Day 4: Chief Andrew Isaac

Today the midwife and I both scrubbed in on a C-section that took place in the morning. This was a young mom with an intestinal condition that caused a normal birth to be out of the question. After the C-section took place, the next patient was a no-show (I was told the no-show rate is anywhere from 20-60%, very common, unfortunately, since these visits are so precious).

After lunch we had a 55 year old woman who came in with a myriad of problems. This was her 30^th visit to the clinic in the year 2012. She was a heavy drinker, a smoker, had diabetes and depression, a previous foot fracture that was improperly treated because she refused to wear the cast, she was overweight, and had severe osteoarthritis. She did not make eye contact with me or the midwife at all, which we took as a cultural sign with a woman this age. She told us she had not consumed alcohol the past nine days and had lost a significant amount of weight because of it. I tried to imagine how hard it would be to be living in her shoes.

The next patient was a 44 year old woman who was a quadriplegic with another myriad of issues. She was the SWEETEST lady and her husband was so kind. I got to sit and talk with her about her life for awhile, which was so refreshing, coming from a culture where the doctor meets with you for two seconds without giving any opportunities to ask questions.

Overall I learned that it is very hard to not open a can of worms with patients—that is, I would have loved to just sit and talk with each of these patients for hours but unfortunately time does not allow. In the type of facility such as Chief Andrew Isaac, though, the patients DO get to know their providers on a more personal basis, which is really something I personally advocate for. I believe that these providers see these patients on such a limited basis because of cost, access to care, etc., that the patients need to take full advantage of each visit. This takes participation on both ends. Over 50% of patients at the Center are flying in from remote villages.

It is SO important—key, in fact, to developing rapport with these patients. Trust is the most important factor in the nurse or provider obtaining a detailed history of the patient. It can be a form of stress relief for the patient as well—to have at least one person who truly oversees your well-being. I think this has made a large impact on the kind of setting I want to practice nursing in. Some say nurses are the glue to a patient-physician relationship because they are the ones who spend the most time with the patient. After having done clinicals on the big “floors” in the big hospitals, I discovered (even when I was studying community health and nutrition) that I liked smaller, more intimate settings where I could get to know patients by name and hear their stories. I much preferred that type of environment where I could spend more time putting together a framework for each patient, rather than having more people on a patient list but no trust, no rapport, no time to interact. I continue to be so thankful to God for giving me these wonderful opportunities, to be embedding me in a new culture where I have so many things to learn and so many ways to grow!