FNP students learn lessons in caring for


patients in Guatemala W


By Linda Childers


hen 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 profes-


sor 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-gov- ernmental organizations such as Common Hope and Hombres y Mujeres en Accion, Goodman and her students set up rural clinical outposts to provide much-need- ed 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 in- flicted with a number of health condi- tions 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 facul-


ty-supervised teams at different clinical out- posts. In each clinic, one room is dedicated to cervical cancer screening, one room for adult exams, one for pediatrics and one for a


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pharmacy. The nursing students have to rely on basic medical tools, including tongue de- pressors, 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. “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 im- poverished, 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 Ar-


kansas DNP program, said she plans to return to Guatemala someday to serve the community again. “ S o u t h


Florida also has a large Guatemalan population and 20%-25% of our nursing students who participate in the cultural im- mersion program go on to provide culturally meaningful care locally in underserved com- munities,” 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.” •


Linda Childers is a freelance writer.


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