Atlanta VA

I’m sitting on the 6th floor of the Atlanta VA medical center and as I look out the window I see a marvelous expanse of gray sky, rain, and a parking garage. OK, so it is not nearly as exotic as some of the other locations but we are here and doing exciting things also.

We’ve worked closely with Nurse Executives, Nurse Managers, the VA Quality Scholars, and many in the QI organization.  We participated in leadership meetings, a mock Joint Commission inspection, and have learned about the VA Quality methodology.  The six of us are working on four different projects and I’ll the others talk about their part.  Jonathan and I are working on an Excel file that captures survey data for the Medical Specialty Outpatient group. The file then presents the results using green-yellow-red indicators based on numerical results of the survey. It may sound complicated but it is actually pretty straightforward.

I don’t spend much time with the veterans doing patient care but I do get to talk with them in the halls and elevators.  Every day I walk through a hallway decorated with frames that contain pictures of former POWs and a little bit of their story.  There is another hall that has pictures of men and women who once lived in the Community Living Center that is attached to the VA hospital.  The physicians, nurses, and support staff all seem to straighten up and lighten up a little when they are talking with a veteran.  Despite the headlines and the inanities of the bureaucratic system there are many here who clearly enjoy their work.

I’ve very much enjoyed being in Atlanta over the past days: I’ve spent time with my family including all three kids and Mom came in from Houston.  We ran the Strong4Life Superhero Sprint in Piedmont Park.  I’ve worked a few shifts and I have basically enjoyed sleeping in my own bed.  As a group we’ve gone to eat at Community Q BBQ (twice – we went on Tuesday just to get the “Rooben”) and we ate at Sobban last Friday.

I think that I have learned a lot about the VA, about the health care that they deliver, and the people who are on the front lines of that delivery.  This immersion has changed my perspective of the VA and the people who work here.

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D.R. Day 5 and Day 6

6/4 and 6/5
We got the opportunity to speak with the director of public health as well as epidemiologists in D.R..  It was amazing to see their processes and their passion for truly making the D.R. a better place.  We are in the groove of going to our locations.  We are able to have people switch locations just to get a sense of the two locations.  As you may recall, one location is at the hospital specifically focused on the Canguro program and the other location is at Casita de Salud.  After gathering data and visiting patients at our respective sites, we set off to visit a cacao farm and factory.  It was very interesting to know where cocoa begins.  The factory we visited was filled with cacao that was dried and ready to be exported.Cacao Factory
Here is a picture of the cacao fruit. Cacao Fruit 
We discovered many things including …chocolate wine!!!  We visited to the farm and a feast of snacks awaited us.  The owners gave us a tour and took us through the process of collecting the cacao. We even got to taste some amazing chocolate that literally melted in our hands!
We left there and visited a hospital in the area of Castillo.  This hospital was funded by Taiwan.It was well organized and pretty quiet.  There was one gentleman who had fallen out of a tree and had a hematoma.  He was awaiting transportation to a bigger hospital to get the help that he needed.  Hospital in Castillo
After a long day, we made a stop by one of our favorite places…La Sirena.   In our minds, it is the equivalent of a Wal-Mart!
A few students had the opportunity to go to the hospital to explore the emergency room and to see a birth!  It was a long day.
Today, everyone was focused on getting data at their respective sites. We are now preparing to analyze our data and to determine what else we need to collect tomorrow.  Marielle is also leading us in preparing for our big CPR demonstration tomorrow!  We may be able to attend the neighborhood Zumba dance in the park this evening…but the weather does not appear to be Zumba friendly…
The pictures should be in our gallery!
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Dominican Republic Day 3 and Day 4

6/2 and 6/3
We began our day at the main hospital.  We had the opportunity to meet with the administrator of Hospital San Vicente de Paul.  She answered any questions we had, welcomed us and gave us an overview of the ADAMES.  After meeting with her, we broke off into two groups.  One group would focus on Programa Canguru and the other group would focus on La Casita de Salud in Manhattan (Not NYC).  Due to our meeting with the administrator, the Canguru group did not get to see many women.  They planned to arrive earlier at the hospital to see a typical day from start to finish. The La Casita de Salud group had an opportunity to join the community leaders in collecting census data.  They had an opportunity to learn more about the people of the community.  We all met up for lunch and decided to plan for data collection the following day.  We had to decide what areas we would specifically look more into based on our initial observations and questions.  Two students were able to join a midwife in Labor and Delivery at the hospital.  They were able to see a birth!  Monday proved to be a challenging day as we adjusted to a more rigorous and tight schedule and challenging transportation.
Tuesday flowed much better.  The Canguru group got to the hospital early and were able to see a full day there.  The Casita group began the day visiting an UNAP (Vista del Valle).  This is a clinic that is the closest to Manhattan.  Everyone welcomed us and gave us a tour.  The Casita group went to La Casita de Salud to get a sense of the community issues and the progress or lack of progress of La Casita de Salud. A specific questionnaire was used to collect this data from community leaders and members.  In the afternoon, we were all able to see two more UNAPs.  These two were much smaller than the one we had visited that morning.  We were able to get a sense of the level of convenience to patients as well as the general medical issues of the communities.  We are now making plans for data collection tomorrow.


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Pictures from May 31s

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June 1st: Sunday


It is Sunday in the Dominican Republic.  We went on a trip to Saucedo to the museum to learn more about the 3 sisters who were politically involved in an opposition party against the cruel dictator Rafael Trujillo.  The museum showcased their family home and their burial site.  We got a chance to see the sisters’ lifestyles, collections, clothes, pictures, embroidery and artifacts from their assassination. They were from an affluent family that seemed to be much ahead of their time and very much focused on doing the right thing for the greater good.  The girls were educated and this was uncommon at the time.  Severe punishments were used with any people who opposed the Trujillo government. The Butterflies, as the sisters were called, were very popular with fellow people who held the same beliefs and had seen firsthand the cruelty of Trujillo.  They were constantly thrown in prison and had their belongings seized, but they continued their fight for civil liberties for everyone.  Unfortunately they were assassinated as they returned from visiting their spouses in prison.  Trujillo was assassinated 6-months after the sisters.  November 25th is now known as International Day Against Violence Against Women by the United Nations in honor of the three sisters.
We also visited the area of the family’s first home in Ojo de Agua where there is a monument dedicated to the three butterflies as well as the mangled chassis of the jeep their bodies were found in.  Not too far from here, we got to peruse The Park Ecoparque which is dedicated to the three sisters and features amazing flowers and sayings that advocate for the end of violence worldwide.  Afterwards, we returned to Rosa’s house to an amazing meal of fish, cabbage, rice and beans…and that amazing fresh passionfruit juice that we gulp up by the gallons.  We then began to divide up and repackage the medicine and vitamins that would be distributed in three locations. After discussing the tentative plans for tomorrow, we dispersed for a much needed siesta, some N-Clex studying and some reading.  As we sit here, we are enjoying a breeze and the latin music that can be heard from across the street.  What is it?  It is time for dinner and we can’t wait to see what awaits us…yum yum!
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Welcome to the Dominican Republic

Our flight into Santo Domingo was absolutely beautiful!  After getting our bags, tourist cards, empanadas and some pesos, we were on our way to San Francisco de Macoris.  There was a van…and all of us would squish in for a two hourish drive.  It made for an interesting trip. When we arrived at Rosa’s house, we were relieved to be able to stretch out and we were welcomed to a delicious meal and a home brimming with hospitality.  The students who were staying in other places met their hosts at Rosa’s over food.  We retired to the upstairs porch where we enjoyed a breeze and a random guy playing a guitar.  After a day of traveling, we went to sleep and had brief interruptions of confused roosters at random hours throughout the night and a group of dogs starting their own orchestra.
The next morning, we again woke to a great spread of food.  We crowded into a van and headed to the hospital.  What a culture shock it was for us to see.  The hospital had a home feel to it.  Many family members seemed to have brought items from home and were involved in taking care of the hygiene of their ill loved one.  Everyone was very welcoming to us and we got to see the entire hospital.  Because it was a Saturday, things were not as busy.  We left the hospital and headed to the market.  The market was an experience in itself.  To see all of the fruits, vegetables and spices in a small, but bustling area was amazing and overwhelming at the same time.  We walked back home, but stopped to have juices and smoothies.  We arrived at home for yet another amazing spread of food with steaming hot rice and beans stealing the show.  Many of us needed a quick siesta after that meal!  At about 2pm, we headed in two small cars to the community health center.  Manhattan, and not in NYC, was a completely different world.  The roads were not paved and were rocky and filled with potholes.  The community health center there serves about 600 people in the area and helps with the management of chronic illnesses and general health concerns and directing them to the hospital or clinic.  We were able to visit the neighborhood and visit the homes of patients that had some concerns about their health.  This We were able to try new fruits along the way.  Everyone was so nice.  We left there and went to La Sirena which is like the Spanish version of Walmart.  We ended the day back at Rosa’s with another spread of amazing food.  Today was Christy’s birthday, so we were able to celebrate it with a cuatro leches cake.
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Welcome AMSN 466 Nursing Bloggers

St. ThomasFor those of you who started your adventure today, please continue your thoughts on this site visible only to your fellow classmates!

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