Wednesday, July 27, 2011
Throughout our time with these three nurses, we tried to figure out what type of project would benefit our patient population the best. Because the patients are separated into categories (mom/baby, wound, etc) we figured it would be smart to focus on one of those areas. We chose to focus on the mom/baby population due to the lack of information they are currently receiving from the agency. When they are admitted into our agency, the patients receive a general admission packet which contains information related to the agency, infection prevention, etc. but nothing specific to mom/baby. We have also noticed that a lot of the patients are young, first time mothers.
We decided that the best project would be to make a packet that is specific to mom/baby that could be given out with the general admission packet. We started the project by getting input from the nurses on what they felt would be important aspects of the packet. Once we had that, we put together the packets and got approval from the clinical director. We are awaiting final approval from the director before we print and distribute the packets. We feel that these packets will greatly benefit the new mothers and will give them much needed information about taking care of themselves and their new babies.
Overall, this clinical site has been absolutely wonderful and I would recommend it to anyone! The clinical director said that she hopes we will send students again next summer, and I am very glad that we were able to establish this new site. I am sad that it is almost over, but I could not have asked for a better capstone experience!!
Some of the health screenings offered at the event include blood pressure, bio nutrition, memory, hearing, HIV, vision for the elderly, blood glucose testing, and mammogram screenings. Residents of Fairfax from the adult population really seemed to utilize the mammogram service as well as the blood pressure screenings.
The Kids Fun World was another large component of the health event. This area offered exercise, smoothies, clowns, balloons, a water slide, a sprinkler, the Fire Department Smoke House, and great prizes such as bikes and gift cards for the winners of various contests. One of the more popular contests was the hula hooping contest. The children seemed very excited for these activities and were great participants.
Part of the reason I feel that this event did not reach 150 residents is due to the organization of the event. Medical providers were being added to the provider list at the very last minute, making organizing the tables and tents hard to accomplish. The advertising for the event was also last minute. If the community members were aware of this free health event at an earlier date, I believe that more people would have participated.
A third factor that played a role in the limited clients who attended the event includes the location of Otis Moss Medical Center. Otis Moss is hidden away on Quincy Avenue and East 89th Street. If it weren't for this Capstone experience, I would not have known that this wonderful health care facility existed. The Cleveland Clinic receives the majority of the recognition because it is profit oriented and continues to create new spaces in the Fairfax neighborhood. After interviewing residents in the Fairfax area, it seems like the people from Fairfax are upset with the Cleveland Clinic Foundation for moving into their territory. One resident referred to the Clinic as "the octopus of the city" because it invades the town and spreads wealth without offering any to their neighborhood. University Hospital needs to advertisement their facilities more in order to let Fairfax residents know about the different health care options in the community. If the residents were more aware of this UH facility, I believe it would be utilized more, especially by the elderly population.
Since Live Long Live Strong is now over, Kana and I are focusing on the creation of our poster, the completion of our paper, and the identification of better methods for evaluating our final data. The hard part about our project is tracking down specific statistics regarding HPV, cervical cancer, and genital warts in the Cleveland area. We have called the Ohio Department of Health, the Cleveland Public Health Department, the Merck Vaccination company, and have researched endlessly online. HPV is considered to be a non-communicable disease according to the health departments, making the statistics hard to track. Kana and I disagree because HPV is spread through genital contact and often people pass it on without knowing as well as after being treated. It will be hard to illustrate that HPV is a concern in Fairfax without these statistics, and without taking up too much of our poster space. We will keep you updated on current information we find and other interesting facts about our capstone experience within the next few weeks.
Monday, July 25, 2011
One way that I have been working on this is by collaborating with other organizations in the city to help spread the word about the clinic in the community. A specific group that I have been working with is SHARP (Student Health Advocates Reaching Peers). This is a wonderful group of high school students involved in promoting health through community awareness. The students go through a 3 week training program, during which the health department came to talk to them about our project. I put together a powerpoint presentation about the importance of immunizations as well as the dangers of lead poisoning and ways to prevent it. The SHARP students were very engaged during the presentation and asked many questions. They seemed to be very interested in the project and willing to help us reach the community. I conducted a pre and post test, and the students’ results greatly improved in 4 out of the 5 questions. We came back another day a few weeks later to teach the students how they can help spread the word about the Summer Shot Clinic. I gave examples of different people they may encounter, such as angry people, rude people, and people who are too talkative. We had fun acting out examples with the students and they were all enthusiastic and eager to participate.
After practicing with the students, we put them to the test! We decided to go to Thornton Park, a nearby pool where we thought we would be able to reach a lot of people. We set up a table right at the pool entrance and put out lots of silly bands and tattoos to attract the children. These were a big hit! We had so many kids come up to our table asking if they could have a silly band. Ten SHARP students showed up, which we were very happy with. All of them did an extremely good job of approaching people and passing out flyers. I was impressed with how many people the students were able to talk to! I think preparing them and practicing different scenarios was helpful. I was very grateful that the students of SHARP were so willing to assist us spread the word about the event coming up. We were able to reach many people and hopefully this will increase our turnout at the shot clinic.
Saturday, July 23, 2011
Today Otis Moss Jr. Medical Center had a health fair event called the “Live Long Live Strong ". My capstone group and few other nursing students from other groups volunteered at the event. This event offered free health screenings for blood pressure, lead toxicity, vision, hearing, HIV, podiatry, nutrition, memory, mammogram, and others. Outside in the parking lot there were vans from Mammovan, Ronald McDonald, Health Department, and Cleveland Fire Department. My capstone group prepared for this event throughout the summer and I felt nervous in the beginning to organize the event. Once the event began it went by very quickly. I had a great experience working with the staffs from other organizations. This event was a great public health experience. It felt rewarding to help the Fairfax community by providing free health screenings and education.
This event not only offered free health screenings but also entertainment for the community. There was an area outside called the Kids Fun Land where children can go and play. We had sprinklers, balloons, face tattoos, slide, and a smoothie stand for the children in the community. Characters such as Ronald McDonald, Scooby Doo, and Spider Man also came to the event to play with children. We also had free raffles at the event for adult and children bike, membership at the gym, and gift cards. Some of the community members and volunteers had a hula hoop competition at the event. Participating in these fun events seemed to bring the community together. People who came to the event seemed to have a great time. I hope Otis Moss will continue to host this health screening event in the future. This was the ninth year for the Live Long Live Strong event. Overall, the event was a great success and I would love to see the event again next year.
Thursday, July 21, 2011
During this last week and wrapping up the program our group has been working on our final paper and it has been a good way to show our teamwork to each other. We are excited for the camp to be over for the fact we can now concentrate on this paper and the poster that will display all of our work. We are working on analyzing our pre-test and post test to see the differences in scores and hopefully the percentages of right answers, will increase to show we were able to get some information through to at least a couple of campers.
Wednesday, July 20, 2011
Most of the kids were very receptive to our teachings. They stayed interested and participated in discussions. A lot of the kids were very knowledgeable on these topics and were happy when they could answer questions correctly. We made sure to have some fun games and activities for them to do such as creating their own daily menu using the correct number of servings of each food group and making their own trail mix. Having games and activities for them to participate in kept them entertained, focused, and interested in the topics we were teaching about.
Overall, my NYSP experience was great. I was able to learn a lot about these kids and also a lot about myself. There were some bumps along the road but we were able to work through them and really experience the greatness of the NYSP program.
After the first part of the camp I was able to participate in softball and at the halfway point I had the opportunity to teach the campers about nutrition. This at first was a challenge getting the campers to sit in a classroom and educate them on health related issues. I soon realized that I needed to get creative to get the campers engaged in our health lesson. My fellow nursing students and I educated the campers of what nutritional snacks include. Once the campers understood what a healthy snack was my fellow nursing students and I brought in food for the campers to make trail mix! The campers loved it! We gave them each a plastic bag and they went around the room and made their individual trail mix consisting of various nuts, raisins, and chocolate chips. This was great because it got the campers engaged into our discussion and actively participating in hands on activities. We also played fun nutritional games with the kids. We portioned out various foods and showed them how much sugar and salt was in each item. I found that the kids responded best to visual demonstrations. Showing the kids how much sugar was in a candy bar versus yogurt put a really good picture of how unhealthy certain foods are. I had the opportunity to have Australian students in my classroom. I found it interesting that they did not know what "pop" was. I had to show them was it was when I was discussing it in class. I feel they brought a great contribution to the class. They were able to share their daily nutritional diet to the rest of the class. By doing this the other students were very engaged on how differently their diets were. The campers where asking each other questions about their diet and I was very proud that the campers could facilitate a conversation within their group. In the end, I enjoyed teaching the campers about nutrition. I feel that I have made an impact on what they know about nutrition and feel that they will make better nutritional choices in their everyday life.
For the past two weeks, I have had the pleasure of teaching the swimming portion of NYSP. I worked with a few other staff members to teach the beginners group. I was amazed that so many kids did not know how to swim and that many of them were afraid of the water. I grew up always having access to a pool, whether it was a neighborhood pool or our own personal pool in the backyard. The thought that not everyone has the same opportunities or resources that I had never really crossed my mind. Teaching kids to swim started out as a challenge because of these differences in our backgrounds. It took a lot of time in the beginning to even get the kids in the pool. But as the two weeks went on, I was so proud of the growth that was taking place in the kids. Those who were once afraid of the water or who said they "couldn't do it" were now able to go under water without plugging their nose, they were able to kick and use their arms properly, and they were gliding in the water. They were swimming! It was an absolute joy to see them proud of themselves and proud in each other! It really showed me that what we were doing was making a difference in these kid's lives. It wasn't the fact that they could swim that made a difference, it was us encouraging them and in return, them pushing themselves to achieve something that they didn't think they could accomplish. They were starting to have confidence in themselves! It was extremely awarding to see the changes being made in these kids. I can only hope that when we switch to the education portion, that we see the same progress.
I am currently participating in the National Youth Sports Camp Program. Before the start of camp, the other nursing students and I came early to get acquainted with the program as well as plan for our lesson plans that we would be teaching to the children involved in the NYSP camp. Once the camp started it was nothing i ever experienced. I was very nervous at the beginning of camp and did not know what to expect. I went in with an open mind and took every day to the fullest. I soon found myself to be very overwhelmed with how hectic the camp day went. There were hundreds upon hundreds of children inside the gymnasium anxiously waiting to begin their first day of the NYSP camp. As the day went on I became more comfortable interacting with staff members and the campers. I feel extremely fortunate to have already known my clinical capstone site of Case Western Reserve's campus. Other staff members and campers asked me where buildings were and I felt useful because I could direct them where to go. I soon felt even more comfortable interacting with the staff members and campers from walking back and forth from campus.
The first part of camp I had the opportunity to facilitate sports with the campers. I was in charge of softball. I have played softball since I was little so I felt that I could teach the campers many useful skills that would benefit them in playing the sport of softball. One difficulty with playing sports is that many of the campers wanted to do whatever they wanted; therefore it was difficult to grab every child's attention to listen and watch various softball drills. Soon once the campers got confident with practicing and performing different softball drill, we were able to play a game with them. This is when I truly saw the campers come out of their shell. They were running around and playing together as a team in their game of softball. They were once individual campers but once they started playing the game with each other they worked together and I must say I was very proud of the cohesiveness that they displayed on the softball field. Throughout this NYSP camp, I always want to bring out the best in these children and show them that anything is possible. I interacted with specific female camper who did not even know what the sport of softball was. She was very hesitant to try the sport. By the end of the first week she came out of her shell and absolutely fell in love with the sport. She was shy and timid at first to try to throw and catch the ball. I knew this camper had great potential to succeed in an activity that she was not confident in. I was very patient with her, working everyday one on one with her, encouraging her to keep trying even if she did not master the skills the first time she tried it. By the end of the week she was a star softball player. I could not wait to see her the following day. She told me she went home and played catch with her brother and stated how impressed her brother was with her at how well she threw the ball. That touched my heart wen she told me that story. It made me feel as though I made a difference in her life. She was confidence in a sport that she did not even know what it was. From that day on, every time I saw her she had a bright smile on her face because she challenger herself to something that she did not feel as though she could do. Something as small as taking the time to explain to her how to throw a softball gave her confidence to get on the field and play with her fellow campers. So far my experience has been absolutely wonderful with the NYSP Camp.
Tuesday, July 19, 2011
The "Live Long Live Strong" campaign takes place annually in July and offers hearing, blood pressure, dental, sickle cell, cholesterol, mammogram, and other screening services of this nature to people of all ages. My partner Kana and I have completed the following tasks to help make this event a success: Contacting heath care providers to attend the fair to provide screenings, Calling, emailing, and contacting area businesses for donations to be raffled off as prizes, Organizing the tables, booths, and chairs and creating the maps for set-up purposes, Registering people for the screenings of their choice, Contacting volunteers and organizing the volunteer assignments, and other necessary tasks needed to make this event possible. Although this experience has been enjoyable, it has been a little hard focusing on our main goal of the semester.
After speaking with pharmaceutical representatives from the MERCK Company, Kana and I discovered that Human Papillomavirus (HPV) has high prevalence in the Fairfax neighborhood of Cleveland and is growing throughout Cuyahoga County. Our goal for the semester is to increase vaccination rates for Gardasil in our randomly sampled population size of 100 current Otis Moss patients aged 11-20. The criteria for selecting our patients to be sampled from included that the patient would have to be aged 11-20 male or female, received testing for the sexually transmitted diseases gonorrhea and chlamydia, and would have to be a current patient at Otis Moss. The patients that had a positive result for a previous STD test were considered high risk, while the patients that tested negative were considered low risk. Kana and I then manually screened the patients charts to see if they have received Gardasil, and if so, what stage of the cycle were they in. For those patients who never received Gardasil or who did not complete the cycle, a letter was sent home to the parents encouraging them to get the child vaccinated. Our goal is that the parents respond in a positive way and that our baseline number of vaccinations increases by 5%.
As the semester is coming to a close, this experience has been fun and rewarding. It has opened my eyes to a whole new kind of nursing, community nursing, and has strengthened my organization and people skills. I am looking forward to finishing our data collection for the project to determine if we have achieved our main goal of the semester.
The campers showed me the ropes. They taught me that respect comes from everyone in everyplace. We basically preach to these young individuals that we deserve respect when trying to coach, teach, or instruct them. They turned it around and stated that many people are not respecting them because they are considered the younger and less experienced. I remember one camper who was asked not to be eating in front of the whole class out of respect for the others. His response was, "Miss Sam, we get up, eat breakfast around 6:30 AM, go to camp, and then don not get feed again until 1 PM. I can not go 6 1/2 hours without eating. Come on now, could you do that?" It was at this point that I realized that these young campers really do put in a full effort in this camp. They make sacrifices just like we do to be here.
This camp comes with both challenges and rewards. I am proud to say that the rewards completely outnumber the challenges. The campers bonded with me and trusted in me to talk about personal feelings. I liked being able to learn about their home life or what they desired in life. Being with the children everyday for 5 weeks gave me first hand experience into what a Public Health Nurse may deal with on a day-to-day basis. I was able to learn to understand not only what the community is thinking about but why they think that particular way. An example shared to me was about the issue of school bullying. One young female stated that she was often a victim of school bullying because she was overweight and wore the same outfits routinely. She expressed that she did not like it but she didn't know how to change anything. In a group discussion about this topic many individuals agreed this was wrong. We talked about hows there are things in life that we can not help. We talked about not judging people for aspects like that. Overall, we had a good group conversation. My only hope is that I made in impact in the campers life as they did mine.
Monday, July 18, 2011
This week I switched from helping teach volleyball to teaching Nutrition with my group. Teaching volleyball was interesting experience. A lot of the campers were not very interested in playing volleyball so that meant I had to be creative to have everyone participate. One of the ways we were able to have everyone participate is by doing drills and games instead of just volleyball games. One of the games we played required teamwork and communication skills. They would toss the volleyball over to the other team and it must be caught - if it was not then whoever was closest would have to sit out. Which ever team ran out of players first lost, the kids really enjoyed the friendly competition.
I was able to work with 2 other awesome staff members and we had a lot of fun together. I was not the greatest volleyball player but the 3 of us worked well as a team, we even played dodge ball against the campers on the last day of camp. Discipline was all of our jobs because a lot of the campers just ran around and would try to play basketball or just sit and talk with their friends. The biggest challenge this far has been keeping all of the campers attentive to the task for the day, but overall it has been a positive experience!
Sunday, July 17, 2011
The program was a fun experience for me too. I love sports, so I was glad to have a chance to participate in some sporting events and competitions. The last week was very fun for me because I enjoyed getting ready for the staff versus camper tournament. I also had fun participating in the extra activities occurring throughout camp. For example, I toured the art museum with the campers, attended a community parade, went to a water park, and learned salsa dancing. Throughout my time at NYSP I made many new friends and formed relationships that I know will help me later on in the future. I learned a lot in this experience about people, nursing, the community, and even about myself.
Sunday, July 10, 2011
I attended my second health fair on the Gila River Indian reservation yesterday. Many individuals look at this population and see an overweight community, who eat fried foods with lots of rice and beans and have the highest prevalence of diabetes in the nation. They see a community of alcoholics who only work in casinos. They believe that this community is lazy, especially regarding their health care. After spending just a month here I see something much different. I see a community that is predisposed to issues with weight, including diabetes. They were a community of hunter-gatherers that ate all summer and fasted in the winter. A heritage that altered their metabolism and didn’t transpose well into today’s world. I see a community working hard to overcome their health issues. Alcohol is banned on the reservation. Health fairs are held almost every month. Heath fairs run by community members attempting to make a difference. The health fair yesterday was unbelievable. The entire time a baseball tournament was going on. A friendly game organized by community members that promoted being active. There was a BBQ that consisted of hamburgers, hotdogs, vegetable pasta, and fresh fruit (pineapple, grapes, and honey melon). To drink there was water, unsweetened tea, and fruit punch. Booths promoting health awareness were set up around the parameter. There were inflatable toys for kids to run through. Teenagers were playing basketball and volleyball. There was even a dance competition. Almost everybody was active. Community members were genuinely interested in the information handed out at the booths. This all day event disproved almost all of the stereotypes that are commonly associated with Native Americans. I’m not denying the issues previously mentioned. I just think it’s important to give credit to this population. After spending just a month here it is obvious to me that this community is working to better itself each and every day. I cannot wait to see what else I can learn about this community the rest of my time here.
*Written July 10th, 2011. Posted late due to issues accessing the blog. *
Image provided by
Saturday, July 9, 2011
My summer capstone assignment is at Otis Moss Jr. Medical Center. I have had a great experience so far at Otis Moss. This medical center is a primary care center that provides adult, pediatric, and OB services. Gina and I have had the opportunity to work with the nurses and physicians in all three fields. We have participated in various aspects of nursing care such as disease prevention, patient education, immunization, screening, and triage care. Other than working in the clinic we are also helping organize a health screening event called “Live Strong Live Long” campaign. This community wide event will take place on July 23, 2011. Residents in the Fairfax community can receive free health screenings such as for sickle cell, HIV, dental, and diabetes. I’m excited to be a part of this event and to help provide health screenings to the Fairfax community.
Otis Moss also hosted a camp for teenage girls called “Seed to Succeed.” Gina and I also participated in this program by teaching the girls about STDs, nutrition, self-esteem, body image, and other topics. During the camp we taught the girls about HPV and Gardasil by presenting a power point lesson and visual demonstration. From our research and talking with the Gardasil pharmaceutical representatives we learned that there was a very low compliance rate in teenagers receiving or finishing the Gardasil course. Gina and I decided to do our research project on HPV and increasing the HPV immunization rate at Otis Moss.
Through my capstone experience I have learned and experienced the various roles of nursing at Otis Moss. We also have a great relationship with the staffs at Otis Moss and they have been very accepting and cooperative. Working at Otis Moss has allowed me to understand more about public health. People living in the Fairfax community are very supportive to each other and involved in improving their community. I’m excited to be at Otis Moss and I look forward to my rest of capstone experience this summer!
Wednesday, July 6, 2011
By attending the Senior Picnic, I had the chance to see how health information and services can be brought to the public and presented in a fun and effective way. The Senior Picnic was held at the Stephanie Tubbs Jones Community Building in Shaker Heights and was a great way for senior citizens to get together and interact. A wonderful meal was served, but the highlight of the day had to be the Elvis impersonator. The seniors were up and dancing by the end of the show, enjoying the musical entertainment. It was great to see them having so much fun!
We brought blood pressure cuffs and were able to do twenty blood pressure screenings right on the spot. When Sandi Hurley, the nursing director from the Shaker Heights Health Department that I work with, announced that blood pressure screenings would be available, the senior citizens could not get to us fast enough. They were extremely appreciative of this service that we provided, and it was beneficial because it could be done right away and while they were already at the event. Some do not have the opportunity to regularly have their blood pressure checked, so having this available to the senior citizens was valuable and helpful.
Because it was an extremely hot day outside, the picnic was moved indoors into the community center. We thought that it would be fitting to provide some information about how to stay safe during the heat. Sandi quizzed the audience of senior citizens about what they knew regarding being safe outdoors in the summer. Prizes were given to those who answered the questions correctly. The prizes included hats, summer tote bags, and certificates for free flu shots. The senior citizens seemed to enjoy this fun way of learning about important tips on summer safety. We handed out flyers that included what was discussed as reinforcement. This was also a great way for the seniors to learn more about the health department and the services that it provides, in case they were not aware. The Senior Picnic was a fun event in which the senior citizens were able to socialize as well as learn valuable health information.
Saturday, July 2, 2011
The Pima natives have seemed to have been very accepting of us so far. When we encounter them and they find out that we are students, they like to hear where we are from and seem to like the fact that we are down here. One new experience with the culture is that of tasting their fry bread. Fry bread is a type of dough that gets fried and can be served in multiple different ways. As of now, I have tried it with honey and powdered sugar on it, which was amazing and similar to a funnel cake, and I have tried it with red chili and cheese. Red chili and cheese and fry bread is amazing. The natives that serve it are nice and will have small conversations with us as they prepare it and then when you try it, you just almost fall in love with the dish. I definitely plan on trying more varieties of it as well as sticking with the red chili.
Outside of nursing, this past month has been to exploring the areas around the reservation. We have only seen a few districts but I plan on being in public health this upcoming month so I am hoping to see more of them and have a greater interaction with the community. But we have explored the nearby towns of Chandler, Phoenix, and Maricopa. They are all nice areas and are all within 15 to 30 minutes of the reservation. We have spent a lot of time in Barnes and Noble in Chandler this month to use the internet.
Due to our location, we have also been able to visit the Grand Canyon. Along the way we stopped in Sedona, which is an amazing place and a pretty decent tourist attraction. We did an overnight stay at the Grand Canyon and had an amazing time. The day after our return, we went back to work, and straight from work we left to attend a Cleveland Indians vs. Arizona Diamondbacks baseball game. It was a great game and Cleveland won also. This upcoming month, I will be in Public Health Nursing and hope to learn a lot more about the Pima tribe and continue to enjoy this amazing experience.