Getting ready for home

Study abroad began many years ago, when students were learning foreign languages and learning about the cultures they were studying.   I still fondly remember my German professor talking about the trips he lead.

Today, study abroad offices in Colleges and Universities seek to educate and expand the horizon’s of students in a variety of disciplines and specialties.   As nurses, we seek to build relationships with our colleagues in other nations, and to gain a better understanding of the issues we share, and face as a global health care and nursing community.  We, the students and professor have a learned a great deal on this adventure.

We came to Cape Town unsure, but eager to learn.  Some of us had never been outside the USA.  Some had traveled extensively, but no one had been here before.   We saw the oceans and beaches, the wildlife, and wine country.  We studied, and played and the time went by quickly.

The South African’s welcomed us, as they will welcome the world this coming summer for the World Cup.  The nurses, the doctors,  restaurant owners, the University of Cape Town, the town of Rondebosch, the tour guides, and bus and taxi drivers,  all welcomed us.    We were unsure of our surroundings at first, but as we progressed, we learned to survive and even thrive in this place that at first was very foreign to us.  We had adventures, and fun, and we also had some serious study time.

Today was our final class, our final exam.  So, finally the testing is over.  The students have completed assignments and succeeded.   We are beginning to pack and excited for our return home.

However, before we leave, we must thank ALL of our hosts.   Your welcome has been gracious, and your kindness will be remembered.   I think we’ll treasure new friends, and memories of the experiences we’ve shared.  The Cape Town winds, and rain, and warm summer sun will linger in our memories, as will the faces of the children, and people who’ve become so important to us.

Thank you all.  Thank you for the kindness, and hospitality.
We will treasure the memories we hold.

Until our next meeting.

Professor B……….

Last Clinical

On our last day of clinical we ventured over to the nearby Children’s Hospital to work with the volunteers. This hospital is considered to be one of the best hospitals in South Africa and is the only children’s hospital in the country.  In fact we were told, it is the only Specialty Children’s Hospital in Sub-Saharan Africa. As soon as we walked in, we all knew that it was a hospital for children. There was a huge wire elephant, a large giraffe stuffed animal and a mural of other various African animals on the wall. We automatically felt comfortable, especially with our past pediatrics experience that we’ve had at other South African hospitals.

Four of us were assigned to volunteer on the liver and kidney transplant floor that is also combined with the neurology floor. The other twelve students were dispersed all around the hospital on various floors. We saw several patients that were waiting for kidneys and livers and also several patients that had just received transplants. All the transplant patients were on precautions, but all were doing well after surgery. The cases at this hospital were difficult and multidimensional and that was evident.

I spent a good part of my morning with a little boy who was receiving hemodialysis. He has spent all of his two short years in the hospital and is now waiting for a kidney. He is developmentally delayed and cannot walk or talk at all. Regardless, we played all morning with puzzles and games while he was having his treatment. He knew all the nurses and was able to communicate with all of them. He was incredibly happy and cheerful. It was enlightening to watch him all morning.

At the clinic

A few weeks ago I worked in a clinic that cares for an underserved population in a nearby township.  I spent the majority of my time in the exam room with a few nurses watching them perform pediatric assessments, all in Afrikaans.  I was able to get the gist of their conversations based on hand gestures, but I’m positive I could have been of more help if only I understood what they were saying.  I saw a lot of rashes, tonsillitis, strep throat, and respiratory disorders (I listened to some pretty gruesome lung sounds) and was even able to perform a newborn assessment on my own.  I was amazed at the authority given to the nurses working there: they make their own diagnoses, prescribe medications and hand medications out to the patient right in the exam room.  In the U.S., only nurses with advanced degrees would be permitted to perform such tasks.

I’ve also come to realize that nurses here are a little different from the nurses I’ve worked with at home (though this is a sweeping generalization).  Nurses in Cape Town are very maternal, for they are not only nurturing, but also often patronizing – though no South African seems to look at it that way.  It’s my understanding that patients and parents of patients here respect nurses and doctors’ authority to a much greater extent than they do in the U.S.  This makes life a lot easier for the South African medical professional, however it does tend to take away from the patient’s confidence in asking questions or refusing care.  On the other hand, I have seen that nurses here in Cape Town are often more warm and friendly with their patients than the cool professionalism I’ve seen in the nurses in the U.S.  I try to look at the differences I’ve seen here objectively; neither culture of care is better than the other, and we each have our own way of getting things done effectively.  Overall it’s been a great learning experience to recognize the differences and decide what kind of care I can look forward to providing my patients some day.

Snowflakes in Africa

My last day at the hospital has been my favorite clinical day so far.  One of the nurses asked us the previous week to bring in Christmas decorations for the floor.  So we bought some garland and made a bunch of paper snowflakes the night before.  We had Christmas music playing as we cut out the snowflakes, which reminded us all of home and our childhood.  The next day, we brought them to the hospital to decorate.  My patient in the morning was only 6 months old.  So he was too young to be taught how to make a snowflake, since he wouldn’t be able to use scissors.  He was discharged toward the middle of the day though, so some of us showed some of the older patients how to make the snowflakes.  A lot of the parents were interested in how to make them as well, so we taught a bunch of the families.  The nurses thought they were wonderful too.  After lunch we took a bunch that we had made and some of the ones the patients had made to hang up around the hospital.  I don’t think South Africa associates snowflakes with Christmas, but the pretty cutouts looked really nice.  Many of the nurses kept saying how we should color them, or that they would bring in colored paper tomorrow.  I don’t think they realized that the cut outs were supposed to be white snowflakes, but they still looked pretty regardless.  Two of the girls and I made a chain of the snowflakes to hang above the table in the procedure room for the kids to look at.  I had so much fun at then end just playing with the kids and teaching their parents the technique of making snowflakes to bring back home to show their other children.  Not only was today fun but it reminded us of the approaching holiday that we would get to spend with our families.  So the whole day was exciting with anticipation even though it also indicated the end of this wonderful experience in the one of the most beautiful places.

They are why I am here

            My most memorable clinical experience to date happened just last week. I found my assignment for that day in no time, because the children made it so easy. I walked into one of the Wards and saw a group of four children gathered on one of the patient’s beds. There were two boys and two girls ranging from ages 8-11. I think they were all a little shocked and never expected a young American woman to walk through the doors ready to help them. It only took a minute before they all acted like my best friends and warmed right up to me. I had my notebook out to chart on my patient and collect information and I could tell the girls were eyeing my paper and pen instantly. I offered them the notebook to draw pictures if they wanted. To my surprise, they took the pen and began to write me a note. I tried to peak and see but they got all excited and giggly, as they proceeded to hide the paper. Both of the girls wrote me notes saying how much they loved me and thanked me for coming today. They wanted me to come back again tomorrow and drew me hearts and pictures all over the letters. I was so excited and had an instant smile on my face. My presence and company were enough to make them happy, and it meant the world to me. I did my assessments and kept up on my nursing care while also playing with them all. The girls took my stethoscope to listen to my lungs and heart. They knew exactly what to do and asked me to take deep breaths. I then listened to their lungs, so it was all fair and everyone was included. They boys were shy but still engaged in activities and hung around us all day. We then went to the play room at the end of the hall to read a book. Both girls grabbed my arms and held my hands on the walk down, as the boys followed. After we read we went back to their rooms and the girls began to braid my hair. Everyone was having so much fun that they said they wanted to stay in the hospital with me instead of going home. They are the reason why I am here. I am here to make the kids smile and learn while doing so. Seeing the kids so happy made my day and really appreciate what I do. I enjoy clinical so much because I get to interact with the kids of this country and learn about their culture and way of life. We talked about things we both share including music and tv from America that they know of and like. I get to learn from the kids as they get to learn from me. Beyond the culture is the nursing care I am experiencing as well. It is all new information and even more new since I have the abroad aspect as well. I am put in situations that might not happen in the states and appreciate the experience I am getting and what I am learning each and every day.

Celebrations around the World

In the last week of clinical our group was asked by staff members at one of the hospitals to help with Christmas decorations on the pediatric floor. Although we went about our usual two clinical days by choosing patients, identifying interventions for them and providing care, these days offered something more special than we had experienced before. Several of the students in my clinical group purchased garlands and other decorations at the local grocery store, and we showed up to clinical ready to decorate! The nursing staff members were both impressed and grateful at several students’ creativity in constructing paper snowflakes, red and green paper chains that would line the hallways, and balloons of all shapes and colors that were covered in glitter and symbols of the holidays. Throughout the day, staff members joined our group and several patients who were eager to participate. I realized during these two days the power of coming together in celebration, and the many advantages it had to all who were involved. Not only were the staff members happy to have some sparkle added to their work environment, but pediatric patients seemed to forget about their illnesses for the time they immersed themselves in the festivities. Not to mention, all the girls in the clinical group had a great time working alongside our patients and seeing them smile. In a hospital with few toys for the patients, it was great to see that such basic supplies could create the spirit of Christmas and happiness for everyone. Although I am so excited to celebrate Christmas at home with my family this year, I will think of the kids in South Africa and the happiness at the hospital that we witnessed.

Kirstenbosch Gardens

For a number of us, including myself, last weekend was the first time we made it to Kirstenbosch Gardens. The summer concert series began two Sundays ago, so a group of us decided to go to the second one. After arriving there I immediately regretted that I had not found the time to come earlier in the semester. Although I still saw a beautiful variety of flowers, I can only imagine what the gardens looked like in the middle of the spring season. I spent some time walking around the rolling hills and weaving pathways before the concert and took some photos of beautifully colored and shaped flora that I had never seen before. I also did not realize the wide expanse the gardens cover and that I should have allowed for more time to explore. Not only are the flowers and plants enjoyable, but the views of the mountains and lower areas of Cape Town make the gardens one of the most beautiful concert venues I have ever seen. Those of us who went had a great time spread out on the grass with drinks and snacks amongst the large group of hundreds of others who also came to listen to the musicians. There were two performances, which were both thoroughly enjoyed by all. Even though we didn’t know the artists or recognize the songs, we were impressed with their talent and found ourselves swaying, clapping, and sometimes even singing to the music along with the rest of the crowd. I highly recommend going to all the future study abroad nursing students!

Sunsets and Full Moons

We’ve been focusing on studying and school work so we haven’t been able to travel much since our Garden Route trip. We did hike an hour up to the top of Lion’s Head Mountain the night of the 2nd. We went to see the sunset and moon rise. I didn’t expect so many people to be up at the top of the Mountain and was happy that we beat most of the crowd and was able to lay out in a nice spot. We talked, ate, took pictures, and just took in all the scenery while enjoying being and worrying about nothing.

The sight was beautiful. I couldn’t take many pictures because I wanted to take it all in. Soft hues of orange, pink, and purple filled the sky as the sun set over the water and then the lights of Cape Town lit up as night hit and the moon rose bright over the city. In my opinion Cape Town is definitely more beautiful than New York at night. Especially with the magnificent view of Table Mountain lit.

Hiking up was a little scary, crossing narrow ledges and climbing ladders, so I knew the hike down was going to be a challenge especially in the dark. It took us two hours to make it back down the mountain but we did and I definitely felt accomplished after (it was my first hike up the mountain). Even the view from the bottom of the mountain was beautiful. We could see a ring of light wrapped around the mountain from the top to the bottom from all the flashlights of everyone making their way down. It actually resembled a lit up Christmas Tree. Now I have to do something special my next full moon…back home.

~Ashley

Summer Concert in the Gardens

Sunday night, a group of girls and I attended a summer sunset concert in the Kirstenbosch Gardens. We laid our blankets along with hundreds of other Cape Townians on a beautiful, large green that was surrounded by the botanical gardens. Beyond the stage was a backdrop of mountains and sunset to admire as the band was setting up. Many concert goers were eating cheese and crackers, drinking wine, and enjoying the company of family and friends.  Neo Muyanga and Black Sonshine were the opening performers. They performed upbeat South African pop music while the crowd danced and sang along. The second performer, Claire Philips was an amazing singer who displayed a wide vocal range accompanied by her flair on the guitar. She had three back-up singers and a variety of acoustic instrumentalists. The girls and I were dancing to the mix of jazz, funk, soul and folk. We enjoyed the music, the scenery, and the diverse population and culture we embraced together.

Learning about TB-Mennigitis

Clinical has been going wonderful.  With the nurses supervision we are allowed to assist in doing full initial assessments and admitting our own patients.  Recently a little girl was admitted with suspected tuberula meningitis.  This is something we very rarely see in the united states so I was excited to have her as one of my patients.  She had a history of recurrent headaches, a history of TB and vision changes with eye pain.  Upon admission a full set of vitals were taken and a full body assessment was done.  There were no abnormal findings except for what the child reported.  We prepared her for a CT scan, chest X-ray and a lumbar puncture.  As the student nurse I was able to follow her to all of these procedures and provide therapeutic calming talk and encouragement.  She was so brave and did not cry once…not even during the lumbar puncture.  I had never seen any of these procedures done before so everything was a new learning experience for me.  No results were returned while I was in clinical that day, but the next morning everything was back and showed negative results for TBM.  This was thrilling to me because it’s a severe illness and this child was so young.  I continued care for the child who was alert oriented and quite pleasant to be around while the doctors tried to determine what the problem was.  Unfortunately nothing was determined during our shift in the hospital and by the time we returned the following week she was already discharged.  I probably won’t ever see TBM in the US so overall it was a great experience seeing how it would be diagnosed and the eventual treatment.