Grace's journal

At Night Camp

When we first arrived to Circle Road, I very soon learned that bug spray was one of the absolute necessities! Today, I was at foot care station. My goal at the night camp today was to familiarize and master foot care as soon as possible! At first, I had to ask a lot of questions – but even before I felt ready, patients arrived to our station and I had to just do it. At first, I stumbled a little trying to figure things out as I provide the care – I even forgot to write down my first patient’s name on the chart that tracks how many people were seen at the station (person in charge was notified of the mistake)! L As I saw more and more patients, I felt more confident in not only providing care but also initiating conversation in my broken Spanish. The hardest part of today’s experience was not being able to speak Spanish. Because most of the adults didn’t speak fluent English, it was hard for me to explain or educate on foot care. One thing I have observed was that the population we saw today was friendly and really appreciated what we do which motivated me (and the others) even more to provide the best care as we can. Although it was hard work physically, I enjoyed from the beginning to the end of the night camp service – and I wouldn’t mind to do it again!

June 10, 2013 (Monday)

In the morning: Community Assessment

This morning, my group and I went out to the community to gather more information on Colquitt County (where Moultrie is located). We were lucky enough to be assigned to Colquitt County so that we didn't have to drive a long distant. This was actually our second time going out for community assessment. We first went to local CVS in order to talk to the local residents but there were no customers yet. So instead, we talked to the pharmacist and his tech. At CVS we learned that some common diseases that they dispend medications for were heart disease, diabetes, hypertension, and mental illnesses. We asked about if they see migrant farm workers at CVS for medications, and the tech replied that they see about 15%-20% of them, and that they generally pay cash for their medications (meaning that they probably don't have health insurance). Next, we went to Beans & Strings, a local coffee shop at the town square to talk to local residents. There, we got to talk to a mom whose young daughter had infant cataract that could only be treated at Emory due to lack of specialists available around Moultrie. After that we made a trip to the department of agriculture where we were able to meet a representative who is doing a study funded by the USDA on child obesity in the local community. According to the representative, child obesity is a major problem not only in the US but also in Moultrie, both in the non-Hispanic/non-migrant farm worker population and the migrant farm worker population.

Night Camp

Tonight, I was at the blood pressure station. By now, I am pretty confident in obtaining blood pressure manually. It was a little crowded and loud so it was a bit hard to hear the S1 and S2 that determine one’s blood pressure. But I was able to hear them with focus with no problem. I tried to apply very limited Spanish words I have learned so far during the Moultrie experience. Although I still couldn’t have conversations with my patients, I was at least able to community in fragmented sentences such as “your blood pressure is high” or “it’s not too high, but a little high.” Due to my limited Spanish skills, I couldn’t give much education on hypertension (it’s mostly the NPs’ role but repeated reinforcement does not hurt but only benefits) other than “lower your sugar, fat, and salt” or “eat more vegetables and fruits.” I’m very sure that these patients probably hear these simple “education” over and over again. Despite the redundant phrases I seem to be saying to each patient, all of my patients today nodded and smiled at my Spanish attempts. Among the patients I saw today, the oldest I’ve seen were in their 40’s; but I also took care of few patients who were of the same age as me or a little older or younger than me. As I took blood pressure of these young patients, it made me reflect that although we are of the same age group, I’m in school to be a future health care provider while they pick vegetables to send money back to their family in Mexico. The thought made me very grateful for what I have and have respect for the young (and old) farm workers who willing to come over to US to work and send money back home for their families.

June 11, 2013 (Tuesday)

In the morning at Cox Elementary School

I struggled to get up this morning. I (and the rest of the team) am so tired especially with assignments and projects due along with providing care day and night, and lack of sleep. At the school, I was at the vision station. Because we are testing young to older children, we have two kinds of tests for vision – typical Snellen chart with alphabet letters and a chart with shapes/pictures for children who don't know their letters yet. I found testing vision on younger children hard because many of them are so young that they don't even know what to call a cross, for example, when we point to it. But thanks to those adorable children, I was able to learn some Spanish words; I now know how to say a heart, boat, cross, star, moon, and hand in Spanish! Many of the children were shy that even if they know a letter/shape, they say it very softly that we cannot hear. So my station partner and I have decided that one person will stay with the child 20 ft away from the chart to repeat back what the child has said. Overall, I had fun at the vision station, especially learning Spanish words together with younger children.

Dr. Freemen Seminar

After lunch, the BSN students had a seminar/lecture to attend. Dr. Freemen was the lecturer and she discussed about ethical concerns or issues about the immigrant status in US. From what I learned today through her seminar, US has a great misconception about “the immigrants are taking our jobs.” Specific to the population of interest of the Moultrie Project, nobody wants to pick vegetables/fruits all day in extreme heat (or cold) for 12 hrs (or more). US is actually making profit off of those backs who are willing to do one of the hardest, unwanted jobs. Moreover, farmers are able to make profit because the workers are undocumented or “illegal;” if we were to legalize the workers and the immigrant labor system, we actually won’t be able to make too much profit. So it is actually very untrue that “the (illegal) immigrants are stealing our jobs” – they are in fact, working to benefit us. Coming to realize this, it saddened me to think that America who speaks of the American Dream to anyone who comes to this country is actually making it harder for some of its new incomers to achieve it. I still think United States is a great nation that opens up numerous opportunities for many people of diversity. No individual is perfect, and thus no country is perfect – but we can always raise an awareness of an issue as a beginning step towards better change.

Night Camp

Tonight, I was at the foot care station. At this station, I soak the patient’s feet while I gather my supplies, then clip toenails, soap, rinse, dry, apply lotion, and then apply foot powder. To some people, foot care may seem like an “un-nursing” task. However to me, it provides the time for a health care provider to really get to bond with their patients. Foot care truly provides room for bonding between a patient and a health care provider because it involves touch, eye contact, and talking. As I sit across from the patient with their foot on my lap, I can’t avoid but to look at the patient and make eye contact when we talk. Often times in a hospital setting, health care providers are so busy with documentations that must be done on computers and scheduled tasks for more than one patient at a time. But during foot care in this project, there is no technology or task-mindedness to distract a health care provider’s attention to the patient. With my very limited Spanish and “Spanglish” at times, I would try to talk to my patients, and I actually got to know some of them well. For example, I got to learn that one patient has his family (wife and 2 baby girls) back in Mexico, to whom he sends his money every month, and that he goes back to Mexico about every 8 months when the peak of harvest time is over. I was able to connect with the vulnerable population of the migrant farm workers despite the language barrier better than with some of the patient I had during clinicals in a hospital setting. I have learned tonight that nursing isn’t all about the tasks or the clinical skills. Just because you don’t know how to put an IV almost unconsciously, for example, does not mean that you are a bad nurse. A nurse should be able to communicate and bond with his/her patients in order to provide the best, individualized care as much as possible.