Missin’ you Peru

I can’t believe it’s been over a week since I’ve been back from Peru.  Time has flown by, but probably because I’ve been so busy with school!  I went straight from Peru back to school, with an exam within the first 2 days, a full blown head cold, and my preceptor clinical hours starting.  Now that I’ve finally had some down time to breathe and think about my experience, I’ve realized how incredible my Peruvian experience was and how grateful I am to have had this opportunity.

In the past week, it has been hard not to speak Spanish.  Even in the airport, we found ourselves answering questions and ordering food in Spanish.  This experience has strengthened my desire to learn Spanish in order to become fluent in it.  I also find myself reaching for my Peruvian alpaca blanket and my Arequipa coffee mug over others because they have become my most cherished.  Every time I use them, I smile and think of Arequipa and how it has a piece of my heart.

Overall, I wouldn’t trade my time in Peru for anything, as I already miss Arequipa so much.  The culture, the food, and the people were so amazing.  I miss the new friends we’ve made, the experiences we embarked upon, and the continuous opportunities for learning and knowledge.  It was hard coming home knowing that the living and health care conditions we left are often the only conditions many Peruvians know.  We came home to warm houses with clean and sanitary water, cars we drive daily without a a second thought, and resources and access to health care that many Peruvians lack.  It was such a bittersweet feeling.  But, I find myself thinking about Arequipa when I’m at clinical and how lucky I am to have the resources in order to take care of my patients.  Something so miniscule as changing gloves after each patient encounter, or using gloves in general, is such a drastic difference implemented in my daily practice compared to Arequipa.  Also, while using droplet precautions to care for a patient with the flu and discarding the PPE after each encounter made me think of Arequipa and their lack of resources – I kept thinking and wondering if Peruvians would think Americans are wasteful.  I feel extremely grateful to have the ability to protect not only our patients from illness, but ourselves, as many Peruvian nurses do not have this ability.

My experiences from Peru have shaped my current practice, as I strive to give my patients the best care possible just as the Peruvian nurses do.  This experience made me realize that regardless of the country, the conditions, or the facility (clinics versus hospitals), nurses are universal and their role is the same – to care for patients to the best of our abilities.  This experience has also improved my abilities to think outside of the box when it comes to care – specifically in comfort measures.  When I lack the resources to comfort a patient, I think of ways the Peruvian nurses comforted their patients and adapt them to mine.  Overall, I have grown and furthered my skills in all aspects of care, all of which I owe to my new nursing friends in Peru whom I miss so much.  But I keep telling myself, it’s not a goodbye, it’s a see you later!

Adios, Peru!

The day has come – time to leave Peru! I’m so sad to be leaving Arequipa and all the new friends we’ve made.  It feels like just yesterday that we were meeting the nursing students and getting settled into our hotel rooms.  On the other hand, it feels like we’ve been here for months.  I’ve felt so comfortable in Arequipa, regardless of the fact that I don’t speak Spanish.  Everyone has been so welcoming and so helpful that it honestly felt like we were living there, rather than visiting.  Specifically, the nursing students and faculty of Universidad Catolica de Santa Maria are incredible – speaking for my fellow students from MCPHS, we are so sad to be leaving our new friends and are looking forward to coming back in the future.

Picking up from Thursday after my sickness, we went to the clinic and I got to work in the blood pressure and diabetes screening clinic.  It was an incredible experience – I worked with a Peruvian nursing student named Ivan.  He showed me how the clinic and screenings go – a patient would come in with a slip and would sit in the chair.  The patient’s blood pressure would be taken, followed by a finger stick blood sugar to screen for diabetes, followed by a weight and height.  If necessary, Ivan would educate and counsel the patient on necessary lifestyle changes in order to improve their health.  Once he showed me what to do, I took over and did the blood pressure and blood sugars on patients while he did the height and weight.  While we had to reuse gloves due to lack of resources, much of the process was the same for the blood sugars.  The clinic had lancets (which ran out the day before but I did not have any issues), iodine soaked cotton balls for sanitation of the finger, and a glucometer with strips.  Overall, I was shocked at how low the patients blood pressures and blood sugars were, especially since a large portion of Peruvian nutrition contains high amounts of salt and sugar.  However, many Peruvians walk great distances, which contributes to their lower readings.

Halfway through, I switched from performing the blood pressures and blood sugars to asking and recruiting patients for free screenings.  During this part, I worked with a Peruvian nursing student named Mili.  She was amazing and gave us a phrase to say in order to determine if the patients would like to do the screening.  Many of them were happy to be screened once they found out that the screening was free.  I also had a form with questions about the patient’s lifestyle that I had to ask the patients.  Once I filled this out, the form was given to the patient so they could go to the room for their screening.  In the beginning, I was so nervous to speak Spanish to the patients because I am not very good or confident in my speaking abilities.  However, I toughed it out and many of the patients still understood me, which was an amazing feeling.

Not long into my recruiting of patients for screenings, Mili and I got pulled to go into the Pediatric Therapy Simulation room.  In this room, children can be recommended for extra help or therapy in certain areas of development.  For example, when Mili and I went into the room, there were 2 14 month old children who needed help with walking.  One in particular was tripping over her feet, which would cause her to be unsteady.  So, I got to hold the child’s arm and walk with her to help her improve and remain steady.  She was so happy and it was so awesome to be able to interact with the children and help with something so monumental in their lives.  Following this, two babies came in – one was 6 months and one was 11 months old.  The 6 month old was having trouble sitting up without falling backwards and the 11 month old was having difficulty standing.  I was able to interact with the 11 month old and work on his cognitive capabilities before the nurse began working on his physical therapy.  (The 6 month old was shy and didn’t like strangers).  Lucas, the 11 month old, needed to follow directions and put individual marbles into a cup.  He was slightly distracted by all the people in the room and had difficulty at first, but after some time, he managed to follow my directions, which was such an amazing feeling!  It was awesome to see the progress he made working with me.  It was definitely a proud moment for me!

On Friday, we went to the clinic for 2 hours and I was able to observe in the emergency room of the clinic.  We had a little girl with a dog bite to the face.  Her lacerations were not very deep so the nurse used suture tape to close the lacerations and prevention of infection.  The little girl was so scared at first because she thought it was going to hurt, so one of the Peruvian nursing students turned on a youtube video to distract her and she didn’t even notice the nurses working on her face.  It showed that even small gestures can go a long way in order to make a patient more comfortable.

Following the clinic, we went to a public health hospital in Arequipa.  We learned that because it is a public health hospital, the funding comes from the government and as a result, the supplies are limited and the population of patients are generally poorer.  We went on a tour of the facilty and saw the vast differences between hospitals in the US and public health hospitals in Peru.  In Peru, depending on the unit, many patients are put into 1 room whereas in the United States, it is usually 2 patients to a room.  Also, resources are limited and nurses have to be creative in order to care for patients. This experience was extremely eye opening and truly something I will never forget.  It made me extremely grateful to have the resources we have in the US.

After the hospital tour, we went and had a final dinner with the nursing students and faculty.  It was a beautiful dinner of traditional Peruvian food, gifts, speeches, and music played by Danielle, another nursing student.  It was an evening filled with love, gratitude, and sadness (mostly that we had to leave our new friends).  The amount of love in the room was palpable and I felt so extremely lucky to be surrounded by it.  I remember sitting at dinner thinking how happy I was that I decided to come on this trip, because it truly was an experience I will never forget or experience again.  I am so grateful, lucky, and wouldn’t trade this experience for anything.  I’ve met new lifelong friends, learned SO much about Peruvian culture, and enhanced my nursing skills.  I would 100% recommend this trip to anyone!

I’ll be posting pictures once I get back to the states (we’re in Lima as I write this).

Adios!

Let the Peruvian Adventure Begin!

We made it to Peru, although it wasn’t without any bumps in the road! Our flight from NYC to Lima was delayed, which caused us to miss our connection to Arequipa.  However, we were able to be booked on the next flight in to Arequipa, thank goodness!  All of this meant that we didn’t have time to change or refresh prior to meeting the President and faculty of the Univeridad Catholica de Santa Maria.  Definitely one of the most embarassing moments of my life.  The President and faculty were all dressed so nicely and professionally in suits, and we stroll in with leggings and sweatshirts straight off of many plane rides.  But, the university was so welcoming (regardless of our appearance) and excited to have us in Peru that it definitely made up for the embarassment level we felt.  That moment set a wonderful tone for the rest of the trip to come.

The rest of the weekend, we went sightseeing – we visited a museum and saw the mummy of Juanita, went to Monasterio del Carmen, went shopping throughout the city, and took a bus tour of the city of Arequipa.  The bus tour was amazing, because it allowed us to see the outer limits of the city that we wouldn’t have seen if it weren’t for this tour.  This tour allowed us to experience firsthand things we’ve learned throughout our curriculum.  For example, we saw the living conditions, the lack of resources, the distance one must travel to receive health care, among various other factors that contribute to poor health.  It felt so surreal to experience firsthand much of what is being taught to us.

On Monday, we went to work at a health clinic in Arequipa.  This health clinic is amazing because it contains so many resources all in one – diabetes and blood pressure screenings, tuberculosis clinic, pediatric clinic, adolescent counseling, emergency medicine, maternity, nutrition, and community health nursing.  For a clinic with few resources, the work they are doing is incredible.

My first day, I went on the community health nursing visits.  This experience was much different than in the United States.  For example, nurses within the US see at least 5 patients a day (usually more) and they drive to and from patients.  However, in Arequipa, nurses see only a few patients a day and walk to patients houses.  Also, in Peru, community nursing is more preventative, whereas in the US it is a more focused visit, like for wound care.  On our community visits, we went to families homes with children under 3 years old.  The government requires that children under 3 years old receive micronutrients or “sparkles” to prevent anemia.  Therefore, for parents who cannot bring their child to the clinic, nurses go out into the community to bring the nutrients to the family.  The micronutrients contain calcium, magnesium, folic acid, iron, etc.  Our first patient was a 13 month old boy named Mauricio who was with his grandparents while his parents worked during the day. I was shocked at how willing the grandparents were to not only listen to the nursing education, but to also welcome and encourage that I played with Mauricio by immediately handing him over to me.  It was really amazing and not something I see in the US.  Also, I was shocked that when the grandmother mentioned she has back pain, the nurses did not physically assess her.  They asked her questions but never once inspected or palpated the area, which is very different than in the US.  I am used to seeing a series of questions being asked followed by physical assessment of the complaint, so experiencing this was very eye-opening!

Another part of the community assessment that stood out to me was when we went to an area called El Azufral, which would be considered the slums.  This area was situated in a valley, so stairs were required to access the area.  El Azufral also lacked electricity, running water, and toliets.  The houses were made of concrete, rocks, and any other useful materials, all lining dirt roads.  Unfortunately, the families did not answer the door for our visits, however, it was extremely eye-opening to be in this area.  I couldn’t believe that this was a standard way of life for some people – maybe I’m just naive?  But walking through it rather than just looking down on the area seemed to really exemplify the quality of life these individuals have.

On Tuesday, I worked in the Pediatric clinc with nursing student Cristina and Peruvian nurse Leslie (Both of which are incredible!).  In the pediatric clinic, I was able to watch “controls” or assessments done on children of various ages (typically less than 4 years old).  The clinic also gave vaccines to pregnant mothers as well as several children who  had dog bites.  During the assessments, I was able to see the difference between ages, what they need for vaccines, as well as the developmental stages.  Overall, the children appeared to be bigger than US babies and children, both in height and weight.  Also, the mothers were very receptive to having me in the room with them while the controls were being performed.    For the controls, a newborn (7 days old) had only the height and weight taken.  However, for a 3 year old, a complete physical exam was performed as well as developmental tests and vaccines were administrerd.  There was also a difference in the focus of the assessments.  The Peruvians placed a lot of emphasis on the arches in feet, as it can relate to kidney damage later in life.  However, in the US, arches are not something that is focused on.  Therefore, it was awesome to see the difference in practice and the implications it can have on the child.  Lastly, a big difference I noticed was with infection control.  In between patients, there was minimal hand washing, the beds/tables were not cleaned after use.  Also, for vaccines, the vials were never cleansed prior to insertion of the needle, and the nurse used soap on a cotton swab to cleanse the area on the patient rather than alcohol like in the US.  I’m unsure if it is due to lack of resources or knowledge, but it was interesting in the vast difference of infection control between Peru and the US.

Unfortunately, on Tuesday afternoon, another student and myself got sick and had to go to the Univeridad Catolica de Santa Maria’s doctor to be examined.  We both had fevers, stomach pains, muscle aches, and were exhausted.  So on Wednesday, I had to sit out of clinical, but I feel much better now and am looking forward to diving back into clinical on Thursday!! (What can ya do, right?)

Ill post some pictures once I get some free time!
Adios!

2 days to go!

It wasn’t until I laid down in bed last night that a huge wave of excitement washed over me.  The recognition of a new adventure and cultural exposure coming my way hit me all at once.  I couldn’t believe that I am leaving for Peru in 2 days.  How did the time go by so quickly?   When first learning about this trip, I thought it would take forever to get here.  But now, I feel like I blinked and here we are, 2 days away from this incredible trip.

As my friends and family ask me if I’m ready and excited, I find myself thinking that excited is an understatement.  I’m excited to experience and learn about a different culture with a great group of students and awesome faculty.  I’m excited to experience health care in a different country, which I have never done before.  I’m excited to learn about Peruvian’s views on health and variability of these views throughout the lifespan. But I’m most excited to further my skills and teaching abilities on specific areas of health, like blood pressure screening.

In addition to nursing care, I’m looking forward to sightseeing, visiting markets, hiking Colca canyon, eating Peruvian food, and experiencing a Peruvian nursing school in comparison to ours.  Finding differences between cultures is what makes traveling so incredible and unique and I’m so extremely lucky to be able to experience it, especially since I hope to be a travel nurse someday.  This trip feels like the perfect place to begin!!

See you in Peru!

Excitement, overload

You know that indescribable moment, the one where extreme excitement and adrenaline kicks in and you cannot contain yourself?  Where you can’t sit still or think about anything else?  Where your mind is working so fast its racing from thought to thought, just trying to keep up with the adrenaline coursing through your body?  When you cannot keep that smile from creeping across your face no matter how hard you try?  That’s the kind of excitement I felt when I received an email about a nursing trip to Arequipa, Peru.

I immediately texted my two friends asking if they saw the email.  After a series of “oh my god’s” and “I really want to go”, my friend Jess and I both emailed our Professor that we were going to Peru.  Fast forward two weeks and not a day has gone by without google searching or Pinterest-ing Arequipa, Peru.

(The image below is Misti Volcano.  It’s last known eruption was in 1985.  There are 2 main climbing routes that used to hike up the volcano)

(This image below is the main plaza called Plaza de Armas de Arequipa)

I’ve since learned that the first few days, we will arrive in Peru and head over to the “sister” University to meet the Dean of Nursing and get a tour of the school.  We then have two days or so to do “touristy” things and spend time with the nursing students from Peru to learn about the culture.  From there, we will be working in various community clinics taking care of patients of varying ages with the nursing students from Peru.  I’m so excited and grateful for the opportunity to be able to put my clinical skills to use while immersing myself in a completely foreign culture.  I already know that I am going to learn SO much and I am crawling out of my skin just waiting for this opportunity to come!

In the meantime, I guess I’d better go brush up on some Spanish?

Welcome!

Hello!

As the title of my blog reads, I am embarking on a trip to Arequipa, Peru and I wanted to bring you along with me on this journey! I have traveled in the past, to both Italy and the Dominican Republic and honestly wish I blogged or kept a journal of the trip to reflect back on. But, we get smarter and wiser as we age right? So here we are.  I plan to use this blog to communicate my emotions and thoughts about international traveling as well as any tips and tricks I’ve learned along the way.  I will also use this for any updates I get about my Peru trip.

First, I want to tell you a little bit about myself.  I am a complete wanderlust – just ask my sister.  Any mention of a vacation and exploring a new place, I am 100% on board.  I also love to read and learn new things. I love my family, friends, and two dogs endlessly.  Now onto my professional life:  I graduated college in 2014 from Emmanuel College with a Bachelor’s of Science in Biology with a Concentration in Health Sciences.  From there,  I began working at my first “real person” job in a primary care center in Cambridge MA as an administrative assistant for a full-time physician and a physician’s assistant.  Although it was a great first job, I was getting tired of the same thing every day, and decided I was going to go back to school for nursing.  When I was in college, I wanted to major in nursing, but my school did not have an undergraduate program and I did not want to transfer, so I decided I would graduate with my biology degree in order to have a degree to fall back on if I hated nursing.  Fast forward a year, and here I am at MCPHS University in the accelerated nursing program.  I have about 4 months left in the program until I graduate and I am so excited.

Please ask any questions you may have I will respond ASAP!
See you soon 🙂