Today I spent the day in the Charles Harwood Memorial Clinic, the clinic for the Department of Public Health. This clinic provides healthcare for the vulnerable population of St. Croix, the Community Health portion of which is managed by a Nurse Practitioner. Mrs. Todman sees an average of 12 patients per day, mostly appointment-based with a few walk-ins. I was thoroughly impressed by the amount of patients who complied with the patient education provided by this Nurse Practitioner in their previous appointments. Many of which admitted that he or she would be much less healthy without Mrs. Todman’s education on proper diet and exercise. In addition, I found it interesting that so many of our patients at the clinic were homeless, but I was glad to see that there was a healthcare provider for everyone on the island. Overall, I truly enjoyed my experience at the Charles Harwood Memorial Clinic with Nurse Practitioner Todman.
Alexis and I went to downtown Christiansted to complete our windshield survey. We started by going to the fort. We learned the history of St. Croix and how it was sought after by many countries. The fort had many purposes, mainly of which to protect commerce from piracy. The fort also served as the jail. Our hearts felt heavy as we walked through the fort which consisted of an arsenal, many small jail cells, and a dungeon. Another room in the fort now had a collection of broken china wear, that is known as “chaney”. The term stems from the word “china” and “money”. When the slaves were emancipated, they smashed the china and lit the sugar fields on fire. Today, slivers of chaney can be found all around the island. We continued our day by walking up and down the streets of downtown Christiansted. We counted 6 churches, 9 historical sites, 23 restaurants, 39 shops, 8 corporate buildings, 3 clubs, 3 bars, 1 post office, and 1 police station. Walking the streets and talking to locals gave us an idea of some of the strengths and threats to the community here. A definite strength is the availability of fresh food to the community and very few fast food restaurants as compared to the mainland United States. A threat to the community is the lack of income to some residents. Many residents do not have a primary health care provider due to costs, and are unable to obtain medications for health issues. Therefore, the only maintenance of their health must rely on lifestyle modifications such as physical activity and a healthy diet. We are doing the best we can while we are here to educate the residents about healthy lifestyles. I really enjoyed learning the history of this island and being able to identify strengths and threats to continue to care for the people I interact with here.
From the delightful food, sounds of the Caribbean, and good company, Caribbean night was filled with laughter and some sweet moves. We vibed with the Moko Jumbies, walked it out like granny, and wobbled our way into a night to remember. The event provided a much needed release from our work intensive clinical days. With our departure drawing near, we find ourselves making the most of the time we have left and creating memories we’ll never forget. It’s a bittersweet feeling, but we’re comforted with the thought that we’ll return better Bull nurses.
Today Jessica, Kerri, and I provided a presentation about internet safety and cyberbullying to a group of 6th graders at Alexander Henderson Elementary School. The 6th graders combined classes to form a large group of 50 students for our presentation. When comparing Alexander Henderson to other schools in the area, this school has about 500 students, clean, air conditioned, and built like a school back in the states. The common health complaints (chronic and acute) the nurse receives each day include asthma, headaches, and stomach pain. The nurse also mentioned diabetes and seizures, however those conditions were well managed. We focused our lesson on the key internet safety factors such as keeping personal information (phone numbers, addresses, last names) offline and how to manage cyberbullying. We used a couple fun acronyms to help the students remember the material. The students were interactive and answered questions throughout the presentation. We hope they will take what we taught them today and apply it when they use any social media.
Today I went to Claude O’Markoe Elementary to teach 4th graders about cyber bullying and internet safety. Most of the students already had multiple social media accounts, so this was an important discussion. We went over what to do when cyber bullied, and many of the students already knew how to contact trusted adults. A lot of students had questions, and the school nurse kept an eye on who was asking the most, because they might be getting cyber bullied. We also discussed how to be safe on the internet by having private accounts and not letting strangers follow them on social media.
We taught three classes and they all behaved differently. One class was very involved and well behaved, and another class was well behaved but did not ask as many questions. Another class had a lot of students with ADHD, and it was more difficult to keep them focused. We also had some computer problems in the first two classes, but we did a good job of remembering what was on our PowerPoint.
By the end of the presentation the students knew who to contact if they get cyber bullied. They knew that their parents, teacher, and school nurse could help them. One student asked how the school nurse could help, and we explained that nurses aren’t just for bruises and coughs, they can also help with feelings. We also passed out handouts with a cyber bully hotline and a suicide hotline if they don’t have adults can talk to.
On Monday Erika, Alexis, and I had the opportunity to return to Flamboyant Gardens after our home visits and provide the residents with a health information session about reducing their risk for stroke and heart attack. Despite a smaller turnout, I think those that attended the session really learned a lot about changing their diet and lifestyle.
We provided the participants with a healthy snack of hummus, cucumber slices, cherry tomatoes, and peppers. One of the resident expressed his desire to eat more snacks like this instead of the salty ramen we discussed. We also used visuals to teach about the daily serving size of salt and sugar. Residents were shocked to hear about the amount of sugar in a can of Coca-Cola, more than double the daily allotment!
Erika also discussed the importance of exercising regularly while Alexis explained the meaning of “your numbers,” like cholesterol, BMI, and blood sugar. Overall I think the attendees participated well and enjoyed our talk. They got answers to questions they had after our presentation and even got some nice giveaways! I hope they are able to implement our suggestions successfully and continue to live healthily and happily so they are well for the next group of USF student nurses that visit them!
Coming to St. Croix, I was very excited about the possibility of following a Certified Nurse-Midwife (CNM). The first week, I was able to spend two clinical days with Ms. Thomas a CNM at Fredriksted Prenatal Care. I was surprised to see the variety of issues and questions that the women came with during their appointments, and I saw the diversity of patients and skills the CNM must know to effectively provide care. During the two days at Fredriksted, Ms. Thomas showed me how to measure the fundal height, palpate for the baby’s position, and find the fetal heart rate with the monitor. Along with all these new skills, I was able to observe sonograms, and be with a patient when she found out the sex of her child. Prenatal care was the focus of Ms. Thomas’ daily schedule, but she also had many women come in for well check-ups. During these appointments, I observed Pap smears, and participated in conversations about overall health which included topics such as nutrition, exercise, STDs, medications, and existing medical conditions.
During my days with Ms. Thomas, she learned of my interest in becoming a CNM in the future, and she offered to call me the next time that she delivers a baby. The next couple days I (very anxiously) waited for a call, and much to my excitement, Ms. Thomas invited me to observe a birth! I was able to be with the patient for five hours during her labor and encourage her throughout the whole process. I was also able to see all that the CNM does to prepare for the birth, and learn about possible complications as well as what to expect in the delivery. Finally, the baby was ready to be born, and I watched as a beautiful baby boy was delivered at 6 pounds and 13 ounces! I watched as the nurse and the CNM worked together to check the newborn as well as care for the mom after all her hard work. This experience helped me gain a deeper understanding of women’s health as well as labor and delivery as I witnessed a new life entering the world. The time I spent with Ms. Thomas definitely helped solidify my desire to become a CNM and see the importance of health care in the community setting here in St. Croix.