Monday, November 28, 2011
I really enjoyed the free lunches from the pharmaceutical companies that we often got too :) . The medical assistants I loved because they were so helpful. They taught me how to draw blood and do assessments. I was really cool and they were so friendly.
I remember my first week of intensives. I thought I was going to lose my mind being in class from 8 to 5 everyday for 2 weeks but it turned out to be amazing because my professors were funny, engaging and I learned so much. I especially enjoyed my Health in the Global Community class. Mrs Katia Almaida was such a free-spirited teacher and she always kept my interest. My experience at the Cleveland Clinic was beyond up-lifting. I learned so much from the nurses and doctors. My patients were all wonderful and very inviting. I feel as thought my skills have definitely ventured.
I've met some amazing students from all over, china, ghana, india and canada. I have fallen in love with all of them, especially my nursing companions. They have been hospitable and have shown me such a great time. My first "outting" was the PAINT PARTY during the first week of classes. I had such a great time and got paint in every corner of my body, literally lol. I have went to the Euclid Tavern and performed karaoke, in which I've gotten great compliments for my singing.
Now that the cold weather has set in it has been a big adjustment but my roommate and I always seem to find our way to the mall and restuarants (Applebees and Cheesecake Factory which is my favorite). I am dreading the snow but also looking forward to it.
Sunday, November 27, 2011
Overall this was a great experience for me. I got to follow cardiologist, ophthalmologists, endocrinologists, urologists, orthopedic, podiatrists and general physicians and gained so much knowledge and information from every one of them. I also got to see the pharmacy and how they worked and learn a great deal about what medications are used for what and the adjustment of these medications. This is a great place for someone to volunteer their time and is somewhere that I plan to volunteer my time at once I graduate.
Our Vitamin D project turned out to be a success. I loved seeing parents comment on the posters that we had made for the exam rooms. Our interventions sparked a lot of questions with the parents and we were able to educate them on the resources of Vitamin D. Overall, my capstone experience was great. I am so glad that I got to spend my semester at the Otis Moss, Jr. Health Center.
We were able to visit mental hospitals where it was actually depressing to see adolescents cooped up in one room with a limited amount of entertainment resources. They just had one TV, a ping pong table, and chairs and tables where they could read or draw. Patients are interviewed individually by a group of doctors and nurses, an experience that I would find intimidating. The staff also has little time to interact with the patients so when they saw us foreigners, they all crowded around eager to speak English with us. We were invited to teach them some basic English words so we reviewed fruits, vegetables, and different sports with them. It was quite interesting to see how well they responded to us. However, I don’t believe that the care in this institution is of good quality, and I think that their protocols and plan of care should change dramatically to one that puts the patient’s best interest as a priority.
We have met so many amazing people here and have made an abundance of good friends. Everyone has been so eager and willing to help us with anything that we need. They truly made sure that we were taken cared of, and I really appreciate this wonderful belief in hospitality. I believe that part of this is due to the general idea/outlook on foreigners. All the Chinese people are so excited to talk with us as they so eagerly want to practice their English. This experience has been incredible. It could not have been more perfect, and I would not change this experience for anything in the world. Because of this, I am more worldly and more culturally aware. The Chinese work very hard day and night and yet they continue live simple lives with few complaints. This is an idea I hope to adopt one day. I am ever so grateful for this wonderful opportunity!
Friday, November 25, 2011
Reflecting back on our capstone experience in Hong Kong reinforces what a great learning experience that we had. Not only did we acquire a large amount of knowledge about smoking cessation through our work with the University of Hong Kong’s Youth Quitline, but we also learned a lot about doing research in general. Towards the beginning of our trip, we had a project lined up to with a professor from the university, who had an ongoing research project dealing with promoting social harmony in ethnic minorities. We encountered problems with communication, and finding a substantial project that we could accomplish and bring back to present to FPB. After a number of set backs, we had to make a choice about what our best choice would be. Though we did have some stressful and difficult times, we learned that doing a project, especially in a foreign country, could be very tricky. This process provided us with a lot of insight on how research, projects, and grants in the community work sometimes. Thanks to Dr. Gueldner and Dr. Quinn Griffin, Kim and I were eventually linked with a great contact and found a project that suited us well! We were able to work with a wonderful group up people who responded to our project ideas well. The experience as a whole has been extremely educational, especially because we were dealt with frustrating situations. I believe that the most important lesson that we learned is that you have to be proactive, and roll with the punches until you can overcome your obstacles. We met amazing friends along the way and gained so much knowledge about their culture. We had an amazing trip in one of the most spectacular cities I have ever visited!
Monday, November 21, 2011
As the semester continued and we checked schools off of our list we realized that in order to be able to accomplish our overall goal of screening all of the schools in the district we needed more man power. Erin Whitehouse, the project manager of the Prentis Grant, communicated with the Ursuline School of Nursing. We paired up with student nurses from Ursuline and screened eight schools together on two different Tuesday's. It was great to have more man power to accomplish all we had to do in the schools.
For me it was exciting to be working with another nursing school in order to accomplish a huge goal that we as a group set at the beginning of our project. We got to teach the protocol that we had utilized through the semester and test the nursing students off so that they can properly screen for height and weight and know how to input the information correctly into the iPad. The students were very receptive to our project and put forth a huge effort at the schools. At the end of our 300 hours the Ursuline nursing students will continue to screen the remaining schools, and eventually accomplish our ultimate goal.
Starting out this senior capstone project, i did not really think i was going to get as much as i did out of it. I have enjoyed my times in the schools and getting the chance to make a difference in the lives of the children in CMSD. I can only hope that the screenings we have done and the reformatted parent notification letter we have created, will help to decrease the rates of obesity in CMSD and ultimately give children a healthier way of life.
One of the schools that I will always remember was Charles Mooney Elementary School when Amber Maciak and I were runners to the classrooms to collect the students and bring them to the screening site. There was a vision center special education classroom in this school that consisted of blind children and other disabilities. We had to bring each student up one at a time and really got to know each of them and their stories. That day made a big impact on me and it will be something that I look back on from my senior capstone.
I cannot believe that I just left China! I am going to miss all of the friends I’ve made, the faculty at the HOPE Nursing School, all the staff at the community clinic, and the delicious jian bao… Last week was our last week collecting data from the patients in the clinic, and it was incredible to think how 2 months ago they had no idea who we were or what we were doing. Two months later, there we were communicating with them (a very little bit and as best as we could, but much more than we were at the beginning)! I have learned and experienced firsthand just how frustrating language barriers can be, and I think I can say that I am now a more patient person because of it.
Since we had been so busy with our project, we had not been able to visit many other hospitals to see the differences in the health care and the role of the nurses there. The last week we (and the staff) had time to see a few different hospitals, and a few different floors. The week before we had visited the ER and VIP units at Zhongnan Hospital. The VIP floor was beautiful and spotless. Each room was equipped with a bed and some modern equipment, a second room with chairs and couches, and a private bathroom. Despite my personal objections of hospitals having VIP floors, I thought it was a very welcoming environment, and any patients would be lucky to be there. Even though we were able to see that floor, there were no patients. We craved the chance to see nurses at work and the chance to see everyday citizens on various floors. We got a brief tour of the Women and Children’s Hospital and were able to see the Pediatrics Plastic Surgery floor. It was so strange (and might I say almost comforting?) to see the absence of the cage-beds we see in the pediatric units in the US. I know the purpose of the beds we put the children in at the hospital, but I always wonder how many babies and toddlers get traumatized when placed in one of them and how this detracts from their healing process. There were a few reasons I noticed as to why the peds floor did not have these beds: 1) They only have the large adult beds available to them and must make due with what they have and 2) The families are much more involved in patient care and life than in the United States. It would be unnecessary to have another kind of bed because the family was there to watch the child at all times. The nurses recognized, too, that infants sleep better in more familiar places, and we saw an infant patient sleeping its own stroller. Even though there is a potential problem with germs and bacteria being transferred through this stroller, there is still something beneficial to patients’ healing in being comfortable and feeling more at home – especially for children.
Tying in with the decreased consideration for germs, we noticed on the cardiac floor that nurses do not wash their hands between patients, when entering, or when exiting the rooms. They also did not wear gloves when inserting IVs (which were just needles they left inside the veins). I wish I had found out what the rate of infection was, but I did not ask at the time. China is still developing its theories and practices in Western medicine, and it seemed as though the hospital were just behind us in the times in terms of practice and equipment (they use gravity instead of automatic pumps for IVs). The interplay and occasional conflict of Traditional Chinese Medicine (TCM) was also apparent while on the cardiac floor. We listened in as a doctor was explaining treatment to a patient. After the patient said something, everyone in the room laughed, and the nurse said that the patient had said that Chinese medicine had cured his disease, but Western Medicine had saved his life. That one statement really got me thinking, and I think that it really shows how many people really put their faith in TCM. TCM helps them in their daily lives to overcome illness and to maintain a balance, but they still believe that if this balance shifts too much at one time that Western Medicine can save them. The patient did not think that Western Medicine had cured him but that it gave him more time on the earth in which to keep his balance of yin and yang in check. I hope that makes sense, but if not, feel free to ask me.
The day after we went to the cardiology floor, we went to a psychiatric and a mental health hospital. As for the mental health hospital, it was very nice (and expensive) with therapy rooms, patient rooms, and a variety of programs for patients to participate in. Overall, I was impressed with the facilities. That is all I will say about it because I want to focus on the psychiatric hospital we saw. We observed the nurses and nursing students on the adolescent floor, and it seemed to be out of an old movie where patients are in locked rooms and wander around in a daze. When we got there, all the patients were in one room either watching TV (a violent movie was on), playing ping pong, playing cards, looking at magazines, or wandering around aimlessly due to sedation. When we walked into the room, a horde of them gathered around us and talked with us in English. Many of them had smiles on their faces, and it made my day. Being there and seeing the young people in that room and imagining what it would be like to be in one room all day made my heart ache. I realized just how far a little bit of attention can go. The nurse told us that other than the students, the patients don’t really have anyone talk to them because doctors and nurses were always so busy. This sounded so familiar to my experience at St. Vincent’s where the patients were so appreciative to the interaction that the student nurses had with them. It does so much good for everyone to have someone pay attention to them, to talk, participate in an activity together, or just interact in some way. Even just a comment or a smile goes such a long way. When I say interaction, however, this does not mean sitting them in a chair and interviewing them about private things in front of a room full of people. We were able to sit in a few interviews of patients, which were educational to see, but I also had the feeling like I should not have been there. I just wanted to patients to feel comfortable and to know that someone cared about them, but anyone would be intimidated by a room full of people listening to everything they said and judging them. I also found myself getting angry with the parents of the patients because as adults in China age, their children take care of them – even when they develop mental illnesses. This is why, we found out, that there aren’t many elderly people in mental hospitals. How could people find the time and energy to take care of their parents but not their own children? As I become a nurse, I hope I never forget that patients are people who deserve privacy, attention, and care.
I hope this post does not make my experience in China sound bad. It is not meant to deter people from traveling abroad but to give you a piece of the picture that I saw there. I am so lucky to have seen as much as I did, and I loved traveling to the various hospitals and comparing them to the only ones that I knew. This experience was so amazing, and I would never have passed it up. I had the privilege of seeing so much, and it really made me appreciate everything we have in the United States not only in terms of health care but also in terms of everyday practices and hygiene. All that I have seen, experienced, and learned here in daily life, working at the clinic, and visiting other hospitals will all help me to be a better and more culturally competent (yes, I had to throw in that term) nurse.
Sunday, November 20, 2011
Teaming up with the senior Ursaline nursing students has been a great way to reach more schools by increasing our man power. On the 15th, we had a screening day with them, and it was a really fun and effective day of screenings. Our goal for this screening day was to hand the reigns over to them, as they will be screening independently soon, and we wanted to ensure that they understood every aspect of screening—from check in, to running and tying shoes, to getting new student information. As the Ursaline students became more independent, I had time to sit down and talk to the kids as they waited in line to be screened. This has been the best part of the screening. When you get down to their level, their faces light up and they will talk about anything. They mostly all talk to you all at once each one trying to catch your attention and tell a silly story or a secret. We talked about Thanksgiving, the Transformers, their field trip to the zoo, their favorite game in gym class, how pretty someone’s shoes were, and flying spiders.
Saturday, November 19, 2011
Friday, November 18, 2011
My time in Hong Kong was an incredible experience and better than I ever expected. I can’t believe it’s over and I am home! Although we had many setbacks related to our project, I think Alexa and I were able to learn a lot about the health care system in Hong Kong. We started our project by joining with a researcher who currently works with children, and we originally planned to assist him in promoting social harmony and well being in Chinese children and ethnic minority children. However, we realized after several meetings that this project would not be possible for several reasons. We had to find a new project and eventually paired up with Dr. Sophia Chan who works with smoking cessation.
Smoking is a very big problem in Hong Kong and 68.2% of smokers begin smoking before the age of 20. Dr. Chan and her research team started the Youth Quitline at The University of Hong Kong, which is the only resource that targets the youth population. This resource is effective and provides service to many young people trying to quit smoking, but the research team has been looking for ways to improve the Quitline. Hong Kong is very technologically advanced, so we decided to focus on implementing web-based and phone-based technology to the Youth Quitline. Because of the limited time we had after many issues with finding our project, we did not actually get to implement these services. Instead, we helped the Quitline start the research process to find information about technology services that have assisted with smoking cessation in the past.
The day before we left Hong Kong we gave a presentation to Dr. Chan and her research team about our findings. We gave suggestions on how they can improve the Quitline and therefore make it more accessible to the youth population in HK. Our two big suggestions were to improve the website by adding a feature that allows users create an account so that the website will be personalized for them, and to add a text messaging system. After we presented, we had a discussion about our ideas and we were also able to hear many interesting things about smoking and the Quitline’s efforts to help the young residents of HK directly from the research team. One of the research assistants is also a counselor at the Quitline and was able to give us a lot of valuable information about some of the issues that arise during counseling. A lot of these problems would be eliminated with the use of our additional technology features. The research team really liked our ideas and is excited to start to implement some of them. They promised to keep us updated on their progress and said they will continue to ask us for our opinions. We think it would be great for the people who go to Hong Kong next year to work with Dr. Chan on this project and develop the Quitline even more.
After our presentation, the research team treated us to Dim Sum, our last traditional Chinese meal! Later that night we said goodbye to our friends and also met three of the students coming to Case in April! They are very excited to come to our school and see what nursing is like in the US and we are excited to show them around! Although I miss Hong Kong already, I am excited to be home and can’t wait to share our experiences with everyone back at school and hear about everyone else’s semester!
Wednesday, November 16, 2011
Through the capstone experience, I have had the opportunity to learn about working on a research project. As a member of the CMSD team, I have learned how to fill the role of a senior screening leader for the Prentiss Grant. This has entailed learning how to follow, teach, and enforce our screening protocol, understanding the technology used to collect and organize the data, and how to collaborate with a large team. Currently, a large portion of our time has been spent sifting through the data we have collected and sorting it so that the data we submit is free from errors which occurred in the data collection process. It is important and tedious work. As a person who does not work well with technology, I have surprised myself at how proficient I have become with Microsoft Excel and Apple’s Filemaker program. After you learn a few shortcuts, like using “Ctrl+X” to cut and “Ctrl+V” to paste, the task becomes a lot easier. Additionally, having an extra pair of eyes help you read through the Master Lists, and read out the numbers is incredibly helpful. It is also exciting to look through and see how many schools and students we have screened this semester.
Thursday, November 10, 2011
Central meeting points such as churches seem to be great venues for disseminating resources and health information. During elections and vaccinations, a food pantry and mission store already drew community members to the church. Furthermore, a kiosk at the entrance of the church provided multiple community and health-centered publications. Pamphlets related to traffic safety, Cleveland MetroParks hiking and snowshoe tours, Planned Parenthood, World AIDS Day, and LGTB awareness were available. Amidst all of the resources available to the community at this site, the presence of a flu vaccination clinic definitely seemed appropriate.
My experience at the Otis Moss Junior Health Center (Community Clinical) was also amazing even though I was a little apprehensive at first. I had asked my classmates if they had ever heard of that particular site and many of them did not. Being at Otis Moss, the staff made me feel very welcome, the nurses and doctors took every moment as a teaching moment. By the second week I felt comfortable checking in patients (weight, height, temp, urine dip stick test, ECG’s, and venipuncture’s). I even administered immunizations such as PPD, DTap, TB, etc. I was also called upon to administer majority of the flu shots. Being at Otis Moss thought me how imperative it is to work as a team (communication, patients care) so the patients experience can be as satisfying as possible. At the O.M.H.C we were given the opportunity to come up with a project. At O.M.H.C, majority of the lab results of pediatric patients showed that their Vitamin D levels were either deficient or insufficient, therefore our project was to educate patients/parents on Vitamin D deficiency/insufficiency. There are two other group members (Jazmin Townes and Sarah Milligan). Working with them has been a blast. We came up with the idea of doing a pre-test survey to see what people knew about Vitamin D and posters to educate them on ways that Vitamin D levels could be increased (nutrition, sunlight, etc). Overall I really enjoyed both my experience at the Otis Moss Junior health Center. I learned not only from the doctors and nurses but also from my fellow classmates. I’ve learned a lot of different things as an exchange student since I have arrived in Cleveland and hope to learn a lot more before I leave.