A typical day in the clinic...

... was anything but typical. Going out in the field was only one of the many tasks we were put to during our stay at Hombro a Hombro; on most days, a few students stayed back to help the resident physicians and nurses see the patients that lined up at the door each morning. Penn Nursing students, at varying times, helped with the following range of activities and cases in the clinic:

• navigating the impossible, Rolodex-heavy patient information system
• rotating nights of being "on call" with fellow students
• stitching machete wounds
• extracting a live bug from a woman's ear canal
• assisting with ultrasounds
• hand-developing X-ray films
• taking blood and checking hematocrits
• checking urine samples for evidence of infection - and to check for pregnancy!
• doing full pre-natal checkups
• working with a team of physicians and other students to devise comprehensive care plans for acute patients
• round-the-clock observation and care for an acutely ill little boy
• counseling women coping with domestic abuse and men struggling with alcohol addiction
• doing home visits for patients that were unable to visit the clinic
• lots of injections and medication administration
• a ton of patient education and health advice
• catching a baby (congrats, Lindsey!)

... the list could go on and on. Many of us came back to Penn claiming that the things that we were able to see and do and the skills we improved on during our stay in Honduras equaled a semester-long clinical course at home. I think we all realize how incredibly fortunate we are to have been chosen for this trip; now that we've been home for a few weeks and have had time to reflect on our experiences, I think many of us realize, too, that the lessons and skills we learned in our clinical practice in Honduras will stay with us for the rest of our careers.

For me, reflection brings an overwhelming feeling of gratitude. I'm grateful for the work that Shoulder to Shoulder has done, and I'm grateful that I was allowed to be a part of it. I'm grateful that I had such an amazing group of fellow students to work with, to learn from, and to share the experience with.

I would be remiss if I didn't mention one of the the resources I'm most grateful for: our outstanding teachers. Maime and Dawn and the other fabulous midwives on the trip were wonderful mentors, clinical instructors, and travel buddies. (We also learned that they are hilarious comedians and great actors!) The Family Practice physicians that accompanied our group, and the resident physicians as well, were also incredible resources. All-in-all, the atmosphere that these nurses and doctors helped create resulted in a perfect environment for learning clinical and interpersonal skills. As one of my fellow nursing students described it: it was "the safest learning environment I've ever been in." (Above: Maime uses Michelle as a student model to show a local Honduran midwife how to check for edema.)

Finally, I think we also learned a lot from our patients and from our fellow Honduran health care workers. For example, our last two days at the clinic were spent with local lay midwives. We had designed a number of popular education pieces to teach about different topics surrounding childbirth; for all of our preparation, we surely learned as much about midwifery from them as they learned from us.

(Penn Nursing students and faculty with a wonderful group of Honduran lay midwives)