My First Post

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Posing outside the Hospital de Dia which is a day program for psychiatric patients in Talca, Chile.

Today was a long and tiring day. We went to the same outpatient facility as yesterday and we sat in on psychiatric appointments which involved a psychiatrist, a nurse, a psychologist, a social worker and a paramedic (similar to an LPN in Chile).

Patients were interviewed about their symptoms and after a discussion between the patient and the healthcare team, a plan was made and medications prescribed. Some patients proceeded into the exam room for injections of longer-acting psychiatric.
There were a few things that really captured my attention today. The psychiatrist, Dr. Sjoberg, told us he likes to work with the nurse and social workers, etc. as a team because they can work as a cohesive unit making suggestions to each other with thenotion that someone might miss something and the other providercan point those things out to their colleagues if something the patient says or does goes unnoticed.
I admired the teameffort and attitudes of the peopleI met today. I also liked how welcoming the staff was at the clinic. They were understanding and patient with me when I spoke slow, broken Spanish and they really tried toget to know me and the other students.
We all sat down and ate a mid morning snack including the psychiatrist. I was surprised that as a doctor he took the time to sit down with us and happily answer any of our questions. I feel like that would rarely happen in the U.S.
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Students with new friends from the Hospital de Dia.
Today, like every other day we have been here in Chile, we were forced to challenge ourselves and use the little Spanish we know in order to communicate with our new friends at the clinic. They reciprocated this effort to us by trying to speak some English (those of them who knew any). I feel that psychiatric health is a priority here in Chile and I am happy about that. The staff at the sites we’ve visited seem very passionate about what they do and caring toward the patients.
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“Creando lazos” (creating bonds)

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Allison Read and Sarah Post pose next to earthquake damage in Talca, Chile on their way to the clinic.
Today was our second day of our Talca psychiatric experience. First stop on our list was an out-patient psychiatric clinic. Our expectations were to observe multiple meetings between doctors/nurses and patients, however there was much more depth to this facility. At first we arrived at the wrong clinic (story of our trip). However it gave us the chance to explore and observe another area of Talca. We walked a few blocks to the correct location, and saw sidewalks made of crumbled stone with high curbs. Although it was good that they had sidewalks, they were not safe or desirable for those handicapped. We also noticed some buildings and houses that were more wealthy, as well as many that were poor and/or damaged from the 2010 earthquake. There were cracks in homes and chunks of walls and roofs missing.

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Earthquake damage to a church in Talca, Chile.

So far every facility we have been to has been temporarily moved due to their previous location being destroyed in the earthquake. The staff mentioned how it took a while to find somewhere, and until then they were giving care on the street outside of their damaged clinic. Despite the deconstruction, there was signs of hope that the community will rebuild. We observed a few construction workers. We also observed a playground/park. It was very clean and well maintained. We saw a woman watering the garden. We were comparing this playground to some of the not so well maintained playgrounds in the United States.

Initially we thought our destination was a house (which it was previously), and we thought we were once again lost, however we saw the nurse wave at us confirming we had the right location. We met the staff and some of the patients, and took a tour around the facility. We noticed a pool, and at first we were concerned for the patients’ safety. We also noticed a courtyard, kitchen area, dining hall, main gathering hall, exam rooms, intervention rooms, and even met their clinic’s therapeutic dog and kitten. The facility was very clean.

We joined the patients in morning exercise, which nine patients and two staff members attended. The nurse says they usually have 10 – 15 patients there each day for their daytime activities. Some patients come every day and stay all day, some a few days a week, some occasionally, and some come only for their medications or meetings with the psychiatrist.
The exercise was an energetic way to start the day while focusing on range of motion and deep breathing. After exercise the patients had breakfast. A part of the routine of this facility is to involve the patients in daily activities and management of the facility. The patients all have rotating each day. Some assist the staff members with cooking breakfast or lunch, some help clean, and others may help take care of the dog. There is a wide range of duties. The nurses, the social worker, the psychologist and other staff members stress the importance of the patients being involved as well as rotating the duties to ensure and promote independence, confidence and meaning to their days.

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Katerina Kafkas with Luna the “pet therapist”.

After the patients’ breakfast, the staff graciously organized a tea time gathering for us students and our professor. They were very generous and welcoming. After getting to know everyone better, such as their professional roles and responsibilities, we moved the the main lounge where one rotating staff member (the facility really enjoys rotating the duties among the patients and staff) debriefs the patients on the day’s work. This is where they decided their daily roles, as well as discussed upcoming events including their field trip to the beach. From here the patients had some art therapy involving newspaperclip outs,drawings, writing, etc. We joined the patients during their activity and were able to get to know them better.
We had a great morning at a great facility. The staff members were incredible and well-educated on the aspects of patient and staff relationships and patient well-being. They deeply cared for their patients and worked hard to provide individualized care to each patient and their families. It was a great experience overall. We gained a lot of respect for the facility and staff.
Sorry for the delay of blogs, wifi is sensitive here in Talca. Stay tuned to hear about our trip to the University here and another day of psychiatric experience!!
Sincerely,
Sara, Mariah, and Sarah (the mariah sandwich roomies)

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Talca Nursing 101

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Sarah Post and Sara Pietila in the anatomy lab.

n Tuesday afternoon we were very fortunate to meet and talk to the Dean of Nursing at Universidad de Catolica. We learned that their nursing program is 5 years and there is a HUGE focus on science… and we complain about our 4 year program. We discussed the curriculum and learned that they have similar clinical rotations and that their 5th year is a unpaid nurse residency. Currently there is no nationally recognized nursing boards but it is in the developmental stages. Class size is small with a max of 35 students in a (large) lecture, and there is a 1:4 faculty to student ration during clinical. We toured the classrooms and were surprised that they had simulation models due to the expensive price. The rooms were also equipped with smart boards and lecture capture technology. Come to find out the nursing department received a large government grant.

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Jenna Connolly checking out the nursing lab.

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We continued our tour and ventured to the anatomy and physiology lab where we were once again shocked by how advanced the labs were. The labs contained numerous models and diagrams, but what was most surprising was the adult cadavers and fetuses. The anatomy professor was very accommodating and enthusiastic. He was more than happy to go through a brief lesson of anatomy with the cadaver, and then allowed us to touch and explore on our own.The upper classmen taught Sarah (a sophomore) and Javi (our interpreter) how to put on sterile gloves.

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(l-r) Sarah Post, Sara Pietila & Mariah Wentworth prepare to examine a cadaver.
We wrapped up our tour and headed back to our hotel on the city bus. Although we did not have the opportunity to interact with the students we still felt integrated in the university.
Overall we were very impressed with the university and curriculum. The faculty we met are very compassionate, knowledgable, and personable. We felt welcomed and would love the opportunity to strengthen the bond between university and possibly someday have an international nursing exchange program.
<3 Sarah Mariah Sara (the Mariah sandwich room).
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A round of applause for Chilean Nurses

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Henson Phan plays with Luna who is the “pet therapist” at Hospital de Dia.

After spending the day in Talca and visiting a psych hospital; I have much respect for these psychiatric nurses who are taking care of these people.

Our first visit involved an inpatient psych facility that housed A LOT of patients. We were supposed to arrive at the location at 9 a.m., but ended up being there at 8:30 a.m. I learned that it was rude in Chilean culture to arrive early, but the staff welcomed us with open arms. A security guard welcomed us by opening the gate that led to the facility. After coming inside the gate, we were welcomed by 3 or 4 patients who were getting some fresh air. All of these patients were most likely above the age of 60, but they all shook our hands and gave us kisses on the cheek. The first thought was “I am in a psych facility. You aren’t supposed to touch the patients; we were told not to in America,” but these patients were so kind that I didn’t feel an ounce of danger. Besides, kissing on the cheek is a way of greeting here so its not like they’re intending to invade personal space.

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Earthquake damage at a historic church in Talca, Chile.

After, we met with more patients, younger patients who have been in the (temporary) inpatient hospital for more than 30 days. The earthquake destroyed the main hospital so this inpatient hospital is actually temporary. Many of these younger patients’ ages ranged from 20-50 and they suffered from depression. Regardless, everyone was interested in talking to us and asking us about the American culture such as music (they all thought that Lady Gaga was “loco”) and movies. The patients seemed to have a good relationship with the nurses. The patients sat in this large recreational room/dining room on these black couches with the nurses sitting directly next to them as if they were friends. This bond that I saw between the patients and nurses did not match what I saw back in the U.S. during my psych clinical rotation. From my experience in the U.S., it seemed like the nurses and psych patients always kept their distances. The depressed patients were always quiet, and I would always struggle to get a word out of them. Finding out that these Chilean patients were admitted for depression surprised me since many were smiling and talking up a storm.
Later we went to a different part of the building where they held many of the geriatric patients. Most of these patients did not have family who visited them, but according to the staff,Chileannursing students and others wouldvoluntarily come visit the patients on their free time. All of the geriatric patients were very kind and I probably shook about a million hands within a period of 15 minutes. All the patients came up to us holding our hands, putting their arms around our shoulders. Every one of the patients had the biggest smiles plastered on their faces. “Momma” Val even made a new friend when one of the patients followed her around for an hour holding her hand and calling her “mami.” The most amazing thing about this is the fact that there is only ONE nurse taking care of these 80-something patients. ONE. How? I don’t even know. Maybe the Pisco Sours here in Chile gave this nurse super multitasking powers, but I would never be able to handle over 80 patients every day at work. Somehow, the nurse working in this facility makes it happen, and for that, I applaud him.
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Bienvenidos a Talca

Welcome to Talca! And clinical! A lot in 24 hours, right? We arrived yesterday a little after 5 p.m. and headed straight to our hotel, which looks like something out of a 50’s Humphrey Bogart movie. It was hit hard by the earthquake a few years ago and is still recovering. We are one of the only people here!

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After we got settled, we walked to a famous local restaurant for dinner. Well, after walking the diameter of Talca, getting lost several times and being followed the entire way by a stray dog, we finally arrived at our destination. The food was delicious and cheap too!
Today, we went to the psychiatric hospital for the first time. The facility looked surprisingly similar to psych hospitals in the U.S. We sat and talked with several of the patients and then sat in with a doctor doing his walking rounds. Later in the day, we went to the geriatric psych section and got a tour from the charge nurse. We were allvery impressed with the care of the geriatric patients at the hospital. Out of 81 patients, only one of them had a pressure ulcer!
Today was exhausting (between walking around the psych facility and attempting to translate Spanish), but it was definitely one of the most interesting days we’ve had so far. It was so cool to be able to see how other countries handle mental illness and patient care. We cannot wait to go back tomorrow!
P.S. This blog was supposed to be posted on Monday, but the wifi at the hotel stopped working…
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Oh The Places We Go

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On Sunday we packed our bags to begin our departure from Santiago to Talca. After spending a few days in a developed city we were eager to experience a developing community in Chile.

We liked Santiago, and there were differences, but it felt like a city from home. Although we were experiencing a lot of cultural aspects of Chile our hearts yearned for a community in need. Before leaving the USA we spoke so much about the destruction that remained from the earthquake in 2010, however, for the most part Santiago was rebuilt and we did not truly see any remaining aftermath of the earthquake.

After our 3 and a half hour bus ride we were more than thrilled to stretch our legs and explore the community of Talca. Leaving the bus terminal was an eye opening experience. Right away we saw a difference in the economic status of the citizens. The people of Talca were no longer dressed in suits and business attire but rather everyday, blue collar working clothes. The buildings were smaller, and more simple, but there is a bit of wealth throughout the town.

We checked into the hotel we discovered it was far less lavish and the residents of Talca are more welcoming and friendly. After we unpacked we went on an adventure to find it first traditional Chilean meal. What was supposed to be a 15 minute walk, became an hour and 45 minutes. To be honest the extra long walk was definitely worth it. The walk gave us an incredible opportunity to observe the development of a town.

There were numerous homes and businesses with large cracks in the foundations, destroyed roofs, broken windows,and completely crumbled walls. The destruction was heart breaking. As we continued to walk we saw some incredibly poor homes hidden along the riverbank. At one point we saw a bridge that an entire section had fallen, but in the other direction there was a beautiful river, glorious mountains, and people celebrating.

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These people know how to cherish life and be grateful that they are alive. They were more than happy to give us directions even if they were not accurate on the time it would take to get there. The road that led to the restaurant was an old dirt road compared to the cement sides walks we had been traveling on. We were told we needed to travel up the narrow hill that had no side walks and quite a bit of traffic. We asked yet another local and they told us we climbed this hill for nothing, because the restaurant was on the bottom of the hill next to the riverbank. We FINALLY made it to the restaurant and enjoyed an amazing traditional Chilean meal.

Instead of another adventure back we called a taxi so we did not half to walk in the dark. Overall our first day in Talca was overwhelming, but good. I truly made us appreciate all of the amenities we have at home.

<3 Sarah Mariah Sara (Mariah sandwich room).

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Exploring the City

Nursing students stand with statues for a photo op in Santiago, Chile

So far so good in Santiago, Chile except for my awful cold (thanks fellow sick co-workers). We have not ran into too many problems, beside getting lost…A LOT. However, we are getting much better with the buses and subways. I do not ride public transportation much back home, so I cannot accurately compare the two, but we have had an abundance of transportation available to us here in the city. The city reminds most of usof a Boston or New York. We are excited to travel to Talca today, to see how those in the suburbs live.

Yesterday while exploring the city we discovered a nursing store. It was closed so we could not enter, but we were peaking through the glass to see what they had. Across the street we also found an orthopedic rehabilitation center. We hadn’t seen any of those yet, so that was nice to see. Throughout the streets we have seen a lot of people in wheelchairs, and several amputees. There has been a mixture of handicapaccessibleareas. The public transportation does a good job, but other local streets do not.

Nursing students pose on rooftop in Santiago, Chile
We have also been enjoying using ourSpanish Javier, ourliaisonhas been very helpful. MySpanishis decent so I have been enjoying using mySpanishskills with the locals. The other students at first were asking for help or translation with everything by Javier, Alli or me. However it has been great to see them gradually ask us less and try to communicate on their own.

Awaiting the bus journey to Talca, Chile

We are off to a 3.5 hour bus ride, where we are looking forward to seeing a contrast of Santiago. Ourhospitalexperience begins on Monday. We arealleager but nervous for the hospital. We are not sure if we will have wifi or a computer yet, but we will see how it goes!!

We will try to keep you all updated!!

Sincerely,
Sarah Post

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A history lesson in Chile

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I’m not going to lie, even though its only been a few days, I do miss my American burgers. We went to a small ice cream shop that reminded me of Friendly’s. They also had “normal food,” but their focus was ice cream. I had a cheeseburger with bacon. I know I can’t really expect for the burger to taste the same as an American burger, but it still tasted alright. I still want to try authentic Chilean food, but many of the places that we know of so far cater to tourists, so it’s not surprising to see hamburgers, pizza, hot dogs (garnished with avocados) and other foods that you would expect in the U.S.

After eating, we decided to go on a free tour that was in the middle of a plaza. This tour lasted 4 hours, but our tour guide was amazingly entertaining. He was a chain smoker and probably smoked about 5 cigarettes within a span of 30 minutes, but he was extremely kind and personable. He spoke with a mix of an Irish/Spanish accent about the history and certain key areas of the city. We saw Plaza de Armas, which is Santiago’s main square. They had people painting, dancing, singingand selling various knickknacks.
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We saw Municipalidad, which is Santiago’s city hall. We also saw the old congress buildings and many other beautifularchitecture. I noticed many cracks and chipped paint on the building due to the aftermath of the earthquake fromFebruary 2010. The earthquake happened on a Friday night at 3 a.m. in the middle of the morning. It was a 7.9 on theRichterscale in Santiago and an 8.8 overall in Chile. We finished the tour in the Barrio Lastarria at a cafe.
After the tour, we went to the flea market to buysouvenirs. Ihaven’tfound anything I like yet, but hopefully we’ll see some things in Talca!

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Charlie on the MTA?

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Ah …. transportation.

Often we don’t think about it too much until something goes wrong or you are challenged by your mode of transportation. You will have to forgive me as I lapse into a bit of reminicising about transportation issues from previous nursing trips.

Here in Chile I am impressed with the airport and the cleanliness of the streets and metro system. It is such a refreshing change from some of our Metro systems in USA. There are bright murals and lack ofgraffitior the tell tale smell (if you know what I mean). We have had a few adventures today as we navigate the streets of Chile with our wonderful leader, Javier C., who was born in Chile but now goes to school at BU.

Today we had to navigate the metro to the bus station, oops.. not the right station… we have to go a few blocks down to the bus station. We buy our tickets but get on the wrong bus. It worked out fine because we met our correct bus at the next stop.

Once we arrived in Vina del Mar for a visit to the coast (i.e read… “beach, sand, lots of beautiful Chilean young adults having fun). We have to take a crowded city bus but the system here is pretty good so we make it and enjoy a lovely day at the beach. The air is great but the water is pretty cold. At the end of the day, a long wait for empanadas almost caused us to miss the 2 hour bus ride back to Santiago. We arrived back around 9 a.m. (after a few mishaps on the Metro.. “did he ever return, no he never returned and his fate is still unheard”… Boston people will be humming along).

It has been a long day but the students hit the store next door for some food to munch on and I leave them to relax alone. So despite the travel glitches I am recalling transportation in other countries like Ghana where the students traveled in Tro-Tros, which essentially are larger rusted out vans that have seen better days. Today we were a bit crowded on the buses and metro but all in all it was a safe journey. I think about the challenges in poorer countries where the transportation is not that easy or accessible. Two years ago I traveled with 2 live chickens and 25 people in a 9 person van while holding someone’s sleeping baby on my lap.. This year I had some giggles about missing buses and going the wrong way on the MTA. So… this is a learning experience for all of us.

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UMass Lowell students pose for a group photo in Santiago, Chile.

Again, we often take for granted our cars and readily available transportation (and the ability to read the schedule and ticket details) at home. Here we are challenged a bit in that regard. So far this experience hasn’t shocked us as much as previous trips, but the learning is still happening.

Today under the sunny skies at the beach I had some great conversations with the students about their life plans and how nursing and this particular trip to Chile fits in with their “bucket list” of dreams. We did discuss the relative comfort we have had the last few days and I hope to see other parts of Chile that may not be as “pretty,” but will show us how the people of Chile live, work and receive nursing care.

I am anxious to see Talca and other areas that are closer to the area that was hard hit by the 2010 earthquake. That was a devastating and deadly (8.8) earthquake but I am told that the area has recovered fairly well. Our work will begin next week so in the meantime we intend to explore Santiago a bit more and learn about the culture and the people.

So… we continue with our transportation challenges throughout this trip. A few more laughs and eventually we make it home.

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We’re chilly in Chile thanks to our sunburns

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One word. Stair-master. Had we known that we would walk so much, we would have brought more shoes.

Our airport experience was less than satisfactory. Leaving Boston, we were stuck on the runway for half an hour due to heavy traffic in New York. Because of the weather, there was a lot of turbulence, but we arrived in sunny Miami at night. This flight lasted 3 hours and 40 minutes, but our next flight from Miami to Chile lasted 8 and a half hours. Most of us had trouble sleeping due to the cramped quarters, but at least the food was decent. We were given a choice of either pasta or chicken. The people who had the pasta said it was decent, but those with chicken said that it was pretty good. We arrived in Chile at 7 a.m., and our global health experience began.
We hiked up a mountain called Cerro Santa Lucia and got a great view of Santiago. Smoking was verypredominant, but the folkof Santiago love to clean. We saw people mopping sidewalks, washing windows, and providing excellent lawn care. Everyone here is super friendly, even though we have a language barrier. It’s a good thing we have Javi and Sarah to talk for us. 🙂 We explored the city on foot and metro.

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The view from Chile of the snow covered Andes Mountains.

We then went to the zoo (TONS OF STAIRS) and saw everything from elephants to penguins to a poor sick cheetah and sleeping kangaroos. By that point we were exhausted, hot and dehydrated, so we headed back to the hotel for a shower and a nap. For dinner we had a traditional Chilean meal with delicious food and service.

Day two! We had quite anadventure on the metro andbuseson our journey to Valparaiso. The beaches were beautiful as were the people. Street performers joined us on the city bus and treated us with to some beautiful guitar and drum music. Being future prudent nurses, we all used sunscreen and applied it often. However our pale winter skin lost the battle and we all got burnt… Ouch! Tonight is recovery and relaxation to rest up for tomorrow’s adventures 🙂
Bye Mariah Sara Henson and Javier

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