Tuesday, January 26, 2010

Care in a catastrophe


“Nothing in my life prepared me for what I saw,” says Debbie Abraham of Haiti’s earthquake destruction, seen here in a previous trip to Haiti, assisting an orthopedic patient.


When you land in a third world country to assist with nursing care, you might expect to be surprised here and there. You don’t expect a surprise of a 7.0 magnitude. That is what happened to Debbie Abraham, ’95 MSN, RN five hours after landing in Haiti on Tuesday, January 12, 2010 for what she thought would be another routine service trip to Hôpital Albert Schweitzer (HAS) in Deschappelles, 70 km north of the capital city of Port-au-Prince.

Abraham, a former critical care nurse and nurse educator in the Philadelphia region, resides in Havertown, Pa. with her husband and two children who are in college and high school. She recently returned to Villanova University College of Nursing to earn a post-master’s certificate as an adult nurse practitioner (NP)—she already held a master’s degree from the College in nursing education. Since finishing her preparation as an NP she has been readying for this trip to Haiti before studying for her NP certification exam and seeking a new NP position.

In 2002, Abraham learned of an opportunity to teach CPR to staff at HAS, which serves 300,000 impoverished people in the Artibonite Valley in central rural Haiti. Within days of her arrival seven years ago, she knew she would return. She has done so once or twice a year to do staff education on nursing and health issues as well as assist with patient care in the hospital and its more remote clinics. She is self-taught in Kreyol, the native language, but also uses a translator when teaching. This January trip was to be a two-week stay, involving more teaching and patient care, her first as a new advanced practice nurse. She did not know she would be delivering care and utilizing her fresh skills in the midst of the worst humanitarian crisis in recent memory in the poorest country of the western hemisphere.

Abraham first traveled to the house of friend Zulta, a midwife, in Tabarre, 10 minutes outside the capital, for a two-day visit. She describes the onset of the quake while standing in the kitchen talking about dinner, “I recall hearing a very loud boom, like an explosion, and then literally shaking…as the amplitude got worse, we got the kids and ran out.” Initially unsure of what was happening, she stood outside with her friend and her husband and two small children as people were running, screaming, looking to the sky and singing, praying or chanting. “It was chaotic,” she says. Miraculously, Zulta’s house did not collapse. Abraham became concerned, realizing she was far from family and essential services were wiped out, “The total isolation for me was pretty incredible.” The car radio was operational so they got confirmation from French radio that it was a significant earthquake. They lived through “tremendous aftershocks,” trying to sleep in the car for safety. It is estimated that the earthquake affected approximate three million people and that the dead will number in the hundreds of thousands.

At the request of another friend, Zulta and Abraham set out the following morning to deliver a few supplies from the home to a neighboring area, Delmar, a section of Port-au-Prince that was nearly razed. They brought gauze, sterile gloves, suture material, betadine, ampicillin, ibuprofen, Benadryl, and some food. “The first injury we saw was a partially amputated foot…then a spinal cord injury and a skull fracture,” notes Abraham. Not being equipped for the more serious cases, they began treating abrasions and other wounds, soon reprioritizing how to treat certain injuries and improvising with their quickly diminishing supplies, for instance using the paper from gauze packaging to wipe a wound instead of the gauze itself. After two hours they returned home. As she reflects on that experience, Abraham notes “In 30 years of nursing I never felt so helpless.”

On Thursday, Abraham saw firsthand the situation in Port-au-Prince as they sought members of Zulta’s family. “It was absolutely unbelievable to see the destruction of the buildings, people staking out areas to sleep, and thousands and thousands in the road, walking,” she recalls vividly, along with the odor from the countless dead bodies covered in the street. Later that day she made the long journey to HAS in Deschapelles as scheduled. Largely unscathed, the town had more operational services than the capital and she was able to make an Internet call to her husband following up on a simple one-way text message she sent from Zulta’s house earlier that said “I am ok.”

At HAS, Abraham again pulled on her NP knowledge and skills to triage patients for two days. While the hospital had more resources than most, she still had to be judicious in ordering x-rays and other tests. She would admit patients and write their orders, or prescribe needed medications and discharge them. She estimates 90% of the cases were orthopedic or trauma, especially among those who had arrived from Port-au-Prince. Essentially this was her “first day on the job” she notes, saying she felt confident in her assessment skills but still unsure about some of her decisions since she was unfamiliar with the paperwork and protocols. She did have physicians to call on for consultation, though stuck with her assessment of one woman whom she thought had a collapsed lung, a situation which can quickly become dire. The staff disagreed. Abraham’s suspicions were confirmed by a chest x-ray and the patient was treated appropriately.

Abraham discusses how nursing knowledge and education translate into various situations. “I certainly felt prepared as I had been given the appropriate information (at Villanova) to use; I used my physical assessment course, no doubt about it!” She acknowledges that setting priorities and assessing patients is part of all nursing. She delivered care and medications on the wards to about 150 people a day in her second week in Haiti though she fears she lost count. Abraham recalls it being difficult having people pull on the hem of her scrub pants for help as she stepped around them on the floor to get to someone else. “I went back to them,” she offers. She remains affected by the people “We can’t fathom their daily life…Despite the horrible living conditions and ineffective leadership in Haiti, to see the grace, dignity and resolve with which they live their lives is overwhelming….everyone had someone in their family who was dead.”

With her two weeks completed, Abraham was able to depart Haiti and fly home from the Dominican Republic. She has great respect for the endeavors of HAS and is acutely aware of their need for funding. This is why she tells her story even before getting much rest since her return to the United States just over 36 hours ago. “I felt conflicted about leaving,” she admits. Determined to return to HAS and Haiti, Abraham says firmly “It is my privilege to be able to work there and it will continue. This will not stop me.”

To learn more about Hôpital Albert Schweitzer and its critical needs, visit http://www.hashaiti.org/.

Nurse practitioner student serves the underserved in India


Soon to be a nurse practitioner, Robin Herb conducts a physical assessment on an elderly Indian woman complaining of stomach pain. “They have it right. They take care of each other.”

"Life transforming” is how Robin Herb, B.S.N., R.N. describes a 14-day trip to Puttur, India. From December 27, 2009 to January 9, 2010, the graduate student from Villanova University College of Nursing used her winter break to serve the underserved with a Christian church group based in Mohnton, Pa. to assist the Good Shepherd Mission in Puttur. Puttur is in the southeast area of the peninsula about 2 hours inland from the Bay of Bengal, in the state of Andhra Pradesh. As Herb triaged local residents to be seen by physicians, handed blankets to grateful members of a leper colony who traveled long distances, and helped dedicate a new HIV/AIDS center, she saw the impact on this agricultural community.

Herb is wife and mother from Reading, Pa. where she is also a nurse in a cardiology practice. She is earning her master of science in nursing degree as an adult nurse practitioner (NP). In 2009, friends connected her to the Calvary United Methodist Church which organized the trip with 10 volunteers from all walks of life. She was later struck by how each member of the team was critical to the effort in aiding the Indian population.

Since mission work has been of interest to Herb, she soon began her immunizations against typhoid and hepatitis A, in addition to preventative malaria medication, for the experience. She packed her stethoscope, a blood pressure cuff and an intrinsic sense of cultural acceptance that served her as well as the nursing tools. Herb says one of the reasons she came to Villanova and the College of Nursing was the overall sense of acceptance she felt on campus. “I took that with me,” she says, along with knowledge gained from a recent lecture on cultural sensitivity to NPs by Elise Pizzi, M.S.N., CRNP, assistant professor. Herb said it helped her comfort level while interacting with a community dealing with serious health and poverty issues. “I was not going to try to change hundreds of years of culture,” she explains. She appreciated the balance the people achieved between the Hindu and Indian traditions. “It reminded me of what the College does. No matter what someone’s background, we accept them,” she offers.

One of three nurses in the group, Herb was in constant motion. The Mission has established a hospital with just over a dozen beds. Herb triaged patients there and visited with those who calmly and pleasantly waiting for extended periods of time while sitting on the lobby floor. Women would watch each other’s babies without fear of strangers. “No baby was crying” remembers Herb, as each child was attended by another woman if the mother was unavailable. She also gathered with children from the orphanage on the grounds. Fifty girls sleep on the floor, keeping all of their belongings in a tiny footlocker. As they and their male counterparts get older, they are encouraged to assist the Mission. Many of the staff members there were supported by the Mission earlier in life and stay to give back to the community.

Herb and the group moved out of the compound to make and lay bricks for the Mission’s HIV/AIDS Support Center on the outskirts of town, the closet parcel of land that the community would offer for these stigmatized patients. At the same site, they celebrated the dedication of the facility with music, prayer and colorful decorations provided by area residents.

Herb traveled with others to three remote villages to triage patients for five Indian physicians. One day there were 800 patients who had waited in line. Each was seen. “There were all types of physical complaints,” notes Herb, though many were musculoskeletal problems related to their life of hard labor in the local rice paddies or peanut fields. Many walked for miles when they heard of the scheduled arrival of the medical team. Because of language and resource barriers, Herb was especially grateful for her NP physical assessment skills and the ability to listen (via a translator who spoke the native Telugu) as she obtained a patient’s medical history. Patients were also able to get a few simple medications such as mild analgesics, antibiotics, antacids and skin creams.

“I had not a clue what life was like for them,” states Herb of the Puttur residents who now have a hold on her heart. “They are the most gracious, appreciative people and they have nothing.” After meeting the people with leprosy (a bacterial disease causing, ulcerations, severe infections and deformities) who are considered to be the lowest caste or level in the society, she recalls “They were so thankful for a $2.00 blanket.” What was her key lesson from the people of India? “They have it right. They take care of each other.”

A belated Valentine's Day gift


With Valentine's Day fast approaching, have a heart and offer three people you don't know a gift they desparately need. Participate in the Feb. 16th blood drive sponsored by the College of Nursing's Undergraduate Nursing Senate!


Tuesday, February 16th

11am to 5pm
Dougherty Hall-West Lounge
Appointments preferred (sign up at
www.pleasegiveblood.org/donate and enter sponsor #2031)

For 25 years, the Undergraduate Nursing Senate has been sponsoring blood drives on campus with the American Red Cross. That's a lot of lives saved by the Villanova community.

What happens to your blood? Blood may be used for whole blood transfusions or it is separated into its components including red blood cells, plasma, platelets, and cryoprecipitated AHF (antihemophilic factor). Each component can be transfused to different individuals with different needs. Therefore, each donation can be used to help save as many as three lives.

Who are you helping? Premature infants in NICUs, babies having open heart surgery, people with hemophilia, and trauma, cancer and burn patients among countless others.

You can help three people and give hope to their families and friends by being there February 16th!

Thursday, January 14, 2010

Gearing up for global health


In the face of the tragic earthquake in Haiti this week, we are reminded of the dire circumstances in which many find themselves and the important role that nurses play in delivering health care.

Right now, our students and faculty are prepping for seniors' annual health promotion experiences during spring break week...researching critical health issues in the areas, developing and translating health promotion materials, and gathering vital supplies for basic health care. This year we are returning to Peru, Nicaragua and the Dominican Republic (DR). Here is just one inspiring story from one experience last year in the DR. http://www.villanova.edu/nursing/newsevents/news.htm?page=2009_6_16.htm

Wednesday, January 13, 2010

Teaching Nursing Research to the Twitter Generation



A preconference of the Villanova Nursing Annual Research Symposium

TUESDAY, FEBRUARY 23, 2010 1:00-3:20 P.M.

DRISCOLL HALL AUDITORIUM

2.0 CONTACT HOURS


Dr. Judith W. Herrman, RN, ANEF
Dr. Erlinda Wheeler, RN, CNS


Learn more about the Annual Research Symposium and preconference at www.villanova.edu/nursing/ce/courses.


To register, visit www.villanova.edu/nursing/ce/registration.htm or contact Louisa Zullo, CE Program Assistant, at 610.519.4930 or louisa.zullo@villanova.edu.

College of Nursing Annual Research Symposium: The Many Dimensions of Nursing Research




Tuesday, February 23, 2010
4:00-7:00 p.m.
Villanova Room, Connelly Center on the University campus
2.5 contact hours














Learn more about the Symposium and our Preconference Teaching Nursing Research to the Twitter Generation at www.villanova.edu/nursing/ce/courses.

For pre-registration discount, visit www.villanova.edu/nursing/ce/registration.htm or contact Louisa Zullo, CE Program Assistant, at 610.519.4930 or louisa.zullo@villanova.edu.

Tuesday, January 12, 2010

Blood drive February 16th


Blood drive sponsored by the College of Nursing's Undergraduate Nursing Senate
Recycle yourself! Give blood.


Tuesday, February 16, 2010
10am to 3:30pm
Dougherty Hall-West Lounge


Appointments preferred (sign up at http://www.pleasegiveblood.org/donate and enter sponsor #2031)

For 25 years, the Undergraduate Nursing Senate has been sponsoring blood drives on campus with the American Red Cross. That's a lot of lives saved by the Villanova community.


What happens to your blood? Blood may be used for whole blood transfusions or it is separated into its components including red blood cells, plasma, platelets, and cryoprecipitated AHF (antihemophilic factor). Each component can be transfused to different individuals with different needs. Therefore, each donation can be used to help save as many as three lives.


Who are you helping? Premature infants in NICUs, babies having open heart surgery, people with hemophilia, and trauma, cancer and burn patients among countless others.


You can help three people and give hope to their families and friends by being there February 2nd!

Contact Information: Rose O'Driscoll 610.519.4905 rose.odriscoll@villanova.edu

Save the date! Promoting Dignity through Research-March 16th

Promoting Dignity through Research is the fourth and final lecture in the College of Nursing's 15th Annual Health & Human Values Lecture Series: Promoting Human Dignity Throughout the Lifespan.

On Tuesday, March 16th at 7:30 p.m. in the Driscoll Hall Auditorium, discover how College of Nursing faculty tackle issues critical to human dignity through their research and contributions to nursing science. Their scholarship focuses on abused women, Internet safety for children, osteoporosis in Asian women and men, and nutrition in underserved diabetic pregnant women.

Participating faculty are:
  • Linda Carman Copel, PhD, RN, CNS,BC, CNE, NCC, FAPA
  • Elizabeth Burgess Dowdell, PhD, RN, CRNP
  • Bing Bing Qi, PhD, RN
  • Kimberly Trout, PhD, CNM, RN

http://www.villanova.edu/nursing/newsevents/events/lecture.htm

All lectures are free and open to the community.


Monday, January 11, 2010

What's Bugging your Health: The Health Impact of Pests and Pesticides




Wondering about pesticides in your home environment? Hear from Dion Lerman of the Penn State Integrated Pest Management Program talking about What's Bugging your Health: The Health Impact of Pests and Pesticides" on Feb. 4th, 7pm in the Driscoll Hall Auditorium. All are welcome. Need more info? Contact Dr. Ruth McDermott-Levy at 610.519.6813 or ruth.mcdermott-levy@villanova.edu.