Medical Missions: Three Lessons and Three Reasons

October 10th, 2011

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By , BSN, RN

Mission accomplished. As I leave the Dominican Republic, packing up instruments, inventorying what is left, noting what we didn't have enough of this year and what else we had too much of, I am pleased with the work completed.

Over the course of the week, the Family Practice Clinic saw 400 patients, there were 93 ophthalmology exams, 11 eye surgeries, 37 general and GYN surgeries and eight people fitted for prosthetics. We handed out everything from reading glasses to multivitamins and accepted simple thanks as payment for services provided. It is the best feeling in the world.

You learn to get by, reorganize, make do and succeed in an environment of need. I was witness to and part of several feats of imagination that ultimately led to success and strong work.

  1. Round Robin – As nurses, we often use a round robin series of movements (a group of resources used in a circular order) to cover for inadequate staffing, providing care and getting ourselves a lunch break. In the Dominican Republic, we used it to stretch resources. In the three operating rooms there was one fully working electric cautery and one working only on very high settings. That was ok until the eye surgeon needed to use one too. So, what to do? Simple—round robin. By working on timing, we could start one case, then another, then a third. As the first one closed, we grabbed the cautery, moved it to the third room, and as the second closed, it went to the first, and around we went. It was a simple utilization of limited resources.
  2. Necessity is the mother of invention – We had plenty of foley catheters—the problem was that we had only one foley bag. As I have said before, what to do? Invent. Some suction tubing, tape and tegaderm, and a water bottle and presto — one homemade foley bag (bottle). Other inventions include the previously mentioned personal belonging bags made from surgical gown sleeves and dollar store plastic boxes turned into instrument sterilizers using a simple hole punch and chemicals.
  3. Every challenge is an opportunity — Every mission is a chance to learn something new. Historically, the group I travel with has been led by a nurse. When she stepped down, others stepped up. Now, team work between an anesthesia tech and a CRNA gets our team off ground stateside and hard at work in the Dominican Republic. This year an OR educator learned to scrub eye surgeries for the first time in her life, a labor and delivery nurse helped run patients through the Family Practice Clinic, and despite being an OR nurse myself, I managed the eye clinic, set up eye surgeries and have even learned how to fit reading glasses. We have an engineer who transports patients and is generally helpful, two translators from the corporate world learning new medical terminology every day, and an airplane mechanic who has taken on fixing medical instruments, scrounging up extra scrubs and ice for ice packs in a hospital that barely has running water.

I share all this for several reasons:

  • I am very proud of the work we do and the people with whom I travel. Physicians, nurses, techs and laypeople volunteer their time at their own expense to help others less fortunate. What's better than that?
  • To encourage others to give of their time and skills. I hope when people read these stories they are inspired, encouraged or challenged to join their own mission trip. Whether you see patients, build latrines or save the rainforest, we all have something to offer. And, if you have access to a computer and time to read my articles, you probably have access to resources, now or in the future, and the ability to make a difference to someone else.
  • In the United States, healthcare is so much more than hands-on care. It is staff meetings, and paperwork, and rules, and more meetings, and regulations, and inspections and insurance and CYA. On these trips, as a nurse friend said, "I remember what attracted me to being a nurse in the first place." It's all hands on care and all hands on deck. Nothing more—nothing less.

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