Bioluminescent Bay

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PC: Tiff “Estefanía” Hochstein

The above picture is from the beautiful sunset we all saw when we went kayaking Saturday, April 9th. The tiny little specks coming off the land in the back are actually palm tress (which will be one of the many things that I will miss as our time here has almost come to an end), the sky was painted with beautiful pink and blue stripes, and the moon (that tiny little speck in the top of the picture) was starting to come out. When the sun completely set, and the stars shining bright, it was time for the biobay!!!
The biobay, AKA bioluminescent bay, is one of the many things that Puerto Rico is known for. I think the first time I heard about the biobay I was reading an article captioned “10 things you must see before you die.” All of us were very excited to see the biobay, but some of us were definitely a little wearisome about the trek out there. Our kayak adventure was about 3 miles round-trip through a tunnel carved out by the branches of the trees. I think some people’s arms were a little sore the next day, myself included. On the way back, the tunnel was completely pitch-black and silent expect for the train of kayakers, which was actually really creepy, but we all live to tell the tale.
Now lets get back to the dinoflagellates- the organisms that make the water glow. When the sun was set and we were out in the open water without any lights except for the moon and stars, our tour guides hooked all our kayaks together and gave us a tarp to throw over our heads to make it even darker. If you stuck your hand and leg in the water and moved it around, it looked like green glitter had just been dumped in the bay. This was definitely different than the pictures that I saw in my “10 things you must see before you die” article, which showed people lighting up the water with the wake of their kayaks, but at least we saw something! I guess in years past the bay has been better lit, but due to the huge drought that Puerto Rico experienced last year, the dinoflagellates died off and therefore we didn’t see the bay at its best.
Either way, if someone was to come to PR and enjoys kayaking, I would recommend doing the biobay. I think we had a good time as a group and we all made some more memories to add to our PR adventure. And for a live update: we are all having a mac-n-cheese/family dinner competition/sampling so I must go and I hope everyone likes my cookies!!! ¡adiós! -Chrissy

Med/Surg Clinical

I have enjoyed my time here in Puerto Rico at the Veteran’s Association. My previous clinical rotation was in a nursing home so the hospital provided quite a different pace. Here we are on a medical surgical unit. Coming into this clinical rotation I did not know my medications well. Passing out the medications with the nurses became like a mini quiz every day on the unit. I looked up and learned why I was giving particular medications to the patient. The nurses were very friendly, patient, and supportive- I felt comfortable learning from and observing them. Professor Apostolidis also posed me with many questions that caused me to have to look beyond the surface of a patient’s condition to the underlying pathophysiology of their multiple diagnoses that composed the song that is the patient.

This clinical rotation has not only provided me the opportunity to learn on a medical surgical floor, but other hospital units as well. I have had the privilege of shadowing in the operating room, the emergency department, and the cardiac intensive care unit. I have had unique and meaningful experiences on each of these units. It is not a goal of mine to be an OR nurse, but there is nothing quite like viewing the inside of a human body: it’s literally a glimpse into a mystery. I had my most pleasant patient interaction in the Cardiac Intensive Care Unit. I had the opportunity to spend a few hours with a patient who was on watch for an MI. He expressed multiple times how he felt I had taken such great care of him. He was so appreciative and he definitely brightened my day. One thing he kept saying to me was “You are a great nurse.” He knew that I was still in nursing school and when I replied that a good nurse is what I hope to be, he corrected me with, “No, you ARE a nurse.” That interaction has really stuck with me. I may still have plenty to learn. I may still have another year to study. I may still have an NCLEX to take. But, because of what’s in my heart, because of who I am, because of how I care for people— I AM A NURSE!

Danielle Black

Med/Surg clinical

I have been on a medical floor of a hospital before, but only as a visitor. Before Puerto Rico, I had no idea what to expect from a nurse’s standpoint. My first time on the medical floor at the VA as a nursing student was different than I had imagined. I now understand what the different machines are for, the great amount of various medical professionals working for each patient, and how nurses are constantly monitoring their patients’ statuses.

Communicating with the patients at the VA is different than how I imagined it would be. Although the communication barrier can sometimes be difficult, I can tell how welcoming the patients are to us. I have never studied or worked someplace where the patients give me tips on where to go or what to eat.

I have learned so much during our medical-surgical rotation so far. It is fascinating being able to apply things I have learned in class throughout the years to the patients I take care of in clinical. It is amazing to realize how far I have come since entering nursing school. I am able to identify signs and symptoms of diseases, understand how medications are affecting each individual patient, and administer medications accordingly. Although we are already half way through this rotation, I am excited to learn more and bring back both my clinical and cultural experiences to the states.

Emily Russo

Med/Surg Clinical

Every individual in the health profession is responsible for providing their patients with the best care possible. Whether they are a Physician, a Social Worker, or a Nurse, they need to take it upon themselves to provide optimal care to a diverse population of potential patients who may come to them in need one day. By stepping on board the plane to San Juan, Puerto Rico, I set out to become an international learner with the goal of learning much more than just Spanish.

It did not take long for me to realize that Medical-Surgical Nursing is not for the faint of heart (pun intended). I have been warned about this particular area of the profession being the “meat and potatoes” of nursing, or the nitty-gritty. Down here in Puerto Rico I feel it appropriate to call it the “Rice and Beans” of nursing, it has proven to be just as challenging as I expected! I believe being in a different part of the world and hearing a different language everywhere I turn puts an emphasis on the medicine in practice; the anatomy and physiology is universal, and easier to analyze without all the distractions of your average English speaking American nursing unit. The health problems, the health care providers, the treatments, and patients are all the same. Regardless of location and cultural setting, people around the world are entitled to a certain level of health care and it is our duty as health care professionals to ensure that it is given. Practicing in Puerto Rico has shown me that universal health care is a necessity, and more importantly a duty of all present and future health professionals to deliver.

Despite the language barrier, communicating with a patient who doesn’t speak the same language is still of great importance. Whether it is a firm handshake following a “Buenos dias”

or a gentle touch preceding a “lo siento”, verbal and non-verbal communication must continue despite cultural and lingual differences. It was quite unnerving having to introduce yourself to someone who may never understand a thing you say, but it emphasizes the importance of knowing a second language and has motivated me to not stop until I have achieved that. The running joke was that if you spoke two languages, you are bilingual, and if you only spoke one language, you are an American. As funny as that sounds it needs (and has to) change in order to provide the best care possible to our patients, especially in a population that is only becoming more diverse! Even just for comforts sake, knowing enough of another language to explain your purpose and exchange pleasantries may seem menial, but not many people grasp the importance until they are on the receiving side unable to comprehend anything going on.

I have made the most out of my international experience thus far and am determined to take away as much as I can home with me. I already dread the day I have to step on the plane to come home, but I am also forever grateful to have experienced and learned these things and will carry them until I hang up my stethoscope.

Ryan M

Psychiatric Nursing

 

I was filled with many feelings of excitement and uncertainty when starting my psych rotation at the VA in late January. Eager to interact and work with the veterans, I was not sure what to expect as I initially walked into the front doors of the VA. The rotation was filled with many great opportunities in a variety of areas in the hospital, such as PAIKU, PIC, MCH, MHICM, and ECT. While focusing on practicing various communication techniques, I learned countless things at each place and from a variety of people at the VA, such as nurses, occupational therapists, recreational therapists, anesthesiologists, and the patients themselves.

Spending the day with MHICM stuck with me throughout my psychiatric rotation in Puerto Rico. MHICM, Mental Health Intensive Case Management, is a program where nurses and social workers visit and monitor patients at their respective homes; it is a concept similar to visiting nurses in the United States. Having previously done my fundamentals rotation with the Visiting Nurses Association, I found my trip with a social worker from MHCIM to be especially interesting. We started the day by visiting a patient at a “foster home”. The social worker explained that a foster home is similar to a nursing home. I remained confused when we pulled up to a regular house in a neighborhood, where I could see two patients sitting in wheelchairs looking out, inches away from the front, glass door. The home was filled with multiple patients and two nurses who were trying to feed the patients breakfast. As it was something I had never seen before, I found the environment to be loud and chaotic. However, I had the chance to talk with the patient about his story and how he is progressing in his new home.

Another house we visited was up in mountains, so I got to experience the many windy roads of Puerto Rico. I was able to talk with the patient about his medications and how they have been impacting his life, all while eating rice pudding cooked by his wife!

My experience with MHICM and the VA itself has been very positive and has provided many opportunities to learn about pysch and the Puerto Rican culture. I have truly enjoyed therapeutically communicating with the Veterans. Even though sometimes the language barrier is apparent, I have learned a simple smile can go a long way. I can’t wait for what is to come!

Allie V.

Zip Lining

On March 3rd, our group went to Toroverde in a town named Orocovis in the Central Mountain Range of Puerto Rico to zip line through the trees. Our day started off early with driving up the mountain in our passenger bus. On one side of the road were thousands of bamboo stalks; on the other side was the face of the mountain. The twists and turns of the tiny road were nerve-wracking to drive on with such a big bus and took a while to drive up but were definitely worth it once we got to the top.

We began by getting set up with our zip lining gear, which included a harness, gloves and a helmet. We walked up from the building to the location of our first takeoff point and took a lesson on all the gear we were wearing, and how to safely zip line. The instructor showed us how to slow down, go faster, and change the direction we were facing while on the line. Then we were ready to begin our “Canopy Tour.” We started off slow with a zip line only around 200 feet long but we were ready for more! Our group zip lined across eight different points of the mountain range. One zip line was over 2,500 feet long and 200 feet high! It was both fun and scary at the same time. When we were in the middle of the line, we could see the ocean past the mountain range- what an amazing view! I remember looking down at one point during the zip line and seeing a little river and all the wildlife.

For lunch after our tour, we went to a restaurant that overlooked the mountain range. We all ordered Puerto Rican dishes, mostly pork and fish with lots of rice. It was a great way to end an exciting day!

Greer Lesnieski

Psychiatric Nursing

So far, our clinical experience at the Veterans Association hospital here in San Juan, Puerto Rico has been incredible! One thing we absolutely love about the hospital here is the staff, and especially, the nurses. The nurses have been so amazingly welcoming and helpful to us.
Our first half of the semester, we spent most of our clinical days on an inpatient psychiatric care floor. Psychiatric care is very focused on the concept of therapeutic communication, which is something that we got to have a lot of experiencing using during our time on the unit. It was always so incredible to come back after four days off the unit to see a patient who had been very low functioning and to see how some time on the proper medication and in the care of dedicated staff could transform them into patients we could hardly recognize. We were also able to have the opportunity to spend time on various other psychiatric units, such as Day Hospital, where patients who have been discharged from the inpatient unit can live at home but check into the hospital each day for eight hours for intensive group therapy sessions, which, on one day included aromatherapy and art therapy, and on another included pet therapy. Patients were able to discuss the heavy subjects that weigh on them specifically as veterans living in civilian society.
For the remainder of this semester, we’ll be spending our clinical days on various medical-surgical floors, such as the respiratory unit, the cardio-thoracic intensive care unit, the emergency room, and the catheter lab. Already, many of us have had the opportunities to pass medications, hang a new IV line, or suction tracheostomies. The nurses and doctors on the floors have been wonderful, allowing us to earn autonomy as we prove our skills and expertise as UConn-trained students, and expertly guiding and teaching us as we learn and attempt new skills.
The VA hospital overall has been an amazing place to do our clinical rotations, and we can’t wait to see what else we’ll get to experience during the rest of our time here!

Haley Malin

Psychiatric Nursing

At the beginning of this semester, entering our psychiatric rotation at the VA Hospital in San Juan, I was completely unsure of what this learning experience would entail. Having little background and experience with psychiatric patients, I was both nervous and excited walking into the VA on that first day. At the end of that week, I had already learned so much about how to care for these patients. Being on this unit made me realize that psychiatric nursing requires a very different kind of nursing care. Communication is absolutely a key concept in this area of nursing. However, it is not the typical kind of communication we had previously learned about and practiced in all of our nursing courses. For this kind of communication, a nurse must be familiar with the various disorders the patient may be experiencing, the defense mechanisms they may be using, and the proper therapeutic communication techniques to be used for each of these. It was a challenging experience, but it taught me so much about the importance of communication in nursing, and the reward that came out of this experience will stay with me for a lifetime. These veterans have sacrificed so much for our country, and it was a privilege for me to be able to give back to them in a way that could improve their health both mentally and physically.

Tiffany H.

Psychiatric Nursing and Palm Trees.

Never in my life would I have imagined practicing nursing in front of palm trees. Studying in Puerto Rico has turned out to be one of the most enriching experiences I have had the opportunity to become a part of.  Looking back at the first half of our clinical experience I have realized how much I have learned and gained working with everybody at the VA. Working at the VA Caribbean Healthcare System I found it very rewarding working with men and women who have served our country knowing that I could give back to them for all they have done for us.

As it was our Psychiatric rotation I initially thought that we would only be placed on one floor PICU, as I have done with my past clinical rotations. To my surprise, each day was a new adventure and we would be rotating around 5 different departments; PAICU, PIC, MHC, MHICM, and the day hospital. I have been to each one besides day hospital.

My adventures started on PAICU (Psychiatric Acute Inpatient Care Unit). This was where most of the students were on any given day. This unit consisted of people from all over the Caribbean including Puerto Rico, St. Croix, and St. Martin. On PAICU, many of us were able to enhance our Therapeutic Communication techniques while hearing of many of the veterans past stories and growing close to them. We were also able to take many EKG’s and visit both recreational therapy and occupational therapy to help people with their social and functional independence.

The next place I went to was the Mental Health Clinic (MHC). Here at the Depot clinic, which they call it, patients who take long-acting anti-psychotics come in to get their treatment whenever needed. This could be every week, 2 weeks, or monthly whenever needed. I enjoyed seeing how many people function normally and are very successful with the right medication.

I next went to Psychiatric Intensive Care unit, or PIC. This is an area, similar to an ER, where psychiatric patients come to get stabilized and further evaluated for placement in another unit.

The last place I went to for a day was MHICM. This is a program where both nurses and social workers take weekly trips to clients houses either to give needed medicine or to take them out for small activities to help them go out and socialize more. I enjoyed seeing this aspect of nursing as we were able to travel around the island. Also my nurse brought me to eat at Mimi’s BBQ, which she said had the best mofongo on the island!

Overall I enjoyed seeing each different area, as it widened my understanding for Psychiatric Nursing. Now I just can’t wait for what med-surge has in store!

Paul D.

Coffee and Ponce!

 

What a morning! Waking up early can be hard for your average college student, but not for nursing students. This morning, our bags were packed and we were ready to get on the bus at 6:30am for an excursion to a coffee hacienda and to Ponce, Puerto Rico! San Juan is a northeastern city of Puerto Rico, and Ponce is on the south side of the island. According to our friends at the VA it is a must see city during our time in Puerto Rico.
We arrived at the coffee hacienda at 9:00 a.m. for a tour of the grounds (lol) and a few cups of 100% Puerto Rican coffee. The hacienda was located at the foot of the highest mountain in Puerto Rico, “Cerro Punte” The coffee was strong, but the taste was complimented with some warm steamed milk added to the coffee which they call “cafe con leche.” The owner of the hacienda was a German man who had lived in Puerto Rico for 46 years with his wife. They recently became the parents of a puppy named Macchiato. The owner, Kurt Legner , shared with us the diverse and sometimes controversial history of coffee. (Ever wonder why tea is the drink of choice in England and not coffee!!?)
After having two cups of coffee and some homemade banana bread we toured the hacienda. Coffee beans actually look like a fruit, and at their ripest they are a cherry red color. If you open up the skin there are 2 beans inside that have 2 more layers that must be taken off by different machinery. Finally when the bean is ready, it is roasted to perfection. Pomderrosa coffee (the coffee the hacienda sells) is sold by the bean because once you grind the bean it loses 20% of the taste. We had the opportunity to buy the coffee at the hacienda and I picked up a bag for my parents.
We then traveled down the road to Plaza de Ponce! The plaza had a similar feel to Old San Juan, due to the influence that Spain had on Puerto Rico. We ate lunch at a place called Lola’s and topped the day off with some ice cream from King’s, another place that was recommended to us from our VA friends. In Plaza de Ponce is the oldest firehouse in Puerto Rico, dating all the way back to 1873. There are also lions around the square that are decorated by different artists in Ponce to represent different parts of Ponce. Why lions you ask? Well, Ponce De Leon!
Ponce is also known for its art and many museums. There is a museum of history and a museum of art.
Overall, the day was one I will never forget. It made me happy (dare I say it) that there is no Dunkin’ Donuts coffee here in Puerto Rico. Coffee here does not need to be flavored, it is already so rich. As for Ponce, it is definitely a place I am happy to say I have visited because everyone knows and respects its culture. What a great day!
Gigi R.