A Community Worth More Than Generalizations

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. *
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Otis Moss Jr. Medical Center

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!

Shaker Heights Senior Picnic

I am currently working on my capstone at the Shaker Heights Health Department where I am learning so much about public health and how it can affect a community. One of my favorite experiences thus far has been going to the Senior Picnic and having the opportunity to talk and work with the senior citizens of the area.

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.

First Month in Gila River

Finishing our first month on the Gila River reservation was something inspiring. We arrived on a Wednesday to get used to the area and prepare for our orientation that Friday. Orientation just consisted of a tour of the main hospital in district 3 (there are 7 districts within the reservation), a small preview of the surrounding district where we would be living throughout our two months, as well as a view of the clinic in Komatke (district 6). We were able to choose our assignments and begin the next week. Emily and I chose to do school health nursing and were both placed in separate schools to work with the nurse. Summer school classes were going on so we seen the students as they came in to be checked up on, given medications, or use inhalers. I received a new perspective on schools nurses throughout this time. Prior to this site, I believed the nurse did not do as much and just mainly sat around doing little paperwork and see the children. It is actually that with a lot more involved. They do planning for the school year and how best to address the students. They attend competencies (which we had the pleasure of attending for three full days) and talk about the previous school year and changes. They go through training to better prepare for their students. That’s one thing that really sticks out; the students are THEIR students. They care for the students and act as providers for them. They go out of their way to get things done for them and even talk to students on a daily basis to see how they are doing and even boost their morale at times. It was great to see the smiles on their faces when they would be given a compliment. While I was there, I assessed a few students when they came in feeling under the weather, gave some medications, and even participated in some of the planning. There was a parent enrollment night for the parents to enroll their students and fill out all the forms for the upcoming school year. I was given the task of finding a major problem that occurs in the schools and create a poster board on it. The topic that was chosen was lice and I learned a lot of information regarding it that I had not even known. It was a great experience working with my school nurse and engaging with the other ones at times as well.

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.

Outreach Efforts in Parma and Lakewood

We started our venture into public health at The Cuyahoga County Board of Health (CCBH) on June 1, 2011. Elisabeth, Kristin, and I were greeted and welcomed by all the nursing staff. Since then, we have integrated ourselves as part of their team. Out of the many departments that the Board of Health entails, our main goal is to provide interventions within our communities that will increase utilization of The Family Planning Clinic, "My Life, My Body". The Family Planning Clinic's main purpose is to provide low to no cost health services for men and women, 13 years old and up. Some of the services include; contraceptives, STI testing and treatment, HIV testing, pregnancy testing, pap smears, sexual health education and/or counseling. This clinic was established by title X grant to provide sexual health services to prevent unplanned and/or teenage pregnancy as well as STI/HIV prevention. As part of an introduction to community outreaching, we have the opportunity to man a table at Parma's Tri-C, west campus. Once a week, on alternating Mondays/Tuesdays from 10am-2pm and 5pm-7pm, we promote and educate the Tri-C students and staff about sexual health through the use of pamphlets, flyers, booklets and resources. Our end goal was to get the members of the community aware of the services available to them and increase utilization of the clinic. This was a relationship in the community that was already established by our preceptor, Sandi Hoch, and in turn gave us a first hand look at what outreaching in the community was like. We are currently working on a new, updated tented poster that will take place of the old poster board shown and have added some informational sheets such as a map with directions to the clinic, and a Mirena/Paraguard info. sheet, etc.. We also plan to outreach to the Parma day cares/learning centers as part of our efforts.

Parma, Ohio has been targeted mainly for its high rate of teen pregnancies. Many efforts and relationships have already been established within this community. Sandi has granted us the autonomy to work together in finding creative ways to market our promotion to other areas of the county. During our assessment of secondary data of Cuyahoga County, we found that the city of Lakewood would also benefit from these services. Interestingly, Lakewood has a rising, high rate of HIV as well as a lack of nearby title X services. With no community partnership with Lakewood, we started on a blank slate. Thus far, we have set aside time to visit Lakewood on a weekly basis to meet the businesses of the community. We started out with a full, detailed listing of all the businesses in Lakewood and aim to visit all of them. We also started thinking about creating a flyer to pass out throughout the residence of Lakewood as well as meeting a community leader that may aid us in printing an ad in their newsletter.


I can't fail to mention our efforts in improving the technology resources at CCBH. We are still in progress of improving the clinic's website found at http://www.ccbh.net/ and facebook page. Everyone is welcomed to visit our sites in the next few weeks and provide feedback!

Even though it took us time to figure out what was expected of us. I feel the experience couldn't be any better without it. I am anxious to see our hard work pay off and meet the goals we set to aim.

My experiences at Great Lakes Home Healthcare and Hospice

I have been working with three nurses from Great Lakes for the past 4 weeks, and they have been amazing. Kailey and I are rotating between med-surg/hospice, mom/baby, and wound care so we have seen a little bit of everything. At first I though we would only be doing vitals and observing, but we have gotten a ton of hands-on experience. I have drawn blood, done physical assessments, and today I even did my first wound vac! We also learned to chart in the laptops and I have been doing the visits by myself. Today the nurse sat back and watched while I did vitals, my assessment and wound care. We also do a lot of teaching regarding diets for wound healing, care for babies that have jaundice, etc.

My first day I was with the med-surg/hospice nurse, and our first patient was actively dying. Although I was not there when she passed away, it was interesting to see how the role of the nurse shifts. Since that day, we have had two more patients pass away, one of which I was there for. It was very sad to see the family so emotional, but I am glad I got to experience it. It gave me a much deeper insight into how a nurse bonds with families and what to do/say in a time of grieving. I have also attended a seminar on crisis intervention, hospice team meeting, and a luncheon at the new women's hospital.

I have already had a lot of great experiences and am very excited for the rest of the summer.

NYSP beginings

My capstone is the NYSP camp taking place on Case campus. It has been going very well and is proving to be a very rewarding experience. We began on June 1, a week and a half before camp, to set up, meet the staff, and prepare the grounds for the campers. We did things like moving equipment, decorating the gym, and helping out with registration. All campers had to complete forms and have a medical exam performed. Nursing students got to take all their blood pressures....that is 400 campers! The staff has been great to work, and I am making many new friendships.

A basic camp day begins at 7:30 with sign-in, staff meetings, and camper attendance, and ends at 2:30 on most days. Sometimes the kids have special afternoon events that end at 5pm. We have all been assigned to one of the 12 groups, which are based on age. Campers are ages 10-16. My role this half has been education, which has gone very well. My topic is physical activity and I am working with Frank and Alaina. We taught about BMI, calories and weight control, cardiac health, sports injuries, muscles and stretching, and tips to stay active inside and outside. We had fun with these lessons and made them very interactive by incorporating dancing games, jeopardy, skits, role play, and even Yoga. The kids can be trying at times, but they are all excited to be there, curious, and want to learn what we are teaching.