In March, 11 nursing students and one faculty member from Adelphi University in Garden City, N.Y., participated in a global community service program designed and implemented by Dean Della Hudson of the Office of Student Affairs under the auspices of Fundacion Humanitaria as a bed-building initiative.
Fundacion Humanitaria is an organization based in La Carpio, Costa Rica, that houses immigrants from Nicaragua. Part of the community service entails building bunk beds for the community members, working in the school that cares for children of working parents and provision of medical care.
Maureen Roller, RN, DNP, ANP-BC, clinical assistant professor, was the lead instructor who designed this community course. Helen Ballestas, RN, PhD, assistant professor, was the faculty member who participated in the Costa Rican experience in San Jose. The trip helped nursing students learn to strive to identify health issues in their patients to effectively administer care.
Nursing student Denese Wilson said her experience at the clinic in La Carpio taught her the importance of patient education. She worked with a U.S. physician in a cramped room that contained an examining table with a small corner table that had a box of gloves, a thermometer, otoscope and ophthalmoscope.
One of the most memorable moments was at the clinic in La Carpio, Wilson said. We assessed a 22-year-old female patient who was concerned about the pain she was experiencing in the areola. She had given birth about a month ago and her left breast was engorged. The doctor assessed the left breast and there was a cyst beneath the nipple.
While treating the patient, Wilson took the patients temperature and determined she was afebrile. The doctor diagnosed mastitis and prescribed antibiotics and pain medication. Then Wilson educated the patient through her Spanish-speaking partner about using hot-cold compresses, increasing fluid intake, temporarily discontinuing breastfeeding with the left breast and expressing the excess milk.
I saw the need of having a nurse at this clinic, Wilson said. The nurse has an important role in educating patients. Patients need more than prescriptions, but also a holistic approach to their care.
In San Jose, the nursing students toured the main hospital of Costa Rica, which provides only private sector services to the immediate surrounding population and only participates in public healthcare services under emergent situations. They also visited an outreach clinic that provides services under a tier method for locals who cannot afford healthcare. Nursing students saw patients with a physician, and participated in assessments, education and communication in Spanish.
You can see a drastic difference between the private hospital and the clinics, nursing student Grace Poon said. The waiting rooms in the private hospital are practically empty, whereas people flood the waiting room in the EBAIs (Equipo Basico Atencion Integral). These are subclinics disbursed throughout San Jose responsible for sectors of the city.
Nursing student Ayana Culley said she walked 20 minutes away to provide patient care at one EBAI. One of the most impactful experiences I had was how much community outreach the healthcare system has built into it, Culley said. We were visiting Costa Rica during their flu vaccination phase. I was able to shadow a nurse that traveled to the community beginning at 7 a.m. to give vaccines and check blood pressures. The patients are prioritized based on age and co-morbidities.