Blog #1--First Impressions of Panama
My first impression of Panama was of all the construction everywhere around me--at the airport, on the road into Panama City with all the new high rises and road construction, and even at the City of Knowledge they were constructing new places for people to stay. It´s very vibrant with much activity and with not many air conditioned buildings, people were outside in the streets talking, playing and laughing.
Going on the tour of the old city was immensely impressionable, and Bianca had a wealth of information to pass along to us about the people who built up Panama City (the first city built on the Pacific coast in Central America per Bianca) along with those who are trying to restore some of the old buildings. I enjoyed seeing the architecture and beauty of the cathedrals that we visited (Augustinian and Jesuit). Going on to the shore line and walking down along the covered walkway where people were selling trinkets and cultural items was also fun, and it was very hard to resist purchasing a lot of beautiful items.
The tour of the Panama Canal was a wonder to behold. It is one of the most incredible feats of modern engineering that I have ever had the opportunity to observe and just knowing that the Panamanian government has already put into play a massive expansion project using newer engineering techniques was very encouraging because it showed that Panama is truly looking at it´s future sustainability as a modern country.
My very first impressions of Chitre´ are very positive. Being from a smaller town, I am enjoying the atmosphere here more than Panama City. I hope that it continues this way.
The clinic that we went to today was extremely busy when we first walked in but everybody was patient and everybody was taken care of in an orderly fashion with no one complaining about the time it took for them to be seen by the doctors, the dentists, the nurses, the pharmacist or anyone. By the time we left, most of the patients had been seen and gone on their way. Our group stayed with an RN in gynecology and obstetrics. She answered a lot of our questions and allowed us to observe a PAP smear of a young pregnant girl and tomorrow she said we should be able to perform some PAP smears if we are able to reach the clinic early in the day.
I look forward to my next days in the clinic.
Blog #2--posted by Valerie for Valerie, Alicia and me
Blog 2: Alicia Francis, Suzanne Prichard and Valerie Englehart
The central plaza of Los Santos is the heart of the city, it is where there festivals are held and families come together to mingle and connect. Several cafes line the area around and the park in the middle has one gazebo that is the focus. Music can be heard at different times of the day, especially on the weekends and any festival, from children playing wind instruments to adults playing percussion and guitars. Political ideals are displayed on signs around the plaza and politicians both nationally and locally come to make sure their campaign is heard. Political offices also touch the square and provide a central sounding board for the members of the city to have their grievances or requests heard. People from several cities come to Los Santos because on the northern end of the square there is a cathedral that is the largest in the area. It was built by the Spanish in the early 1700s to awe native Panamanians with the splendor of Catholicism. Also, there is a huge police station that is the main police station for Los Santos. As for the connection with technology all buildings have electricity and most have air conditioning. There is free Wi-Fi available in the square for those who have laptops or PDAs and for those who do not there are two internet cafes as well. All the buildings have connection to local water and sewer supplies. The restaurants and buildings also have inside kitchens with stoves that are either gas or electric. Ventilation works through fans, AC or both and is usually good. There is minimal trash in the square and on the streets in comparison to Panama City and certain areas of the USA. The trash is collected by a public service every few days. Families come in groups to the square but mostly men of all ages congregate in the city square and gazebo during the weekends and evenings to talk, to play music and to play games. During the daytime, it is also a hangout for local students after school. The buildings are built of block with stucco, the walls are made of cement or paneling and the roofs are made of zinc. As for insects there are several flies, mosquitos and spiders. There are also several stray dogs with ticks and fleas that wander the streets. There are no rats in the city that we have observed. Health education is prominent with posters displayed and flyers available in local restaurants and at the government offices ranging from HIV to HTN to breast feeding. There are no medical clinics within the square itself. We would improve the square by working with the stray dogs by encouraging the ministry of health to remove stray dogs and cats from within the area. Also, we would promote garbage cans that lock down so that the dogs cannot get into and it would also help with the fly situation because most garbage cans are open or old oil barrels. We also could encourage the homeowners to have screen doors and screened windows to tackled part of the fly and mosquito situations in the restaurants. Also, we could encourage the use of insect replants such as bug lights, citronella and fly tape for those that get past the screens. One other safety issue is the uneven sidewalks that encourage people to walk in the streets, if they were repaved and conformed to the local square instead of individual buildings it would be beneficial to preventing sprained ankles and decrease the risk of getting hit by a car.
Blog Three—What would I incorporate into my practice?
Some of the things that I have learned during my clinical experiences in Panama that I would like to incorporate into my work as a nurse would first of all be to remember that each patient under my care for the day is important. Ensuring that his/her needs are seen to in an efficient and honest manner rather than stating that I will return in a moment and not coming back for an hour. I really enjoyed observing the nurses take the time that was needed to make sure that the patients they were caring for each day had the necessary time taken to accurately reflect what was done for them and striving to make sure all areas of care were completed.
I want to remember how very important patient teaching is for most patients. No matter if the patient has heard it in the past, it is still part of my job as a nurse to make sure that if there seems to be a deficit in understanding to provide the necessary education. The nurses I worked with were calm and assertive in their positions and saw educating the patient as part of their job as a nursing professional.
Another item I am taking with me from my experience is a desire to work with volunteer agencies like the Red Cross to provide whatever assistance I can as a nurse. It was so enlightening to visit the local Red Cross office in the town where we stayed, Los Santos, and see how much work the nurse volunteers provided in times of need. I know that when we were receiving our short training while in the U.S. before even coming to Panama, the Tampa Red Cross volunteers and staff were very informative and stirred a desire within me to want to work as a volunteer with an agency such as it.
Sunday, July 10, 2011
Saturday, July 9, 2011
Alicia's Incorporation of practices
I don't have much experience nursing here in FL yet, but I know I saw things in Panama that I would like to incorporate into my own practice. The first thing I really liked was how personal the relationships were between caregiver and patient. The nurses always took the patient's emotions into consideration and made the patient into more than just a number. The nurses were always making sure that the patient was comfortable with what was going on and with a student in the room. There have been times in the US where I felt that a nurse ignored the patient's comfort and/or emotions. I also enjoyed the amount of education the nurses did for the patients. Most of the education I saw was to mothers about caring for their children and about nutrition.
So the two things I would incorporate would be the compassion shown to all patients and the education to provide primary prevention and make the patients more enabled to make good health decisions.
So the two things I would incorporate would be the compassion shown to all patients and the education to provide primary prevention and make the patients more enabled to make good health decisions.
Alicia's blog number one
Before I had come to Panama, i had never traveled outside the US so I honestly didnt know what to expect the country to be like. I was first struck by how small the airport seemed and how much construction was going on at the airport and in the city. the landscape in panama is very beautiful. I look forward to being able to see the beach this weekend. So far all of the people I've met are very friendly and welcoming, and I feel pretty safe everywhere we've gone.
When we went to old panama city, it was very eye-opening to see the places they live and how simple life is for panamanians. I realized how unnecessary some things are in the US that people worry about. I thought it was neat seeing everyone's laundry hanging on lines because that's not something you see in Tampa. We also got to witness the signs of protest against the construction of a highway around the old city.
I was expecting Chitre to be a lot more primitive than it is. There are a lot of people that live here and the houses look small but cozy. The hotel is a little better than i was expecting, at least we have AC and a hot shower. It has the bare essentials. The man who works at the front desk, Celestimo (spelling?), is very friendly and gives the place a warm vibe to come home to. Chitre is different from the city because it's so small, the buildings are small, most families live in small houses rather than the apartment like living quarters in the city. The community has access to all the things they need.
The university of Panama in Chitre is very small; it seems just as small, or smaller than an average high school in Florida. I'm glad we got to spend time at the University when we did because right now they have elections for the new president of the University going on. I noticed that they put a lot of effort in the campaigning; there are banners and posters covering the school. I look forward to being able to spend more time with the UP nursing students.
When we went to old panama city, it was very eye-opening to see the places they live and how simple life is for panamanians. I realized how unnecessary some things are in the US that people worry about. I thought it was neat seeing everyone's laundry hanging on lines because that's not something you see in Tampa. We also got to witness the signs of protest against the construction of a highway around the old city.
I was expecting Chitre to be a lot more primitive than it is. There are a lot of people that live here and the houses look small but cozy. The hotel is a little better than i was expecting, at least we have AC and a hot shower. It has the bare essentials. The man who works at the front desk, Celestimo (spelling?), is very friendly and gives the place a warm vibe to come home to. Chitre is different from the city because it's so small, the buildings are small, most families live in small houses rather than the apartment like living quarters in the city. The community has access to all the things they need.
The university of Panama in Chitre is very small; it seems just as small, or smaller than an average high school in Florida. I'm glad we got to spend time at the University when we did because right now they have elections for the new president of the University going on. I noticed that they put a lot of effort in the campaigning; there are banners and posters covering the school. I look forward to being able to spend more time with the UP nursing students.
Wednesday, July 6, 2011
Blog 3: Incorporation of Practice
In Panama there is a huge focus on education and primary prevention. I would like to incorporate into my practice the amount of time nurse go over information with their patients. During my clinical experience I watched every nurse go over the entire process of pregnancy, child birth and breastfeeding with women who were coming as little as one month pregnant so that the mother’s would know what to expect for them and their babies and provide for them as healthy an opportunity as possible. I also watched when the vaccines where given to children that the parents were explained the reasoning for these protections. In the clinics there are also flyers on everything from HIV to Diabetes to breastfeeding displayed in ways that are understandable. In the grocery stores that hand out flyers on low salt diets to protect your heart and the importance of well balanced meals. In the USA I have not worked in the community clinics only in the hospital setting so I do not know if the focus is the same as here in Panama, but this is one aspect of patient care I have seen breezed over in the hospital. I will make sure to incorporate the literature to my patients in a way they will understand and make sure they have all their questions answered by me or someone able to competently answer them. The second aspect I would incorporate is the feeling of tranquility and unlimited time these nurses provide their patients. They do not rush them but provide them with their services in a way that makes you feel comfortable to take your time and ponder what you are being told. Even with their caseload and paperwork they manage to take the time needed for each patient. Incorporating this into my practice would help build not only therapeutic relationships but provide a more stable environment for our patients.
Blog 2- The Central Plaza of Los Santos
Blog 2: Alicia Francis, Suzanne Prichard and Valerie Englehart
The central plaza of Los Santos is the heart of the city, it is where there festivals are held and families come together to mingle and connect. Several cafes line the area around and the park in the middle has one gazebo that is the focus. Music can be heard at different times of the day, especially on the weekends and any festival, from children playing wind instruments to adults playing percussion and guitars. Political ideals are displayed on signs around the plaza and politicians both nationally and locally come to make sure their campaign is heard. Political offices also touch the square and provide a central sounding board for the members of the city to have their grievances or requests heard. People from several cities come to Los Santos because on the northern end of the square there is a cathedral that is the largest in the area. It was built by the Spanish in the early 1700s to awe native Panamanians with the splendor of Catholicism. Also, there is a huge police station that is the main police station for Los Santos. As for the connection with technology all buildings have electricity and most have air conditioning. There is free Wi-Fi available in the square for those who have laptops or PDAs and for those who do not there are two internet cafes as well. All the buildings have connection to local water and sewer supplies. The restaurants and buildings also have inside kitchens with stoves that are either gas or electric. Ventilation works through fans, AC or both and is usually good. There is minimal trash in the square and on the streets in comparison to Panama City and certain areas of the USA. The trash is collected by a public service every few days. Families come in groups to the square but mostly men of all ages congregate in the city square and gazebo during the weekends and evenings to talk, to play music and to play games. During the daytime, it is also a hangout for local students after school. The buildings are built of block with stucco, the walls are made of cement or paneling and the roofs are made of zinc. As for insects there are several flies, mosquitos and spiders. There are also several stray dogs with ticks and fleas that wander the streets. There are no rats in the city that we have observed. Health education is prominent with posters displayed and flyers available in local restaurants and at the government offices ranging from HIV to HTN to breast feeding. There are no medical clinics within the square itself. We would improve the square by working with the stray dogs by encouraging the ministry of health to remove stray dogs and cats from within the area. Also, we would promote garbage cans that lock down so that the dogs cannot get into and it would also help with the fly situation because most garbage cans are open or old oil barrels. We also could encourage the homeowners to have screen doors and screened windows to tackled part of the fly and mosquito situations in the restaurants. Also, we could encourage the use of insect replants such as bug lights, citronella and fly tape for those that get past the screens. One other safety issue is the uneven sidewalks that encourage people to walk in the streets, if they were repaved and conformed to the local square instead of individual buildings it would be beneficial to preventing sprained ankles and decrease the risk of getting hit by a car.
Welcome to Panama Blog 1
Welcome to Panama City
Excitement and apprehension is what I felt when the plane was taking off for Panama City. Last time I had been in the country I was in elementary school and from what I remembered it was a country seven years from having the control of the canal returned to them. When I flew over Panama City I saw the new addition of skyscrapers and the stunning contrast of mountains and ocean. I was prepared to witness the growth of the country but the splendor of the city and its modern feel caught me by surprise. We had very little interaction with the local people in the main city but everyone said Buenas when you smiled at them. The old city had the feeling of history and some buildings you could feel the spirit of the past five hundred years seep from them. The old city is also protesting progress that will take away the UNISCO world heritage status and alter the tourism by taking away from the views and removing some of the historic façade of the area. There are several alternations currently being undertaken so they are fighting as adamantly as possible for the government to stop focusing on a road and focus on today where litter cleanup is an issue. In the more modern area of Panama City you feel as if you are walking the streets of Miami or another major metropolitan city. Advertisements for local cultural events clash against posters of youthful activities. The youth have created a city for themselves and the nightlife is thriving in certain areas. The city also boasts unique food dishes that can carter to any culinary palate and provides you with refreshing vegetables and fruit mixtures not seen at home.
Welcome to Chitre
Research of Chitre provided me with a semi-idea of what to expect upon arrival in the city. I knew it was a historic location established in October of 1848 by the Spanish but it also is a surprisingly charming city. It is famous for its beaches that I am looking forward to explore. I also found it has numerous individuals who enjoy talking to you about their culture and would provide you with an open home. The city has all the necessities of life and helps bring to mind a different way of life that is more peaceful and focused with family values. We have been here only a few days but already the restaurant we visited on the first night gave us with a breathtaking view and tasty seafood. The university has provided us with an open location to learn and a view of how democratic the process is for the students and faculty vote for their new university president. The clinic showed me a new insight of medical treatment where services are one dollar each and includes dentists to women’s health to pediatrics’ to general practice. It is a city that seems to have a lot of secrets to discover and we shall see what adventures I will have during my next blog.
Research of Chitre provided me with a semi-idea of what to expect upon arrival in the city. I knew it was a historic location established in October of 1848 by the Spanish but it also is a surprisingly charming city. It is famous for its beaches that I am looking forward to explore. I also found it has numerous individuals who enjoy talking to you about their culture and would provide you with an open home. The city has all the necessities of life and helps bring to mind a different way of life that is more peaceful and focused with family values. We have been here only a few days but already the restaurant we visited on the first night gave us with a breathtaking view and tasty seafood. The university has provided us with an open location to learn and a view of how democratic the process is for the students and faculty vote for their new university president. The clinic showed me a new insight of medical treatment where services are one dollar each and includes dentists to women’s health to pediatrics’ to general practice. It is a city that seems to have a lot of secrets to discover and we shall see what adventures I will have during my next blog.
Blog #1, #2, #3
Blog #1
Today is Monday, June 20th. Spent 2-3 hrs at clinical today. We are now in Chitre, we will visit Panama City again our last weekend in Panama. The people here are all very friendly, fortunately our translators are able to understand them very well. Panama City was much more developed than I had anticipated, with several sky scrapers and hotels. Shonie, who visited Panama City 5 years ago, informed us that about 50% of the city has come up in the past 5 years. The landscape flying in was a vast abundance of forests, and mountains. The landscape was exactly what I was anticipating, as I imagined it to be very similar to Costa Rica. I visited Costa Rica for 1 week over the previous summer. I was informed on our tour that the average Panamanian lives in the governmental housing in the city. I underestimated the heat; walking around on our tour I sweat more than I do running the track and stadiums at home. Life is much simpler here, and helps put in perspective what is really important in life. As for Chitre, I had imagined us to be living in much worse conditions. We do have air conditioning. It is 2 people per room; we have 1 bathroom, a closet, TV, and 2 full size beds. There is lots of undeveloped land, but there are stores nearby, internet cafes, and even a small mall. The University here is very nice, with a tropical feel. They have a library with several working computers, have provided us with a classroom for seminars, and have a nice cafeteria. We aren’t eating the food AT the cafeteria however, because we are supplied a home-cooked meal for breakfast and lunch every week day. The food is delicious and as local as you could possibly find. The food is delivered each day to the cafeteria just for us. Today we also had our first day at clinical. I was at the Social Security Clinical and paired with Shonie in the Women’s Clinic. Mrs. Vivien was nice enough to spend the day in the women’s clinic as she knew the majority of us had never performed a papsmere on an actual human. I performed two papsmeres and did 2 breast examinations. They only took two samples at the clinic, and left out the sample of the vaginal wall. The only woman who had the vaginal wall sample done had a total hysterectomy. It feels great to have accomplished another skill, especially considering that I was most nervous about the Women’s Clinic. After our first day of clinical I am much more excited to be in Panama, I think it reminded me of why I really came. Definitely looking forward to clinical tomorrow!
Blog#2
Our first week was spent at the Social Security Clinic in the town of Chitre, Panama. As we walked in we observed that there were multiple people sitting in the waiting area, waiting for direction. It was a friendly environment and several of the people greeted us saying “Buenas!” as we walked in. There were no magazines or reading material in the waiting room. The majority of the patients were mixed Amerindian and white (Panamanian).There was a pretty good sized open space in the waiting area, although the actual rooms were much smaller. We observed that the majority of the patients arrived by the public bus. We were introduced to Maria, the head of psychology and also the Charge Nurse at the social security clinic. Maria led us to our different sections of the clinic when she was there, and was very helpful as she spoke a little English. Our clinic had three sections we were allowed to be in: pediatrics, gynecology, and injections. Once in our individual sections we noticed that the rooms were air conditioned right away, as the temperature was freezing. The general cleanliness of the clinic was very clean, and it was noticeable despite the old architecture of the building along with the old chairs and furniture. In fact a smell of bleach filled the air as soon as we got off of the bus. Shonie and my first day was in the women’s clinic doing papsmeres. We found the nurse to be very friendly and helpful as she got us in the room with the patient almost immediately. Shonie recalls her saying “To be a good nurse you need practice!” Kayla was with Kristin and Jessica in injections and asked if they could take pictures, keeping in mind we have the HIPPA laws in the US. They were surprised to find that the HIPPA laws did not seem to apply, and the nurses as well as the patients had no problems with pictures being taken. We all were surprised to find the equipment very up to date. In the Injections room we always had the proper size needle, and in the women’s clinic we used disposable speculums. There was one obese woman that I used a sterile metal speculum for. We were also all surprised with the bluntness of the nurses, and heard a couple nurses call a patient fat to their face, with students in the room. We also noticed that women were not ashamed to breast feed their children and would do so openly. We noticed there were health promotion posters covering the walls of the clinic, and while we may have those in the US, the ones at this clinic were much more direct and easier to absorb. The majority of the Panamanian population seems to be Catholic, and I observed a large poster of Jesus on the cross in the injections room. In reference to health and morbidity I did not see many chronic conditions, or communicable diseases. The majority of the people were just coming in for checkups or for their first time. The Social Security Clinic was different than what we expected but overall a great experience. We are all very grateful that we had the opportunity to expand our skills and help the people of Chitre in the process.
Blog#3
My clinical experience in Panama has been one that I will never forget. It is so interesting to get to see how a different country operates in their health care system. There are many differences between the US and Panamanian healthcare. The constant cheerful attitude, endless patience, and bold education are all things that I would like to incorporate into my own practice back in the United States.
Despite how many people were waiting to be seen, or poking their heads in asking if they’re next, the nurses never seemed overwhelmed or snapped at a patient. The nurses that I had the opportunity to work with never seemed to let a persistent patient get under their skin. Not only were the nurses typically very busy, but they also had a student in the room. Considering that I speak a very minute amount of Spanish, we can assume I take up time as if I was an additional four patients. Despite my lack of Spanish, there was one nurse in particular who always took the time to answer any of my questions to the best of her ability. She understood a good portion of my English but spoke none. She would answer my question in a couple different formats, until I was able to pick up enough words to figure out the answer. If I was unable to understand what she was saying after the first two attempts she would often exert the effort to act it out or demonstrate using her hands to help me understand. This particular nurse did this the entire day, smiling back at me and never seeming frustrated. To an extent this reminds of some patients I’ve had at the hospital who may require additional explanation. It reminded me to never get frustrated, and to realize what a difference a cheerful attitude and endless patience can really have.
Another thing that I would like to incorporate into my nursing back into the US is the bold education the Panamanian nurses would give to their patients. There was one example in clinical, in Panama, where a nurse called a patient fat to her face and proceeded to tell her the health implications being her size can have. In the US I have often seen nurses beat around the bush when talking about obesity. While I would never be blunt enough to call a patient fat, I think I will definitely make the extra effort to talk to an obese patient about their weight. They may not know the implications of being obese, or maybe they have heard of some of the implications but never from a healthcare provider. Seeing that made me realize the impact we, as health care providers, can actually have by educating our patients.
Overall I’m not only getting great clinical experience in Panama, I’m also learning new ways of how I can provide the best possible care to my patients.
Today is Monday, June 20th. Spent 2-3 hrs at clinical today. We are now in Chitre, we will visit Panama City again our last weekend in Panama. The people here are all very friendly, fortunately our translators are able to understand them very well. Panama City was much more developed than I had anticipated, with several sky scrapers and hotels. Shonie, who visited Panama City 5 years ago, informed us that about 50% of the city has come up in the past 5 years. The landscape flying in was a vast abundance of forests, and mountains. The landscape was exactly what I was anticipating, as I imagined it to be very similar to Costa Rica. I visited Costa Rica for 1 week over the previous summer. I was informed on our tour that the average Panamanian lives in the governmental housing in the city. I underestimated the heat; walking around on our tour I sweat more than I do running the track and stadiums at home. Life is much simpler here, and helps put in perspective what is really important in life. As for Chitre, I had imagined us to be living in much worse conditions. We do have air conditioning. It is 2 people per room; we have 1 bathroom, a closet, TV, and 2 full size beds. There is lots of undeveloped land, but there are stores nearby, internet cafes, and even a small mall. The University here is very nice, with a tropical feel. They have a library with several working computers, have provided us with a classroom for seminars, and have a nice cafeteria. We aren’t eating the food AT the cafeteria however, because we are supplied a home-cooked meal for breakfast and lunch every week day. The food is delicious and as local as you could possibly find. The food is delivered each day to the cafeteria just for us. Today we also had our first day at clinical. I was at the Social Security Clinical and paired with Shonie in the Women’s Clinic. Mrs. Vivien was nice enough to spend the day in the women’s clinic as she knew the majority of us had never performed a papsmere on an actual human. I performed two papsmeres and did 2 breast examinations. They only took two samples at the clinic, and left out the sample of the vaginal wall. The only woman who had the vaginal wall sample done had a total hysterectomy. It feels great to have accomplished another skill, especially considering that I was most nervous about the Women’s Clinic. After our first day of clinical I am much more excited to be in Panama, I think it reminded me of why I really came. Definitely looking forward to clinical tomorrow!
Blog#2
Our first week was spent at the Social Security Clinic in the town of Chitre, Panama. As we walked in we observed that there were multiple people sitting in the waiting area, waiting for direction. It was a friendly environment and several of the people greeted us saying “Buenas!” as we walked in. There were no magazines or reading material in the waiting room. The majority of the patients were mixed Amerindian and white (Panamanian).There was a pretty good sized open space in the waiting area, although the actual rooms were much smaller. We observed that the majority of the patients arrived by the public bus. We were introduced to Maria, the head of psychology and also the Charge Nurse at the social security clinic. Maria led us to our different sections of the clinic when she was there, and was very helpful as she spoke a little English. Our clinic had three sections we were allowed to be in: pediatrics, gynecology, and injections. Once in our individual sections we noticed that the rooms were air conditioned right away, as the temperature was freezing. The general cleanliness of the clinic was very clean, and it was noticeable despite the old architecture of the building along with the old chairs and furniture. In fact a smell of bleach filled the air as soon as we got off of the bus. Shonie and my first day was in the women’s clinic doing papsmeres. We found the nurse to be very friendly and helpful as she got us in the room with the patient almost immediately. Shonie recalls her saying “To be a good nurse you need practice!” Kayla was with Kristin and Jessica in injections and asked if they could take pictures, keeping in mind we have the HIPPA laws in the US. They were surprised to find that the HIPPA laws did not seem to apply, and the nurses as well as the patients had no problems with pictures being taken. We all were surprised to find the equipment very up to date. In the Injections room we always had the proper size needle, and in the women’s clinic we used disposable speculums. There was one obese woman that I used a sterile metal speculum for. We were also all surprised with the bluntness of the nurses, and heard a couple nurses call a patient fat to their face, with students in the room. We also noticed that women were not ashamed to breast feed their children and would do so openly. We noticed there were health promotion posters covering the walls of the clinic, and while we may have those in the US, the ones at this clinic were much more direct and easier to absorb. The majority of the Panamanian population seems to be Catholic, and I observed a large poster of Jesus on the cross in the injections room. In reference to health and morbidity I did not see many chronic conditions, or communicable diseases. The majority of the people were just coming in for checkups or for their first time. The Social Security Clinic was different than what we expected but overall a great experience. We are all very grateful that we had the opportunity to expand our skills and help the people of Chitre in the process.
Blog#3
My clinical experience in Panama has been one that I will never forget. It is so interesting to get to see how a different country operates in their health care system. There are many differences between the US and Panamanian healthcare. The constant cheerful attitude, endless patience, and bold education are all things that I would like to incorporate into my own practice back in the United States.
Despite how many people were waiting to be seen, or poking their heads in asking if they’re next, the nurses never seemed overwhelmed or snapped at a patient. The nurses that I had the opportunity to work with never seemed to let a persistent patient get under their skin. Not only were the nurses typically very busy, but they also had a student in the room. Considering that I speak a very minute amount of Spanish, we can assume I take up time as if I was an additional four patients. Despite my lack of Spanish, there was one nurse in particular who always took the time to answer any of my questions to the best of her ability. She understood a good portion of my English but spoke none. She would answer my question in a couple different formats, until I was able to pick up enough words to figure out the answer. If I was unable to understand what she was saying after the first two attempts she would often exert the effort to act it out or demonstrate using her hands to help me understand. This particular nurse did this the entire day, smiling back at me and never seeming frustrated. To an extent this reminds of some patients I’ve had at the hospital who may require additional explanation. It reminded me to never get frustrated, and to realize what a difference a cheerful attitude and endless patience can really have.
Another thing that I would like to incorporate into my nursing back into the US is the bold education the Panamanian nurses would give to their patients. There was one example in clinical, in Panama, where a nurse called a patient fat to her face and proceeded to tell her the health implications being her size can have. In the US I have often seen nurses beat around the bush when talking about obesity. While I would never be blunt enough to call a patient fat, I think I will definitely make the extra effort to talk to an obese patient about their weight. They may not know the implications of being obese, or maybe they have heard of some of the implications but never from a healthcare provider. Seeing that made me realize the impact we, as health care providers, can actually have by educating our patients.
Overall I’m not only getting great clinical experience in Panama, I’m also learning new ways of how I can provide the best possible care to my patients.
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