Sunday, January 10, 2016

January 9 Blog -Home Safe and Sound

By: Hannah Hayes

Today was the day that we traveled home. We started out at 6am from the Friedenshaus Hotel School at the St. Scholastica College, Manila, where we stayed the last night. We started that early in case there was traffic, but there was none this morning. We made it to the airport with plenty of time to spare. We took off from Manila at 10:55am in the huge double level airplane (Boeing 747) and landed in Narita, Japan at 4:00pm (local time). We had about an hour to get to our gate. We took off at 5:40pm on Saturday and traveled back in time and landed at 1:45pm on Saturday in Minneapolis. During our flights we enjoyed hot meals, refreshments, and free entertainment like movies and music. Some of us read, others watched movies, and the rest of us slept.

I am glad to report that all of us and our luggage made it safely back to the states and back home. It was bittersweet leaving Manila and our new friends, but everyone is happy to be home safe and healthy. I just want to say thank you to everyone involved with this trip. Thank you to Gina for organizing all of the trip. Thank you to the staff and students at Mary Johnston’s College of Nursing for all your help at duty and the friendships we made. We could have never had all the learning experiences and would have never been able to communicate with our patients without you. The skills we learned from you will change the way we look at nursing forever. Thank you to the friends and families that allowed us to go and those that donated to the trip. Last of all, thank you to my classmates who made this trip a blast. We have built many new friendships and share many memories that will last a lifetime.   

Friday, January 8, 2016

January 8 Blog

By: Amy Campbell

We were all excited to sleep in after waking up at 4:45 in the morning all week for clinical. We said our goodbyes to the Mary Johnston students at breakfast before they started classes for the day. We discussed among ourselves how bittersweet it was to be leaving. We very much enjoyed our time at Mary Johnston and are very thankful for their hospitality. We became good friends with the MJ students however, we are all excited to get back home and see our family and sleep in our own beds! We said our final goodbyes and got on the bus to head to St. Scholastica College Manila, an all women school except for their Department of Music and Fine Arts.  The school has students attending from kindergarten to college.  Like, The College of St Scholastica Duluth, St. Scholastica College Manila is a Catholic institution for women established in 1906 and managed by the Missionary Benedictine Sisters of Tutzing, Germany. We met with the college President Sr. Mary Frances and Virginia Fornias, Vice President of Academic Affairs and received a tour of the school. After the tour, we checked in at Friedenshaus, a hotel on the school's campus. Friedenshaus is the training facility for students who are majoring in hospitality and hotel management. We were served a delicious lunch. We have eaten so well on this trip: three course meals and buffets. It's safe to say none of us lost weight. 

After checking into the hotel and settling in we scampered over to the mall of Asia. The mall was a large as the mall of America if not bigger. The difference was that part of the mall was outside and it wasn't in a square. We wandered around for three hours shopping at culture shops and getting last minute gifts for family. Toria, Nate, and I ate dinner at a sushi restaurant and stuffed our faces. Although we have eaten very well on this trip it was nice to be able to pick our own meals. Some of the Mary Johnston students joined us at the mall. A couple of the guys went ice skating with them. Yes that's right, ice skating in the Philippines. There was an ice skating rink in the mall. The MJ students came to the bus and wished us safe travels and said goodbye.  We gathered up the last of our pesos and gave the MJ students the cash. We then headed back to the hotel to finish packing. A few of us hung out in a room and played cards together for one last night of fun. I personally have enjoyed this trip. I didn't know some of my fellow students before coming on the trip, therefore; I have really gotten to know my classmates and have made some good friends here. We are already talking about a Philippines reunion. I'm sad to be leaving here tomorrow, I have learned so much. I know that I can apply this knowledge to my future career and it has made me more aware of different cultures. I can't wait for my next adventure abroad and learning even more!

Thursday, January 7, 2016

Jan 7 Blog

By: Megan Skorich and Jaime Bridge
Hi everyone,
So unfortunately today was our last day of clinicals here at Mary Johnston Hospital. We were up at 4:30 AM for the last time on this trip (so happy about that) and did our last shift from 6 AM -11 AM. Students came back and had a quick lunch and started setting up for a children's clinic hosted here at Mary Johnston.

At Mary Johnston Hospital today, our students had many new experiences. Here are what a few of the students had to say about their last clinical experience:

"The highlight of my day was seeing a C -Section! I was not scrubbed in but I was able to see the newborn come out and assess it. It was honestly the best thing ever to witness. What a beautiful experience."
-Mariah and Paige

"I had my experience in the ER today. There was one trauma case and I loved the adrenaline and how everyone moved so fast and knew where to go."

"I spent today in the PPU (post-partum unit). My favorite part was bathing a newborn. It was an exciting an experience!"

"Today in the ER I learned new skills such as starting an IV and also I had to deliver a medication by direct IV route. The trauma patient we had also excited me; it was cool to see how the team all worked together to care for the patient."

"Today I hung out with all of the babies! I bathed my first baby. My favorite part was seeing and doing all the newborn assessments."
-Nate (I'm tired/can't write)

"Today I was in the medical ward. Sadly I couldn't visit patients as most patients in multiple rooms had tuberculosis. I helped prepare medications for my shift as well as watched an ultrasound of my patient's heart."

"In the medical annex, we drew up medications out of ampules and vials. In the States, medications are prepared in the pharmacy. It was fun to get experience with ampules."
-Amy and Luke

"The highlight of working in the surgery ward was getting to know the staff members better and learning more about Filipino customs and food."

"My highlight on pediatrics today was taking vital signs manually on 10 young children."

"I spent my day on the surgery unit. My favorite part was learning Tagalog from the staff and patients."

"Today I was in the surgical ward with another fourth year student from Mary Johnston. I took care of a patient with an open cholecystectomy, who had multiple different drains that look quite different than they do in the states. I also enjoyed learning multiple new words in Tagalog to address the patients with. They laughed at every one of my attempts, but I was able to put a smile on their faces"

"I spent my day in Surgical ICU. I was one on one with a nurse and a patient so I got to do a bunch. I was able to deep suction a patient who was on a vent (suction down the throat into the lungs), assist in arterial blood gases being drawn, manually calculate and set the drop factor rate for pain medications, help diagnose my patient with Uncompensated Metabolic Alkalosis, and assist the doctor in taking my patient off of the ventilator and be on close standby as the patient started breathing on his own for the first time in 3 days. It was the most eventful of my clinical days"

One of Mary Johnston's mission is community outreach. The school has adopted a community a few blocks away from the school. Today, there were 60 families represented. We hosted a pediatric clinic here at Mary Johnston, children ages 3-6 from the adopted families came with their mothers. We worked with our Mary Johnston buddies in assessing their developmental level. Each child was assessed on their personal-social, fine motor adaptive, language and gross motor skills. We had around 60 children and their families here today with us. At the end of the assessment, we brought them into our kitchen for a nutritious meal. During that time, we assessed their nutritional status. For example, do they eat lots of french fries or do they eat lots of fruits and veggies? We provided education to the parents about nutrition as well. With donations from the college and CSS students, we were able to provide each child with a pair of flip flops, t-shirt, snacks, toiletries, and a stuffed animal at the end of the clinic. It was very rewarding to see how happy the children and their mothers were to receive these items and care.

To end our night, we had a "going-away" party with the students of Mary Johnston college. It was a night filled with pizza, ice cream, music, dancing and new friends. It was a treat to give the kitchen staff here at Mary Johnston a break from cooking as they have cooked every meal for us while we have been here and also as a thank you to the staff and student's hospitality during our stay. It will be a trip none of us will forget. We believe each student will return to the states as a new nurse and a new person from the experiences given to us here in the Philippines.

A huge thank you to all the parents, everyone involved in the planning, and everyone who was able to make this trip possible. 

Wednesday, January 6, 2016

Jan 6 Blog

Highlights of Clinical Day 3
By:  Aaron Egelkraut., and Kyle McCormick

Today most of us had clinical experiences which created reflections that will stay with us for some time.  We interviewed all of the students and have compiled their thoughts to share here.

ER: Students had two code Blue's ( patient flat lined) in the ER. Doing CPR on an actual person is very different than CPR class.  Code experiences lead to a fast learning environment. Some of the challenges that the students faced were learning about new drugs, and having to draw and dilute drugs from ampules in an emergency situation. In our code carts the epinephrine is pre-loaded in a syringe that you simply pop a top to administer.  Here, we needed to open glass ampules, draw up the dose with a filter needle, change needles and then administer (thanks Sue Mattson and all our lab instructors). This caused for longer times than anticipated to prepare and administer the critical meds.

Medicine: One student noted that the highlight of her day on the medicine ward was starting her own IV line. She reported that the needle system is different than an intracath and this meant she had to adjust her hands and technique from what she learned. She stated that she was extremely nervous to start the task, but once she was successful, became overfilled with joy and confidence in her skills.

Surgery: On the surgery unit today, a student nurse assisted with the delivery of a newborn via a ceasarian section. It was an exciting time for this student as it was his first delivery. He stated that it was amazing to be in the presence of an infant taking their first breath. Other students were able to step in and observe as Gina says "be the plaster on the wall-no talking."

OR: Many students had the opportunity of experiencing at least one of the numerous surgeries scheduled for today. CSS students practiced the night before their sterile gowning and gloving with the guidance of a friendly Mary Johnston student nurse, Kay. Students participated in the surgeries as the role of scrub nurse where they assisted the surgical team such as handing the surgical instruments to the surgeon. In the US,
this role is typically performed by a surgical technician. One of the benefits of an OR assignment is that the rooms are air conditioned! As you enter the OR suite you choose a pair of OR guest slippers which are 'Crocs'.  These are easily cleaned and reused.

Pediatrics/PICU: Students working with the pediatric patients today stated that their favorite part of their shift today were the workers. Mary Johnston Hospital nurses and physicians brought energy and a professional attitude to the unit. They were also very accommodating, friendly, and approachable. Pediatric vital signs are difficult to obtain when the child is crying or distressed.

PPU (Post-partum unit) : On this unit, students were able to bathe newborn babies for the first time. They described the experience as very joyful and  empowering. Another student was able to hold a newborn exposing him to sunlight to decrease the "physiologic jaundice" to facilitate the liver functioning properly. Students assessed the mothers' uterine status, vaginal discharge, and health teachings on the importance of breast feeding.

MICU (Medical ICU):  A new but somber experience for one student nurse was her involvement in postmortem care, watching the family grieve and how the news of death is being delivered by the physician. On this unit, students also experienced new nursing skills they had only read about in their text books.

Labor and Delivery: The students witnessed a live birth and was able to care for mom and baby directly after the event. Some nursing tasks included weighing the baby, measuring, giving shots and clothing the baby.

After our clinical today, CSS students and Mary Johnston students had the opportunity of visiting the Malacanan Palace, location of the Philippine Presidential Museum and Library, and also home to President Benigno Aquino III. According to official history the palace, "Malacanan" meant "place of the fisherman." Visiting the palace was our first time out with the Filipino students. We were really able to bond with our newly made friends as we learned about the history of past presidents of the Philippines. If we had Ronald Reagan in the US, the Philippines had presidents who were also actors in films: Fernando Poe Jr, and Joseph Estrada.  The longest reigning president was Ferdinand Marcos (20 years) who declared martial law in 1972.  He was ousted in 1986 by the People Power led by General Ramos who later became president.  Marcos was exiled in Hawaii and died in 1989.  Lastly, before returning to the college, we all stopped for a bite to eat at a well known fast food restaurant and the Filipino version of McDonald's in the Philippines called "Jollibee". All of us from the States were overjoyed to order a cheeseburger and fries we all had been craving. As we prepare for our last day of clinicals tomorrow, we remember all the experiences we had the last few weeks and are thankful for our opportunities we had with this trip.

Tuesday, January 5, 2016

January 5 Blog

By: Matt P., and Anna B.

Today was our second day of clinical here at MJ hospital. I think we all woke up with much anticipation, while still adjusting to the early mornings to prepare for the day. After eating some delicious breakfast we gathered alongside our fellow MJ students where Aaron, a  CSS student graciously took the role of leading our morning devotion. Next, we gathered into our groups for the day and went to our assigned duties.
Today, several other CSS students and I were assigned to the surgical ward where we really enjoyed working alongside the wonderful MJ students and staff at the hospital, as they were so kind and helpful with our learning experiences. Students on this unit gained more experience with taking manual blood pressure and administering intravenous medications. My highlight of today included having the opportunity with another CSS student to work in the outpatient clinic that hosts the Diabetes Club here in Tondo every Tuesday. We performed many complete blood glucose tests and were able to communicate with patients about their blood glucose readings. We felt so very welcomed there and are grateful to have had the chance to experience the outpatient setting here in Tondo, Philippines.  Some of us were on the Pediatric floor where we took vitals and gave babies their medications.  Those who were on that unit also learned that blood pressure and 02 is not usually taken routinely unless a specific problem is identified with the child.  Others were in the Emergency room, where they performed  several nursing skills where they only had practiced on a mannequin in the skills lab. These nursing skills and interventions include NG tube insertion, foley cath insertion, IV insertion, intradermal skin testing, and more in clinical setting rather than simulation.  A quick shout out to the staff at the ER who were very welcoming and friendly.  I personally was in the Post Partum Unit (PPU).  I learned a lot today; the most memorable moments were watching a newborn being bathed, and assessing the wound and suture of a C-section dressing.  In clinical today, I also learned how to use the charting system, which was a struggle at first because it was on paper form.  It was a struggle at first, using this new charting system, but I got a hang of it pretty quickly.  It was pretty awesome to connect with the Filipino mothers on this floor, and establish a professional nursing rapport with them.  This was not an easy task at first, but as the clinical neared to a close I felt myself become accepted as a nurse to my patients.

Right before lunch the CSS students and the MJ students congregated in the school's chapel, for church service.  The service consisted of introduction, singing hymns, listening to a sermon, the offering, and a final hymn to close out the church service.  The church service occurs three days a weeks at MJ Nursing school.  It also is mandatory for all students unlike at CSS were church service is optional.  The service was very formal, like mass at the College of Saint Scholastica, and it was very fun to sing with our Filipino students/new friends.   After today's duty we got into our "Sunday's best dress" clothing and headed over to meet the President of  Philippine Christian University which is the main campus in which Mary Johnston College of Nursing is a part of. Then, we had the opportunity to go to a restaurant named "Barbara's" that is located in Intramuros.  Our dinner was served as a buffet, and was extremely delicious to say the least!  The food ranged from coffee jello, to salad fixings, to fried and breaded fish.  Sitting with my friends, discussing the amazing food we picked up from the buffet during our dinner was an amazing experience I will never forget.  This is a restaurant that serves a buffet while being entertained by a traditional Filipino dance performance. We learned about the national Filipino dance called the "Tinikling," where two bamboo sticks are used for dancers to jump between following the rhythms of the music. It was a very fun and entertaining show to watch and learn all about Filipino culture. Several CSS students volunteered to perform the Tinikling in front of the audience, which everybody greatly enjoyed.

Monday, January 4, 2016

January 4 Blog

January 4, 2016

-Kim Rice and Jessie Malin

Today we started our clinical experience at Mary Johnston Hospital.  The night prior was filled with anticipation, nerves, and a feeling of walking into the unknown.  We had our breakfast and started our clinical journey with a moment of prayer with the students from MJ. Then, we divided into the groups of people that were assigned to each specific part of the hospital (Post-Partum Unit, Operating Room, Medical Annex, etc).  My group on the Post-Partum Unit started with a quiz and then walked over to the unit to receive "endorsement" or morning report.  We reviewed our patient charts during the preplanning time the next day, so knowing a bit about my patient took some edge off.  To get to know the unit, we all rounded on each patient on the unit, which was nice so that there were no surprises if you got pulled into a room to help with someone else's patient.  It was a very interesting day learning about the different procedures and techniques used during this incredibly sensitive time in a woman's life.  The nurses on the floor were all extremely sweet and did everything they possibly could for their patients (and their babies).  My personal highlight of the day was getting to learn how to bathe a newborn infant.  Not having done it before, I was downright terrified of doing the wrong thing (or dropping him), but the student nurses guided me through the whole procedure and it went very well.  After the hectic night we had, it was easy to get caught up in the anxiety and fear that accompany every clinical experience, but our student nurse partners were like a lifeline and were so understanding and helpful, that it eased almost all of the tension I had.  Some other highlights and reflections from other units included:
Surgical ICU Highlight: working with a patient on a mechanical ventilator
Reflection: Last night was difficult because of the feelings of nervousness, but tonight feelings of confidence and excitement pervade their attitudes.
Pediatric ICU Highlight: Collectively loved working with the little children and working with the student nurses to communicate with the family and other children.
Reflection: Today was calmer than was expected and the staff nurses were so attentive. They listened intently when they ask questions and it is plain that they care about the answers you give.
Post-Partum Unit Highlight: Learning how to bathe a baby, post-partum care and experiencing the different newborn care methods that are common here
Reflection: Some were nervous, some were not, but the overall atmosphere of the unit did a lot to ease the nerves.  The student nurses included us with everything and encouraged active participation, which was intimidating but it turned out well for all of us.
Emergency Room Highlight: Triaging patient's in the ER and assessing which patients were in worse conditions than others and treating them accordingly.
Reflection: Some students felt overwhelmed with our tasks but felt better about our expectations once clinical began this morning.
Medicine Highlight: Learning how to communicate with a patient of a different culture was a great experience for most. Also, practicing skills for the very first time is always exciting! One of our students got to start her very first IV today!
Reflection: Most were very nervous prior to clinical this morning, students stated that they couldn't sleep last night or even eat breakfast this morning because they were so nervous about what to expect out of the day. But today the students collectively feel much better about approaching tomorrow's clinical and are excited for the new experiences that await.
Medical ICU Highlight: The highlight was the patient in general and working with them throughout the day. We are constantly amazed by the strong and intelligent people here and working with them has been an amazing learning experience for all of us
Surgery: Most were excited to finally start clinical! We have been preparing and talking about this for so long that it was so unreal that it was actually happening.
Refection: Students were nervous last night but are more confident in our second day of clinical approaching.
OR Highlight: Being able to observe a laproscopic cholesyctomy and assisting the doctor into his sterile gown and gloves prior to the operation. During the surgery, students were able to hand the surgeon's instruments which is something we have never experienced before.

Overall, today's clinical was an amazing experience for all of us. We are so thankful for the guidance we have received from our MJ partners and staff. We are experiencing a different approach to nursing and learning how to use the equipment that is available to us. The knowledge that we have gained about communicating with patients of a different culture and working with less equipment than we are accustomed to is so valuable for us to take back with us to the states. We are beyond excited for the new knowledge and experiences that await us in the next few days of clinical!