mat on the filthy concrete floor. Her breathing was rapid and shallow and not a sound came from her parted cracked lips.".....from "T-girl by Sue Averill

I WILL NEVER FORGET

                Ecuador was AMAZING!I had such a great time. It was so different from what I expected, but in the best way possible. Our team was remarkable; we all clicked right away from the first day of meeting each other.

                On Sunday, we performed screenings all day of the children who came to be evaluated.  We screened over 48 kids and performed 28 surgeries over five days.  I learned so much and had plenty of opportunities to practice my Spanish.  It was definitely a learning experience which needed flexibility! 

                The first day of surgeries went kind of slow because we were learning where everything was, best ways to communicate (who needed to interpret) and developing our flow.  The nurses there in the OR were fabulous, so shy of us at first, but by the second day, they were joking with us in Spanish and asking favors and teaching us about their culture. 

                For me, since I spoke some Spanish, I connected more.  It is like my world paused for a week, and I was able to get a glimpse of life there in the town we were in, in the hospital we were in and with all the staff.  I felt like I was treated normal, like one of them.  They included us, it was like one big hug the entire week, like open arms.  Everyone in the small hospital was so curious to see us and talk with us; the OR was full most of the time.

                The women down there astonished me!  The OR would have other procedures going on at the same time as our operations, women would come in to have their babies every day, we would see them go into the birthing room, then a few minutes later, no noise or screaming, they would roll them into the recuperation room and a few minutes after that bring the baby to latch on. 

                The kids and their parents affected me most.  Each was so different and so special.  We operated on all ages from 2 months to 15 years.  Mostly cleft lips, palates and scar reconstructions (from burns).  So sad to hear some of their stories. On the fourth day, we had a 6 yr old boy come in for surgery; his dad was soooo nervous and scared, more than the patient! After the surgery I went to update his parents, but only the mom was there. I updated her and returned to the OR. Later I learned that the dad had gone to buy a Popsicle for Dr George (our main surgeon), as a thank you!  Oh my goodness that twisted my heart like no other! To think the only thing that you think of or can do is buy a Popsicle for the surgeon!  No one in the states would even think to do it, nor would a doctor much appreciate it.  It my touched my heart.

                One 13 year old’s father didn’t even want him to come; the boy only let his mom talk to us during screenings, and would keep his hand over his mouth after surgery was done. (palate) Before the surgery he was so nervous, I was trying to get him to talk to me, so I could calm any fears, I had my mp3 with me (English and Spanish songs), I asked him if he would like to listen to some and he nodded yes!  It really was the little things I tried to focus on.  God bless them, they fumbled through my Spanish with me!  ha-ha, but I would think it would be even scarier to not only go in for surgery with a condition you have been living with since birth, but by foreigners as well.

                By the end of the week, when everyone had exchanged directions and Facebook pages, the nurses started to cry, which made me cry. They all wanted to know when and if our team would be returning soon. It was heartbreaking to not have any answer. I hope so.

                 I spent some time after hours with them too, going salsa dancing, karaoke (my first time ever, and it was out of the country!) and eating fresh crabs, etc.  They taught me a lot about the language and culture, and I tried to learn as fast as I could.  I will never forget this trip.  I think it is my favorite so far, and I wish to return in the future.

~Laura Weisgerber

ONAAT's third scholarship recipient, Laura Maria Weisgerber, RN, BSN,went on her first medical mission to with Healing the Children to La Troncal, Ecuador from March  12 through March 19th, 2011