The International Nursing Experience - Interview with Sivan

Sivan Doron spent Spring Break this year in La Romana, Dominican Republic. Here are some of her thoughts on the nurse midwifery experience:

What did you think of your international nursing experience?

It was an experience who kept me going for a while after I got back. There was a lot to digest.

What did you learn?

I learned about a different culture, about practicing women's health with zero resources. I learned how access to care is not only having services available to you, but also the physical ability to get there. The people we reached out and took care of would otherwise need to cross (by foot) miles and miles of sugar canes to get to the nearest hospital.

What surprised you?

Witnessing birth at a public hospital in La Romana, DR was a suprise and not for the good. One could get over the low resources (no running water in the bathroom, patients providing their own sheets) but doctor-patient power dynamics were hard to overcome.

How did your participation inspire you as a nurse?

I now know how gratifying it is to come with my own philosophy of care and practice it on women that otherwise have limited access to care.

Would you want to do it again? Why or why not?

Yes. Actually after having done that once I feel even more ready to go on and do that again. There's an mandatory "get out of the shock: period in the beginning of every new experience. I'm over that now, I can go straight to work!

Yellow School Bus

This yellow school bus is not your average means of transportation.
It converts to a clinic on wheels!

YSN Midwifery Students in Dominican Republic.

Three New England Universities and 1 Dominican Hospital.
U . Mass Nurse Practitioner and Medical students with their faculty; YSN and Harvard faculty with YSN NM students; Good Sam staff

Patient Screening
Mara Evans and Hilda (interpreter) taking patient histories in English, Spanish, and Creole!

Screening the Patients:
Christy Wilson, Christina Fleming, and the doctor/interpreter screening patients at the back door

“Constructing” our “Exam Rooms” on the Yellow School Bus
Yale Midwifery Student
U. Mass Medical Student

Prenatal exams on the backseat of a yellow school bus!
Christy Wilson doing Leopold’s.

Fetal Heart Rates on a Yellow School Bus!
NM students teaching U. Mass medical student how to find/listen to the fetal heart rate.

Post-Counseling on a Yellow School Bus
Sivan Doron doing WW/GYN/FP post-counseling in English, Spanish, and Creole!

La Romana with YSN Nurse Midwives

YSN Midwifery International Experience

La Romana, Dominican Republic

March 9-20, 2009

Newborn Exam

Sivan Doron, SNM

Gonzalva Hospital

Christy Wilson, Head Nurse, Nurses, Angelina Chambers, Mara Evans

Newborn Assessment

Mara Evans

Postpartum Assessement

Christy Wilson, SNM

Tradional Chinese Medicine - Sarah's thoughts

We did learn some about health preservation today, much of it having to do with balancing emotions, “harmonizing visceral and bowels” (which is related to balancing emotions, as imbalance of emotions can hurt the viscera), and maintaining a balanced diet (with the five tastes, instead of food groups or the food pyramid. The maintenance of balancing Qi and its flow throughout the body is vital to preserving health. Our lecturer explained that being calm, controlling breathing, and balancing emotions are vital to keeping Qi balanced. I love the concepts of Qi and Yin/Yang because they both maintain that balance is vital to a person’s life. I see this in my patients at home and I feel it in my own life.

Sarah Comeaux (TCM Journal March 13, 2009)
Photography by Rick Allen

Traditional Chinese Medicine - Leslie's thoughts

Today was our last day and we spent the afternoon visiting the Haven of Hope Hospital. This was our first visit to the Western Medicine side of a Hong Kong Hospital and it was really interesting to see how similar Hong Kong hospitals were to U.S. hospitals. I thought we were going to visit a hospice and see how TCM played a role in palliative care. It turned out that the hospital had a hospice unit, so I guess I wasn’t completely mistaken.

The tour of the hospice care was perhaps my favorite part of the day. I never worked in or visited a hospice, so this was my first experience seeing one in operation. I thought it was wonderful how the hospice nurses spoke of the importance in getting the patients outside to feel the sunlight and smell the fresh air --- it’s something that we often forget to consider when patients become non-ambulatory or otherwise dependent on machines and devices. The fact that they had designed the ramp to the courtyard to accommodate hospital beds spoke highly of their determination that all patients have the opportunity to spend some of their last days outside the confines of the hospital walls.

Leslie Wheeless (TCM Journal March 17, 2009)

Photography by Rick Allen

Traditional Chinese Medicine - Miriam's thoughts

Today, we had our first clinical site visit to a TCM (traditional Chinese medicine) clinic at Kwong Wah Hospital. This was an exciting day very much filled with interesting interactions and eye-opening clinical observations. Before this trip, I saw TCM as being an alternative way of treating health problems, but I began to think today that TCM may be an "alternative", but it is a very big and important alternative here in Hong Kong.

As we toured the pharmacy, I began to dismiss old ideas I had about TCM. I had seen herbal medicine as being a medicine that was not a science like our drugs/medications. What I saw in this pharmacy was just the opposite. The drugs were not pills, but were specific combinations, personalized for each patient. And, like the pills that we prescribe people in the U.S., these people are given specific instructions about how to take the medicine (ie. how long to boil an herb, or to heat a packet that had already been soaked in herbs). Very impressive.

Miriam Lundy (TCM Journal March 11, 2009)
Photography by Rick Allen

Traditional Chinese Medicine - Susan's thoughts

Our day began with a lecture on the causes of disease. This was a basic explanation of the concepts of excess and deficiency; internal and external forces. The next lecture took place in the Medicinal Nursing Laboratory, which was a room with glass jars full of traditional herbs and various tools for cupping/ moxibustion/ acupuncture on display.

Another lecture was on Chinese diagnostic skills including tongue and pulse assessment. I wanted to continue so we could really have a chance to take and describe each others’ pulses and tongues, but time was too short and we were not able to do more than quickly try each of the pulse machines. After lunch in the staff canteen, we learned about meridians. I love the way various theories are explained in naturalistic terms – rain cycles and seasonal cycles; it makes it really easy to understand.

Susan Wasseluk (TCM Journal March 10, 2009)
Photography by Rick Allen