When Rhonda Goodman, PhD, ARNP, FNP-BC, NCSN, AHN-BC, looks back at her nursing education, she remembers how she mastered some of her most important lessons in patient care during a medical immersion program in Africa, rather than in a classroom.
Today, Goodman, an assistant professor and family nurse practitioner at the Christine E. Lynn College of Nursing at Florida Atlantic University in Boca Raton, Fla., strives to offer her nursing students the same life-changing educational experiences.
In February, Goodman took her fourth group of RNs studying to become nurse practitioners on a weeklong trip to Antigua, one of Guatemala’s most rural areas. The indigenous Maya are vastly different from patients seen in the U.S. Working collaboratively with non-governmental organizations such as Common Hope and Hombres y Mujeres en Accion, Goodman and her students set up rural clinical outposts to provide much-needed health screenings and medical care to underserved Mayan families. To date, Goodman and her students have provided care for more than 4,000 patients.
“As a result of their extreme living conditions, indigenous Maya are inflicted with a number of health conditions including Type 2 diabetes, high cholesterol, musculoskeletal problems, roundworms caused by parasites and malnutrition, which causes physical and cognitive growth issues in the children,” Goodman said. “In addition to treating existing medical problems, we do a fair amount of education and also work with the NGOs for physician follow-up for those with chronic conditions.”
The nursing students serve on two faculty-supervised teams at different clinical outposts. In each clinic, one room is dedicated to cervical cancer screening, one room for adult exams, one for pediatrics and one for a pharmacy. The nursing students have to rely on basic tools, including tongue depressors, stethoscopes, blood pressure cuffs, sterile gloves and glucometers, to provide medical care. One of the most important supplies is acetic acid, or vinegar, to screen for cervical cancer.
Dirt floors, chickens and dogs
“It’s a method that was developed at Johns Hopkins,” Goodman said. “Since we are working in huts with dirt floors, often with chickens and dogs
running in and out, we can’t perform a traditional Pap smear. This method is just as effective — vinegar applied topically turns precancerous tissue white but does not change the color of healthy tissue. It allows us to determine immediately if an area is pre-cancerous, and if so, women undergo therapy to freeze the bad cells and prevent the disease from spreading.”
This year, for the first time, Goodman also brought undergraduate nursing students on the medical mission. Erica Dixon, a senior in the university’s BSN program, said even though the families she cared for were impoverished, they had a wealth of kindness and hospitality to offer.
“One of the most heartfelt encounters I had involved chatting with two young girls who had a few coins in their hand,” Dixon said. “After talking for a while about their school and farm animals, one of the girls left and returned with three lollipops. They offered one of their prized treats to me. They had worked diligently to earn and save those few coins to buy candy, but they never hesitated in their willingness to share their treasure with me.”
Like many of Goodman’s students, Dixon, who is set to attend the University of Arkansas DNP program, said she plans to return to Guatemala someday to serve the community again.
“South Florida also has a large Guatemalan population and 20%-25% of our nursing students who participate in the cultural immersion program go on to provide culturally meaningful care locally in underserved communities,” Goodman said. “Students also grow in leaps and bounds in their ability to assess, diagnosis and formulate a plan of care, including medications and doses.”
Goodman hopes to continue the program and would like to create a way to raise funding to help nursing students pay for the trips. Currently, students pay for their own airfare and other travel expenses.
Ada Saidenstat, who was on course to graduate this May with an FNP degree and a DNP in December, said the immersion trip to Guatemala made her much more appreciative of the American health system.
“I was personally disturbed by the lack of empowerment possessed by the Mayan women,” she said. “It’s as if they have no voice. Yet for having so little, they were so appreciative and showed so much gratitude for the services we provided.”