Day Seven: Suitcases, Stories, & Sanity

Day 7: Taking it Home

How has this experience shaped my view of nursing? What habits of professionalism will I carry home? How will I advocate differently because of what I have seen? What responsibility do I now carry? What are three specific ways I will continue growing after this mission?

    Honestly, I think this experience reminded me of the real reason why I wanted to pursue nursing, to help people who really need it. I believe in the United States the nursing career carries a lot of weight. We seem to be aware of many issues nurses face each day. Along with these issues comes extra stress, burnout, and at times low job satisfaction. When consistently reminded of these issues and concerns remaining motivated to work and stay motivated to become a great nurse can be challenging at times. Experiencing all the things we did while in Panamá this week was not only humbling, but also a great testament to the progress healthcare in America has made, despite these many challenges. I am motivated to remain inspired, motivated, and appreciative of the resources and care we are able to provide everyday, even on our worst days. 

    The further I reflect on our week spent in Panama the more perspectives I recognize and am able to consider. I learned about professional through my own actions, my peers, my instructor, and the Panamanian people we worked with. It was clear this week that to remain professional, good communication is required, regardless of barriers and challenges. This will serve as a reminder to myself just how important it is to communicate clearly with my healthcare team, clients, families, and coworkers. Another professional habit I will carry home from this trip is respect. When going somewhere so unfamiliar with unfamiliar people, and working towards large goals, it is so important to consider the role respect plays in building relationships with others. From sharing spaces to communicating through translation, keeping our team safe, and even ensuring everyone has a turn in the restroom. Any high tension situations weee often solved by establishing a healthy level of respect for one another, and the real purpose of this trip. I will be able to remind myself of these lessons when caring for clients and their families and working as a team with my coworkers. 

    Due to things I have seen while on this trip I will advocate differently for my clients by ensuring I do not ignore the “small” things. I was constantly reminded why preventative care and easy access to medical supplies is so important. It’s easy to become used to the level of care and resources we have readily available in America and as time goes on the level of importance or urgency seems to decrease. This trip was a good example of a snowball effect in communities that are not so lucky. When even small care doesn’t happen regularly problems increase and become more and more difficult to control. This will encourage me as a nurse to prioritize “basic” cares even in high stress situations. 

    The main responsibility I feel I carry after completing this trip is the responsibility to share what I have seen and learned. By educating others on what I have learned on this trip ensures our impact only continues to increase. We did a lot of amazing things as a group and the work each person contributed deserves to make a lasting impact in as many ways as possible. 

    Three specific ways I will continue to grow after completing this mission include reflection, education, and action. I will continue to grow through reflection by thinking about all we encountered on the trip. Things that could have been better, what made the biggest impact, and what this relates to back at home. To continue my growth in education (in relation to the mission) I can grow through sharing all that I learned with peers, friends, and family. I can also continue to push myself to learn more about the disparities difference’s and medical needs observed while in Panamá. I can continue my growth through action by ensuring I am implementing best practices in care and remaining up to date with any modern recommendations in America. I am certainly grateful for any and all advancements we have made in our healthcare even if we are still far from perfect. 

Day Six: Lessons Beyond the Chart

 Day 6: Cultural Awareness

How did I demonstrate respect for cultural differences? Did I encounter any ethical tensions? If so, how did I process them? What biases or assumptions became visible to me? What did I learn about delivering care with limited resources? How did this experience expand my understanding of health disparities? What will I now question differently in my own community clinical settings?

    I demonstrated respect for cultural differences to the best of my abilities throughout the entirety of our trip. I quickly realized and especially through conversations with our translators realized that the Panamanian people appreciated when people wanted to learn more about their culture and their language. Once I knew that it was not only acceptable to do so but even encouraged, I asked questions as often as possible. This lead to great connections and conversations with many people, and led to a great deal of learning throughout my trip.

    As far as encountering direct ethical tensions I think the main "tension" I noticed happened when comparing differences among our lifestyle in American and the lifestyle and culture here in Panama. When these conversations happened, I processed the information by recognizing how lucky we truly are, and reflecting on habits I may be able to change in my own lifestyle in consideration of these differences. I think some biases and assumptions I noticed included assuming that the people of Panama may not be welcoming right away due to us approaching, being new different people, and not speaking their language fluently. I quickly realized that the attitudes and patience in the Panamanian people is much different than people at home. Yes people took time to warm up to us at times, but in general the people were always appreciative, welcoming, and caring. 

    From delivering care to people with limited resources, it made me realize that great care is still possible. This also led me to realize how wasteful we are in the United States. I think this trip taught me that when health disparities are present and continuing, the level of care, work, and effort to stop them just continues to get more and more difficult. We say many examples of people neglecting serious health issues due to limited resources, financial stress, and lack of education which just causes issues to continue, in not increase. 

    Because of this experience I will now always question my own reactions, beliefs, and attitudes when receiving care in my own community medical settings. I will remain more patient and understanding in appreciation of the care so easily accessible at home, remembering that it is not so easy to come by for many others.         

Day Five: Pulse Check, Developing as a Nurse

 Developing as a Future Professional Nurse

What kind of nurse am I becoming? When did I feel most confident? When did I feel least confident? How did I practice integrity and accountability today? What ethical considerations did I notice? What leadership qualities did I observe that stood out to me?

        I am working towards becoming a nurse confident in the care I provide while prioritizing client comfort and support. With a background in mental health I feel strongly about continuing my compassion towards each client and their background, feelings, and care in general. While I understand why burnout is so common in nursing careers, I hope to always be able to reflect on what I want to offer clients when I care for them, which is to leave them feeling like someone cared enough about their well-being to truly listen to their concerns, get to know them, and truly understand what they are experiencing. 

    Today and in general on clinic days throughout our trip I felt most confident when interacting and entertaining the children. I have always enjoyed working with and supporting children so this felt natural, even when I could not always fully understand them. 

    Today I felt least confident at the beginning of the day. I think this was common for me during this trip as I felt unsure of what the day would hold. Today I was a part of the triage team, which meant I spent the day collecting vital signs for each of the clients who came through clinic. I am confident in my ability to collect vital signs, but with being newer to the healthcare field than many of my peers I was concerned with my ability to keep up with the number of people we needed to get through. As time went on this improved quickly. I realized that even with the language barrier I was able to communicate to the clients enough to complete many vital signs and help our team complete our tasks. Once I was done in triage I was able to spend time with the children from the community of Toza and it was a refreshing change in my day. 

    I think I practiced integrity and accountability today by continuing to help throughout our clinic once my group was complete with our tasks. I remained active and tried to offer assistance as much as possible. I also asked questions if I had concerns at all, like when I had very high blood pressure readings. 

    Some ethical considerations I noticed today include how the children reacted to conversations and items they saw today. Many of the children were more social today with lots of curiosity about our lives, habits, and items. Each and every time they got so excited about learning something new, seeing, or trying something new it was yet another reminder that the lives they live vary so much from ours. Especially in terms of materialistic items, the children here are used to living with only necessities. At home, it is not uncommon to see children carrying around electronics and gadgets of their own while they have overflowing toy boxes at home full of toys that are rarely touched. I also think it was interesting noticing that they have different ranges when looking for hypertension, and just the difference in their outlook on general health in what they should be concerned about and what they seem to not be concerned with. 

    A leadership quality I noticed today was growth. Our group as a whole showed growth in our knowledge and abilities to set up and provide the clinic for the community. I also specifically saw growth in myself through confidence and growth in many of my peers as we navigated challenges, completed work outside of our comfort zones, and completed impactful work alongside one another. 

What kind of nurse am I becoming? When did I feel most confident? When did I feel least
confident? How did I practice integrity and accountability today? What ethical considerations
did I notice? What leadership qualities did I obseeach rve that stood out to me?

Day Four: Healing in Context-Lessons in Cultural Health

 Culture & Global Health

What health disparities did I observe? How did limited resources influence care delivery? What assumptions did I have that were challenged? How does this experience expand my understanding of global health? What strengths do I see in this community? What am I grateful for today? 

    Today was the second day of the Global Brigades Health Clinic in the La Pilares community. I had the opportunity to work alongside Dr. Alberto and was able to learn so much through his insights, education, and translations. 

    Unfortunately, I noticed many disparities among the community too. Through research before our trip I knew that hypertension was a common diagnosis of the Panamanian people, and I saw that first hand today. Each adult that came through was either already diagnosed with hypertension and seeking access to more medications or was on the verge of a hypertension diagnoses. Most other diagnoses that we came across, especially for the children, included complaints that we commonly just make a trip to our medicine cabinet or drugstore for. These complaints included back pain, abdomen pain, headaches, body aches, and common colds. This alone highlights the disparities that Panamanian people face in attempt to receive resources, especially medical resources, even for very simple care. Another disparity that is highlighted by working alongside the doctor is realizing that each client receives an anti-parasitic at least twice a year, due to water contamination. We know and understand the importance of drinking plenty of water here for our health, but this is commonly avoided by the Panamanian people even in their very hot, humid environment. Not having access to clean water, and needing to consider risking becoming more sick from the water to provide their bodies with a basic need is a common consideration they must make. 

    Limited resources influence care in many ways depending on the direct and priority needs of the community needing care. This also creates a natural tension among the people within the community to constantly weigh the risks and benefits of prioritizing access to what little limited resources they can access or receive the food, items, and things they still need to survive otherwise. The Panamanian people are also not used to resources and care being easily accesible so there is a certain level of discomfort and unfamiliarity to receiving care with compassion when they do. 

    Some assumptions I had before today that were challenged include assuming that there would be mostly very serious conditions that have gone untreated requiring attention today. While each and every client did present symptoms that needed addressed, most complaints were very basic complaints that we fae often and can typically just quickly address with over the counter medications. These communities are typically not so lucky. They have to constantly look for the next resource that will provide a refill of the medication that they are needed, or even to receive simple pain relief. 

    This experience has expanded my understanding of global health by showing me how widely different care is in different places. There are comparisons to compare in accessible healthcare from the mountain side to the city here in Panama, different countries near Panama, and huge differences in the modern healthcare we are used to in the United States. This experience also inspires me to not only be grateful for all we have access to at home, but also to learn more about further difference in global healthcare around the world. 

    I truly believe the Panama communities we have been welcomed into are so valuable and inspiring. These communities show what is possible when people come together to provide for one another, even when they do not have anything materialistic to offer. They show strength in supporting and lifting one another up and looking out for one another in ways you just do not see in the United States most of the time. 

    Today I am grateful for all the resources I am able to easily access back home. I am thankful that as a mother if I have concerns I can call, or go to one of the several healthcare facilities in town without barriers like the people of Panama face everyday. Overall, again, I am so thankful for the opportunity to come here and learn about the Panamanian people and their culture but also about all the challenges they face. I am also especially grateful for my support system at home that has allowed me to be here and given me peace of mind by caring for my daughter and allowing me to fully immerse myself in this experience. 

Day Three: Bridging Culture and Clinic

 Day 3: Patients First

What patient interaction impacted me today? How did I demonstrate dignity and respect to others? What did I learn from observing providers? How did cultural humility shape my care? What skill did I strengthen today? What goal do I have for the next day in the clinic setting? 

    Today was our first day of clinic and I am inspired by all I have learned and done already. One patient interaction that impacted me today (although there were many!) was working with a 3 year old boy who was learning through playing with the teeth cleaning toys about taking good care of his teeth. He like many of the other children I interacted with today was very appreciative of the resources, and excited for the opportunity to learn about and show what he knew so far about caring for his teeth. So many times so far we have been reminded to be humble about what we do have east access to at home. As someone who was working at schools with children before coming back to school myself, it is interesting to compare the attitudes and excitement for learning seen in the kiddos I got to work with today,  compared to how children often feel about their learning opportunities at home. 

    A way I demonstrated dignity and respect to others was ensuring if I could not communicate something clearly, I was quick to find and request help from someone who was able to communicate with others well. I worked alongside many members of our team and tried to adjust my role to fill any gaps in our process when needed. I did my best to prioritize care and respect to each client I was able to interact with today. I think that doing my best to communicate in spanish also offered respect and humility to the Panamanian people that they seemed to really appreciate even when I required a lot of patience. 

    

    Something I learned today by observing others while working with the children is how respected and important learning opportunities and school is to them as a whole. We really are just able to observe an entirely different way of life than we have grown accustomed to in the United States. Cultural humility shaped my care today right at the beginning of the day until the end. I quickly realized how badly I required someone who could assist with translation and continued learning about the language, culture, and common lifestyle differences all day long. A skill I strengthened today was my use of spanish, ability to be flexible and confident while acknowledging where my skills may be lacking or leading to barriers, and doing my best to overcome any barrier I do encounter. A goal that I have for tomorrow is to become more familiar and involved with the healthcare provided to the clients, especially since I was so focused on the children and the dental education today. 

What patient interaction impacted me today? How did I demonstrate dignity and respect to
others? What did I learn from observing providers? How did cultural humility shape my care?
What skill did I strengthen today? What goal do I have for the next day in the clinic setting?

What patient interaction impacted me today? How did I demonstrate dignity and respect to
others? What did I learn from observing providers? How did cultural humility shape my care?
What skill did I strengthen today? What goal do I have for the next day in the clinic setting?

Day Two: Bridging the Gap-One Conversation at a Time

 Teamwork & Communication

How did I contribute to the team today? When did I need to step up rather than step back? How did I respond to feedback? Where did communication matter most? What am I grateful for about today?

    Some ways I stepped up (with the group) today include completing the community surveys and preparing the supplies for our day tomorrow. I believe I was helpful to our team through participation and communication both amongst our team and with members of the Toza community. 

    I believe I responded to feedback in a positive way today. There were several times our team members may have been thinking about processes differently and instead of being offended or upset I chose to remain flexible to complete the tasks we needed to acomplish. I beelieve many of us were feeling the lack of rest and travel exhaustion today and at times it was difficult to remain considerate of each other but overall we were successful in completing our tasks and showing one another respect and consideration.

    I think communication mattered most in the time we were completeing the community surveys, but also when planning and organizing for tomorrow. Hvaing solid communication and organization for our day tomorrow will help with continued success ech day of our trip. 

    Today I am grateful for how i am feeling. Today was insughtful, and both humbling and empowering. It reassured me that this community does want us here, and that there are so many amazing people we are going to interact with that have seen and lived very different lives than we have. 

Day One: Traveling Midwest to Mid-Continent

 Readiness & Responsibility

What does it mean to "show up" fully as a nursing student on this mission? What attitudes am I bringing with me? How will this impact others? How can I take ownership of my learning experience this week? What professional behaviors do I want to intentionally model? Why am I grateful for this opportunity? 

    To "show up" fully on this trip as a nursing student I think it is important to have an active presence the entire trip, physically and mentally. Today we physically traveled a very far distance, but it there is also significance in being mentally present while traveling with a group and approaching new experiences. This requires us as students to remain vulnerable, flexible, and ready to learn from every part of our trip. While considering this I think it is important to begin our travels with consideration of the cultural differences we are going to encounter. While we are bringing something valuable to the communities with our knowledge, experiences, and supplies, the people we are working with also carry something so valuable to us students through their lived experience and cultural wisdom. During this trip it is important for us to focus on being a student of the culture, and provider of resources and care. 

    The attitudes I am bringing on this trip include flexibility, ready to learn, and patience. I know that I will need to be flexible and have patience with myself, but also others as we do our best to navigate the unknown times of our adventures. I hope that these attitudes will also be offered to us by the local community as we require patience and flexibilty from them too in order to translate, offer resources, and learn/process what it going on around us. I believe that caring attitudes like these on this trip is how we will be successful in leaving a positive impact on the Panamanian community we visit. By offering patience, flexibility, and ready to learn attitudes we can create lasting relationships with the people here. 

    I can take ownership of my own learning this week by remaining curious/inquiitive. Any chance I am able to ask questions, learn a little more, and break down an understanding of patterns or things I am unfamiliar with I will increase my learning. I can also request feedback, from instructors, peers, and other staff to aim for improvement. I can also remain responsible by continuing reflective learning throughout the trip through blog posts, reflection times, and personal journaling and photos. 

 Some professional behaviors I want to intentionally model this week are adaptability, ethical integrity, and a collaborative mindset.

I am grateful for this oportunity for many reasons, too many to name them all, but the underlying purpose is what I will learn and take away from teh experience. I have always wanted to do something like this, and would love to continue traveling in ways I am actually able to learn and imerse in cultures instead of just doing "tourist" activites. Yes, it feels nice to serve a purpose for the people here but the things we will see, learn, and experience are things we cannot find anywhere else, and I am thankful I get to experience it, and that the Panamaian people are welcoming to our presence.