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PREPARING NURSING STUDENTS FOR A SHORT-TERM STUDY ABROAD CLINICAL EXPERIENCE IN NICARAGUA

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PREPARING NURSING STUDENTS FOR A SHORT-TERM STUDY ABROAD CLINICAL EXPERIENCE IN NICARAGUA Mikki Meadows-Oliver, PhD, RN Patricia Ryan-Krause, MS, MSN, CPNP – PowerPoint PPT presentation

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Title: PREPARING NURSING STUDENTS FOR A SHORT-TERM STUDY ABROAD CLINICAL EXPERIENCE IN NICARAGUA


1
PREPARING NURSING STUDENTS FOR A SHORT-TERM STUDY
ABROAD CLINICAL EXPERIENCE IN NICARAGUA
  • Mikki Meadows-Oliver, PhD, RN
  • Patricia Ryan-Krause, MS, MSN, CPNP

2
Background
  • Recent increase in US nursing projects abroad
  • Many projects with undergraduate nurses
  • YSN students all graduate- level advanced
    practice nurses

3
Benefits of International Projects
  • Acquire enhanced global perspective
  • Gain first-hand experience of the culture of the
    host country
  • Observe how culture impacts health care
  • Experience health care delivery system
  • Provide health care to families and patients who
    might not otherwise receive care

4
Objectives of the Project
  • YSN mission Better health care for all through
    clinical care, education, scholarship
  • Develop sustainable health services in a stable
    but resource-limited setting
  • Educate health care professionals students and
    local professionals
  • Develop opportunities to share insights about
    similar projects

5
Ground Work
  • Developed contacts in Managua, Nicaragua who were
    instrumental in helping to establish the clinical
    site.
  • Initial site visit
  • Director of Pediatric Nurse Practitioner program
  • Associate Director of the Center for
    International Nursing Scholarship and Education.

6
Needs in Managua
  • Students at La Escuelita
  • Live in Oriental Market district
  • Too poor to attend public school
  • Uniforms and books
  • Family situations
  • Numerous health and nutrition issues identified
    by teachers/parents
  • No regular access to health care

7
YSN Student Selection
  • Application process
  • Good academic standing
  • Completion of Health Assessment course
  • Statement of interest and goals for project
  • Statement of personal contribution to project
  • Past international travel experience
  • Language proficiency

8
Student Preparation
  • Independent study registration
  • Weekly student/faculty meetings
  • Education
  • Student presentations
  • Culture, politics, history, health care,
    educational system
  • Planning
  • Fundraising
  • Goals while at La Escuelita
  • Group reflection time

9
Health and Safety Preparation
  • Meet as group with the Universitys bio-safety
    officer.
  • Fit-tested for respiratory masks
  • Visit the travel clinic for necessary
    immunizations and medications.
  • Prepare to travel to and from Nicaragua as a
    group.

10
Supplies Purchased in US
  • Used money from fundraisers
  • pediatric multi-vitamins
  • skin ointments to treat common skin conditions
  • folders and paper to create a medical record
    for each child

11
In Nicaragua
  • Housed at CEPAD Nehemias Guest House
  • Coyuntura
  • Historic tour of Nicaragua
  • Presentations on health by physician from Accion
    Medica Cristiana (AMC)
  • Tour of Baptist Hospital (this year)
  • Set up the school for the clinical sessions

12
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13
Clinical Education
  • 7 students ( FNP, PNP, 1st, 2nd yrs of specialty)
  • 4 faculty preceptors

14
Goals of Clinical Education
  • Understand cultural context of setting
  • Engage families in Spanish or experience use of
    translator
  • Improve history and physical assessment skills
  • Identify health and developmental conditions
  • Develop acceptable management plans in
    resource-limited setting

15
Innovative Clinical Care
16
Clinical Care
  • Heights, weights, blood pressures and BMIs
  • Vision screening
  • Complete social, health and developmental
    histories
  • Comprehensive PEs
  • Human figure drawings

17
Clinical Findings
  • Similar incidence across three years
  • Respiratory conditions
  • Skin conditions
  • GI conditions
  • Cardiac conditions
  • GU conditions
  • Psych/mental health conditions

18
Goals of Teacher Education
  • Empower teachers to promote healthy habits
  • Hygiene
  • First aid
  • Nutrition
  • Instruct teachers in recognition and management
    of common conditions
  • Skin
  • Respiratory
  • GI

19
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20
Parent Education
  • Asthma care
  • Hygiene
  • Nutrition
  • Safety

21
While Students at Nehemias
  • Daily journaling
  • Daily informal debriefing and reflection sessions
  • Nightly student-led reflection sessions.
  • Final reflection before departure led by Nehemias
    leader

22
Return to the US
  • Met with faculty to have a final reflection
    period.
  • Discussed changes that would enhance the upcoming
    years mission.
  • Submitted a written account of their clinical
    experience.

23
Student Experiences
  • Students commented on the increased clinical
    skills that they gained.
  • I pushed myself to do more than I ever thought
    that I could do. I learned a lot from our
    preceptors who were knowledgeable and resourceful
    in finding solutions.
  • Ive certainly gained perspective, learned how to
    examine patients in less than perfect settings.
    This trip was a lesson in providing the best
    medical care possible despite difficult
    circumstances.

24
Student Experiences
  • Students felt changed by their experiences.
  • The trip inspired me to make a personal
    commitment not to let this be the only time I
    participate in something so wonderful and needed.
  • I hope that I will never forget what I saw in
    Nicaragua and that I can find the strength to
    advocate for children who have no voice. The
    trip to Nicaragua was one of the best experiences
    of my life.

25
Goals for Maintaining the Vision
  • Identify strategies to integrate new awareness
    into personal and professional life
  • Journaling
  • Continued contact after return with students and
    faculty
  • Informal contact among group members
  • Formal focus groups, mentoring groups with next
    group, newsletters, on-going projects
  • Curricular changes
  • Content reinforces themes related to social
    justice
  • Content includes comparative concepts ie poverty
    at home and in international settings
  • Kirkham, Van Hofwegen, Pankrantz, (2009)

26
Conclusion
  • The faculty at the Yale School of Nursing feel
    that adequate preparation is the key to having a
    successful and meaningful travel-abroad clinical
    experience and that there are ways to maintain
    and strengthen insights gained abroad after
    return home.

27
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