tag:blogger.com,1999:blog-53972890902775308202024-03-25T02:09:58.725-04:00University of Michigan Global Clinical Immersion Admin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.comBlogger38125tag:blogger.com,1999:blog-5397289090277530820.post-68853723515663909702017-11-25T21:55:00.001-05:002017-11-25T21:55:51.182-05:00Let’s Talk About Sex (Education and Health)!<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-align: left;">
<span style="font-family: "arial"; font-size: 11pt; vertical-align: baseline; white-space: pre-wrap;"><span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="font-family: "arial"; font-size: 11pt; vertical-align: baseline; white-space: pre-wrap;">We were immediately intrigued when asked to give a school-based sexual health presentation to adolescents in Thailand. As Nurse Practitioner students, we recognize the importance of sexual education and prevention in this age group and were more than happy to share our knowledge and expertise. After touring the school and meeting with faculty, we sat down with our Thai sisters to plan our school health day. </span></div>
<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-align: left;">
<span style="font-family: "arial"; font-size: 11pt; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span class="Apple-tab-span" style="white-space: pre;"> </span></span><span style="background-color: transparent; color: black; font-family: "arial"; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The presentation was to be about one hour in length for a group of twenty 12-15 year olds. We were given limited direction on what topics to cover, we just knew that we would have to demonstrate the right way to apply a condom. After some discussion, we decided to discuss healthy relationships and consent, common sexually transmitted infections (STI) and prevention, condom storage and use, contraceptive methods, including cost and effectiveness, teen pregnancy statistics and prevention, and overall sexual risk reduction. We also developed a pre- and post-tests to assess baseline knowledge and knowledge gained after the presentation. It was a lot of material to cover in 1 hour and we had 24 hours to prepare, so we got to work!</span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div>
<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">We had the prior knowledge of Thailand having universal health coverage but had many questions regarding trends, standards, and access to care involving sexual health: for this information, we consulted with our Thai sisters coupled with some internet surfing. We came to find out that the cultural expectation in Thailand is that adolescents remain abstinent until marriage. Also, sexual health education is not standardized in the Thai school system. Similar to many other countries, teen pregnancy rates have been on the rise in Thailand. According to the United Nations Population Fund, more than one million babies were born to teen mothers in Thailand over the last 15 years, increasing 31% from 2000 to 2014. Contraception, condoms and STI testing are widely available through local Primary Care Units (PCU), but require a parental consent for anyone under the age of 18. Local pharmacies also offer over-the-counter oral contraceptives and condoms for those of any age at a cost. It was eye opening to learn about organization and access of the Thai healthcare system in relation to sexual health.</span><br />
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<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div>
<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">We were struck by both the similarities and differences of sexual education between Thailand and the United States. Unlike the United States, where sexual education standards are decided at the state level, the schools and communities have more flexibility with delivery of content. </span><span style="font-family: "arial"; font-size: 11pt; text-indent: 36pt; white-space: pre-wrap;">One thing that we found out was pretty universal is that teens will be teens, and sex can be silly and uncomfortable to talk about. The students seemed curious and receptive to the information we were providing, but they also had their moments of uncomfortable giggles. However, we believe the students learned essential information that will help them stay healthy for years to come. </span><br />
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Admin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-32036810202472999782017-11-24T11:18:00.000-05:002017-11-24T11:18:27.812-05:00Thanksgiving-Thai Style<div class="MsoNormal">
Spending a holiday away from family is never easy, but our
Thai family gave us a Thanksgiving we will never forget. The evening began with
a group effort to prepare a feast consisting of regional Thai cuisine and
improvised Thanksgiving favorites. We had pad-mi, curry, and green papaya salad
alongside sweet potato fries, Thai pumpkin, and even a few turkeys. </div>
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The overwhelming amount of food matched the generosity and
hospitality of the village. Dressed in traditional Thai clothing provided by
our SUT brothers and sisters, we were honored with a blessing ceremony led by
the village elders. As we sat in one communal circle, the village elders slowly
approached each one of us to tie white strings on our wrists, bestowing upon us
wishes of good luck, health, safe travels, and future success. We did not need
to understand their language to feel their well-wishes as they tied each
string, blessing us as if we were their own family.<o:p></o:p></div>
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After we overindulged in the delicious feast, we exchanged
performances with our SUT brothers and sisters. The SUT students performed
beautiful traditional Thai dances, while we brought some American flair via the
Cha Cha Slide and the Michigan Fight Song. We also discussed the history of
Thanksgiving and in the true spirit of the holiday, gave our heartfelt thanks
to everyone who contributed to our success over the last two weeks.<o:p></o:p></div>
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We are thankful for our SUT brothers and sisters; for their
kindness, encouragement, and their much-appreciated translation skills.<o:p></o:p></div>
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We are thankful for our faculty members who helped guide our
interactions with patients and each other.<o:p></o:p></div>
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We are thankful for our clinic workers, who provided us with
a new perspective in health care delivery.<o:p></o:p></div>
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We are thankful for the village residents, who welcomed us
into their homes and hearts without blinking an eye.<o:p></o:p></div>
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The story of Thanksgiving emphasizes blending of traditions
and gratitude for each other. Our gathering was the perfect farewell to our
incredible cross-cultural experience.<o:p></o:p></div>
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Admin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-2525488831458106382017-11-23T10:19:00.000-05:002017-11-23T10:19:23.176-05:00Embracing Culture<!--[if gte mso 9]><xml>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="true"
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
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We have been in Thailand for a little over a week now and
what a life changing experience it has been so far. The impact that culture has
on health and wellness is no surprise to us as nurses. The link between culture
and individual/community health has been embedded into our brains since the
very beginning of our careers as nurses; and when I say the beginning of our
careers, I’m talking first day of school, NURSING 101 and every year after. Throughout
our careers as nurses, we are taught about ethnocentrism and how to be
culturally sensitive while trying to see the world through our patient’s unique
cultural lens. We are asked about cultural sensitivity in every interview we
have for any nursing position and take great pride when we are able to help our
patients embrace their cultural norms while supporting their health and
healing. So, as we packed our bags and headed to Thailand for our clinical
immersion experience, being culturally sensitive and adapting to the way of life
and health care in a new land was not something we were necessarily worried
about. Instead, we were busy wondering
if we really should have packed that second bottle of SPF 50, and how many
packets of Kleenex was appropriate amount to bring for a 2 week stay in
Thailand (getting stuck without toilet paper is not a
situation you want to find yourself in), and if we really should have gotten
that Japanese encephalitis vaccine that was recommended, but not required.<o:p></o:p></div>
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<br /></div>
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Well, as well versed in cultural sensitivity as we thought we
were, I think that letting go of our own cultural norms and embracing those of
a completely foreign culture was a lot more challenging than any of us would
have anticipated. Now, that is not to say that every part of this foreign culture
was difficult to embrace. We quickly became accustomed to taking our shoes off
before we entered any building, bowing as a greeting instead of waving, and
taking a second to just slowdown from our fast-paced lives in America. The
people of Thailand value time differently than we do. I think for most of us,
this was a very refreshing change of pace.</div>
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Over the last week I have witnessed amazing things in
Thailand health care. I have witnessed nursing students completely immerse themselves
in their community health clinical experience. Packing up their lives for 6
weeks to live in their assigned village, making daily home visits on their bikes,
and tailoring nursing interventions to improve the overall health of the
community. I have witnessed community health clinic filled up with 150 patients
all by 8:30 AM. Some patients waiting as long as 3 hours to speak with the
doctor. People sat outside in the 90-degree heat, others sat on the floor, and
a handful arrived early enough to snag a chair inside near a fan. All without one
complaint. Yet, the most profound moment for me was witnessing the interdisciplinary
care rounds that occurred IN the patient’s home and lasted over an hour and half.
When it comes to their patients, it is evident just how much these health care
providers truly care for their patients. From the nurses and physicians to the
community health volunteers, these people go above and beyond for their patients.
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
This experience has given me an opportunity to reflect on our
own health care system in America, resource utilization and what cultural
sensitivity really means to me. As challenging as self-reflection can be, it is
an opportunity that I will be forever grateful for! <o:p></o:p></div>
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<br /></div>
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Below from top to bottom: Our clinic with 150 patients on community health day, our nursing students working on their community map, and finally the interdisciplinary, in home care rounds.</div>
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<!--EndFragment-->Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-8599538438948685482017-11-16T07:26:00.000-05:002017-11-17T06:03:33.419-05:00The Thai ApproachGraduating from the U of M BSN program 4 years ago and working on multiple units in the hospital as well as currently working in a clinic setting 16 hrs a day / 7 days a week might lead one to believe that their nursing skills are nothing short of impressive. In 2 days my fellow colleagues and I have watched that view slowly wither as we learn a different approach to care.<br />
<br />
Working in the clinic and out in a rural community is a reminder that NURSES are able to adapt and do things with limited space and resources. We do not always need the monitors or advanced technology. We can do dressing changes in the back of a vehicle exposed to the environment and elements and still protect a patient’s privacy and maintain their dignity. NURSES can find humor in peddling a bicycle in 90 degree weather, in the middle of a banana plant farm, wearing backpacks and full nursing gear, during a torrential downpour as they make their way to see a patient.<br />
<br />
Nursing is a dynamic and complex profession that can sometimes leave us feeling helpless when we want to do more but empowered when we can make even a small impact on a patient. Each day will bring a new challenge, a new adventure and a new friend. Each day our hearts will be filled with sadness, pain, joy and laughter. I look forward to every minute of watching, teaching, and learning with a Thai approach.<br />
<br />
GO BLUE!<br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-71669959111997153062017-11-13T02:27:00.001-05:002017-11-13T02:28:36.203-05:00Year 5: Bigger and BetterUniversity of Michigan School of Nursing primary care nurse practitioner students arrived to Korat, Thailand on Saturday and immediately got to work. We met our SUT colleagues and planned our activities for the next several weeks. With our largest group ever, we have the opportunity to engage with more villages and have some exciting health promotion activities and interventions planned.<br />
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This year we were able to bring back one of our alumni, Tracy, to work as faculty and facilitate an additional clinical group. We are so excited to see what 2017 brings and cannot wait to watch our students explore, learn, and grow from this unique opportunity. Thank you to SUT for hosting us and allowing us to go on this journey with your students!<br />
<br />
#BestClinicalEver #BestInstructorsEver #UMSUTDreamTeamAdmin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-34439937468891740252016-11-29T11:09:00.000-05:002016-11-29T11:09:41.290-05:00Storytellers<div class="separator" style="clear: both; text-align: center;">
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<div style="text-align: center;">
<b>Traveling-it leaves you speechless, then turns you into a storyteller. <i>Ibn Battuta</i></b></div>
<i><br /></i>
The reentry process is never easy. Anyone who has traveled will talk of playing catch up with sleep, with current events, with friends and family, and with work/school. At first it can seem overwhelming. But being in a foreign country for a period of time offers a sense of protection, a buffer, that cannot be fully appreciated until one is home. Upon return, it is easy to notice the NOISE. We are no longer protected from the ever-present chatter as we hear <i>and understand</i> the words and interactions around us.<br />
<br />
Less tangible, however, is the impact the experience has had on our personal values, our outlook, our sense of self. Henry Miller said "One's destination is never a place, but a new way of seeing things." The Thai culture and people are full of values that not only had an influence on our time there, but will continue to influence our lives and interactions as we move forward.<br />
<br />
Tradition.<br />
<br />
Respect.<br />
<br />
Honor.<br />
<br />
Strength.<br />
<br />
Warmth.<br />
<br />
As we adjust to the eastern time zone and our domestic responsibilities, we can share our experience with the climate, the food, and the clinical experience. Even more, though, we will become storytellers: the perseverance, the support of the community and nation, the overwhelming kindness of our hosts and communities. We will notice subtle changes in our approach to patients, to families, and to life.<br />
<br />
A huge heart-felt thank you to SUT, our communities, and our Thai faculty and hosts. Your hard work and time is so appreciated. Until next time, Thailand!!<br />
<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYiloPOgZsxKf7bKQUIUVGYBJvWrAFQGyN1O_gDfakK39mXzKhF-GC4OuUp1qqnUcUkqQ-boT7FyJP26Jlyye-hYGx-9-53_UxrOPrIB0SsHGM7X6a85T827AV8-h_TloC4QSSAE7Tdctw/s1600/Thai+Faculty+2016.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYiloPOgZsxKf7bKQUIUVGYBJvWrAFQGyN1O_gDfakK39mXzKhF-GC4OuUp1qqnUcUkqQ-boT7FyJP26Jlyye-hYGx-9-53_UxrOPrIB0SsHGM7X6a85T827AV8-h_TloC4QSSAE7Tdctw/s320/Thai+Faculty+2016.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><i>A journey is best measured in friends, rather than miles.<br />--Tim Cahill</i></td></tr>
</tbody></table>
<br />Admin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-68820164621905104752016-11-29T09:33:00.001-05:002016-11-29T09:33:56.333-05:00The Eyes of a Foreigner <span style="font-family: "times" , "times new roman" , serif;"><span style="font-family: "times" , "times new roman" , serif;"> </span><span style="font-family: "times" , "times new roman" , serif;">Travel, among all things is truly something that excites the
soul. Quite honestly, the natural discovery of both tangible and intangible ways of life has a keen ability to satiate
otherwise famished visions and perceptions.</span></span><br />
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<span style="font-family: "times" , "times new roman" , serif;"> Prior to setting out, normalcy and taboos of the Thai
culture, villages, and clinics were explained to us. Information such as the death
of King Bhumibol, shoe removal prior to entering rooms, and cultural cuisine expectations were each addressed. Despite this knowledge, nothing could have prepared us for what we experienced by actually being present in the country. </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEio9rvhd5sv15RI-0Dku2xTwY2cymDVK-qgtavjPLhKThFSwhNWCO8f8BzwfO0tnJZCXUmyHVy7KIMi-Vhob_yY9OY-dFeBhXUe7YouznEHO0VFnG4OevAqA32M3afzaKp22vcN4p3yBKk/s1600/IMG_9937.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: center;"><span style="color: black; font-family: "times" , "times new roman" , serif;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEio9rvhd5sv15RI-0Dku2xTwY2cymDVK-qgtavjPLhKThFSwhNWCO8f8BzwfO0tnJZCXUmyHVy7KIMi-Vhob_yY9OY-dFeBhXUe7YouznEHO0VFnG4OevAqA32M3afzaKp22vcN4p3yBKk/s320/IMG_9937.JPG" width="240" /></span></a><span style="font-family: "times" , "times new roman" , serif;"> With respect to the death of King Bhumibol, never has a more powerful sorrow been felt. The ENTIRE country was mourning the death of King <span style="color: #1c1c1c; mso-bidi-font-family: Georgia;">Bhumibol Adulyadej who reigned
from June 1946 to October of 2016. Signs, posters, pictures, and banners of him
were posted and acknowledged throughout the country. Every home we visited had
a beautiful, grandiose shrine of this honorable man surrounded by other significant
figures including other family members and because most people are Buddhist,
Buddha. When we visited The Grand Palace, everyone was wearing black. Little
black ribbons were provided for the attachment to our scrubs as we worked through the
villages and clinics so we could also show our respect for the King. <o:p></o:p></span></span></div>
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<span style="color: black; font-family: "times" , "times new roman" , serif; mso-bidi-font-family: Georgia; mso-themecolor: text1;">Something about living through such an entirely, highly
regarded respect one has for another human being is simply beautiful. As this resonates, because it continues to, I will always be conscientious of the admirable qualities, achievements, or abilities one possesses, being sure to honor these characteristics with subduing respect. </span><br />
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<span style="font-family: "times" , "times new roman" , serif;"> In addition to respect, consideration for others was also consistent throughout the community without fail. A core part of our experience in Thailand involved partnering with our Thai sisters from SUT, and performing home visits throughout the village. Before beginning this experience, this was the single most stressful idea to me! Having had community health clinical experiences in the US as an undergraduate student, I expected that there would be resistance and lack of enthusiasm by the villagers to having a group of students enter their homes, and that they may perceive the discussion of their health as an invasion of privacy. I was so wrong! Starting from the first home we visited, I felt welcomed and appreciated, despite speaking a different language than everyone around me. </span></span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "times" , "times new roman" , serif; font-size: small;">(Making home visits by bicycle in the village)</span></td></tr>
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<span style="font-family: "times" , "times new roman" , serif;"> </span><br />
<span style="font-family: "times" , "times new roman" , serif;"> The villagers were overwhelmingly enthusiastic about seeing us; they welcomed us into their homes and stores, were engaged in conversation with our group, and would ensure our comfort, whether that meant offering us water and fruit, or offering us all a place to sit. Many village residents were overwhelmingly excited to show us their yards and homes, and their friendliness and kindness permeated every interaction. Many people even made an effort to talk with me in English when they could, and used their gestures to express hospitality and gratitude when we couldn't communicate with each other verbally. While life in a Thai village is incredibly different from life in an American suburb, there were lessons I learned about being respectful toward others, providing comfort toward those who enter my home, and being fully present in every moment.</span></div>
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<span style="font-family: "times" , "times new roman" , serif;"><span style="font-family: "times" , "times new roman" , serif;"> Lets talk food! The Thai diet is much different from the familiar westernized cuisine consumed in America. It consists of broth based soups, various types deliciously prepared curry atop rice with fried eggs, grilled meats, seafood, fish sauce and spicy chilies. Dishes are
served family style as opposed to in courses and mixes of spicy, mild, and sweet foods are served together as to neutralize the
palate. Native herbs and spices such as the kaffir lime, Thai basil, lemongrass, and dried red chilies produce mouth-watering flavor combinations. </span><span style="font-family: "times" , "times new roman" , serif;">Also, the Thai way consists of eating only when hungry and avoids placing emphasis on "3 meals a day" or "small meals every 2-3 hours." This contributes to fostering a being present in the moment type of dining experience. In addition, the cuisine lacks the added fats, oils, sugars, and caloric sweeteners
that goes into the preparation of westernized foods-- and also, cheese! Remarkably, cardiovascular
disease is much less prevalent in Thailand than it is here suggesting diet </span><i style="font-family: Times, 'Times New Roman', serif;">really</i><span style="font-family: "times" , "times new roman" , serif;"> does play a strong role in disease.</span></span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "times" , "times new roman" , serif; font-size: small;">(Various vegetables and herbs we gathered at a market prior to learning how to prepare a 5 course meal at Silom Thai Cooking School!)</span></td></tr>
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<span style="font-family: "times" , "times new roman" , serif;"> </span><br />
<span style="font-family: "times" , "times new roman" , serif;"> Lastly, as mentioned in a previous blog post, the work
ethic of the Thai people is quite impressive. We witnessed a sweating, diligent, hard-working gentleman turning a pottery bowl. Later, we learned the amount of money earned for completing such a cumbersome, repetitive task for a consecutive 8 hours! An amount that through foreign eyes could be viewed as
potentially inhumane. This has made me appreciate things I may sometimes take for granted. </span><br />
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<span style="font-family: "times" , "times new roman" , serif;"><span style="color: #262626; mso-bidi-font-family: "Helvetica Neue";"><i>"Certainly, travel is more than the seeing of sights; it is a
change that goes on, deep and permanent, in the ideas of living"</i> -Mary
Ritter Beard</span></span></div>
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<span style="color: #262626; font-family: "times" , "times new roman" , serif; mso-bidi-font-family: "Helvetica Neue";">With Love, </span></div>
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<span style="color: #262626; font-family: "times" , "times new roman" , serif; mso-bidi-font-family: "Helvetica Neue";">Julia and Lizzi</span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-64085660803076099772016-11-23T11:59:00.000-05:002016-11-28T14:02:20.247-05:00Thailand through a Pediatric Lens<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvzMFqEEURFipDi-tDpKxK2Q9JhhvHLlgeXjLxFsGTwg5uIkTdw76VCJV9RQelL9Rgdbzafv9ol-1VWRa9DRpya5qQ1kijpUu6sSiRUcA5Ll1T1_I-63a7osvigHN7euN-5EO9pJXKfnn0/s1600/Aubree+and+cassie.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvzMFqEEURFipDi-tDpKxK2Q9JhhvHLlgeXjLxFsGTwg5uIkTdw76VCJV9RQelL9Rgdbzafv9ol-1VWRa9DRpya5qQ1kijpUu6sSiRUcA5Ll1T1_I-63a7osvigHN7euN-5EO9pJXKfnn0/s320/Aubree+and+cassie.jpg" width="189" /></a></div>
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Two out of ten of us on the trip are Pediatric Nurse Practitioner students. Similar to the United States, the majority of the people that seek healthcare in Thailand are the elderly. This created a bit of a challenge for the two of us, as our population was a bit harder to find. Luckily, we also had some unique benefits that made our experience different than anyone else’s. For example, we were both very fluid with our clinic placements. We followed the children, and if they went to one clinic but not the other, we would, too. This was very special to us because we got to see the differences between each clinic, and all of the care that each encompassed. </span></div>
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<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">In Thailand, they set aside certain days to perform developmental assessments and vaccines for the children. The first day assessment day in which we participated was for babies up to 9 months old and was held at the Dan Kwian clinic. The patients were assigned a number upon arrival and used this to transition from different rooms to accommodate registration and measurement, developmental assessments, and vaccines. During the second week that we were there, we got to repeat the process with toddlers, ages 9-24 months. We were very impressed by the organization of the process. All of the toys were separated into cloth bags, and were labeled with the age group with whom they belonged. For example, in the 2 month-old bag, you can find a rattle, in order to test the baby’s gross motor movement. Each child was accompanied by a booklet that contained details about growth, vaccines, variations of normal, any health conditions, and medications given. The booklet always came to the clinic with the child, whether for a sick or well visit, and everything was easily recorded and congruent. </span></div>
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<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">There were many familiar elements of this assessment day- the developmental screenings were done using milestones we have learned in our programs, the growth is charted to ensure adequate nutrition and screen for possible metabolic concerns, and many of the vaccinations we also administer in the United States (one exception is a three dose series of the Japanese Encephalitis vaccine). Adjusting to technique and supplies differences was initially challenging, but we had the support of the nurse practitioners in the clinic to guide our learning. We were extremely impressed by the strength the children demonstrated when getting vaccinations- tears and screams were rare.</span></div>
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<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Schools were frequently used to provide assessments and support pediatric patients in the community. Kids of all grades were familiar with the 10-point evaluation used to screen for signs of abuse, skin concerns, dental caries, lice, conjunctivitis and other ophthalmologic issues, musculoskeletal and bone deformities, and deviations from normal gait. Vision screening and growth measurements were also included in each assessment day separate from the 10-point evaluation, and a heart and lung assessment was added by the SUT students. During one school visit, two dentists and a dental student were present to assess the oral cavity for caries, administer an injection of local anesthetic, and remove diseased baby teeth. This was a remarkable process to witness, both for its efficiency and for the incredible bravery each child demonstrated. We were again able to see the strength of this population. </span></div>
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<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">In the community, we were able to participate in the assessment of a jaundice newborn who had just returned home from a 24-hour hospital stay under bilirubin lights. The baby was three days old when we met him and he could not have been more adorable! We asked about the number of wet diapers, sleep, and postpartum depression and found that both mom and baby were doing really well. The multigenerational household standard was clearly beneficial from the standpoint of childcare, as this newborn had multiple caregivers and mom was able to rest and recover. </span></div>
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<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">We were so grateful to have had this cultural experience. We saw many differences as well as many similarities in pediatric health care delivery between Thailand and the United States. There were many things to be learned from the Thai population and their methods of healthcare delivery, and we will take some of these lessons home with us to be implemented in our careers. </span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-53832364688700512022016-11-18T09:15:00.001-05:002016-11-18T09:15:24.194-05:00Primary Care in the School Setting<div dir="ltr" style="line-height: 1.7999999999999998; margin-bottom: 0pt; margin-top: 0pt; text-indent: 36pt;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnxlGJJD7Q8hemAOMfDoddJciBqItMg1EmdXMQ8Z9470xQ2zry_ZBIKu0hJsAJve51VULBthMYKTL5yYiSFSVPINDNq4o9LcpjilSZzS45_h8YhrVBALCZX6B83Hg9pWX5_N1PqsOEz_M_/s1600/jane+eye+chart.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnxlGJJD7Q8hemAOMfDoddJciBqItMg1EmdXMQ8Z9470xQ2zry_ZBIKu0hJsAJve51VULBthMYKTL5yYiSFSVPINDNq4o9LcpjilSZzS45_h8YhrVBALCZX6B83Hg9pWX5_N1PqsOEz_M_/s320/jane+eye+chart.jpg" width="271" /></a></div>
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">School assessment and health education in Thailand is quite similar but also different in interesting ways than how it occurs in the United States. It was really fun to be able to teach the kids little songs and dances to remember proper hand-washing and teeth-brushing, as I’m sure many people remember these fun songs from their childhood. I was impressed that the Thai preschoolers learned a lot of the songs in English! It was also impressive to see that the kids were learning another language at such a young age. Some interesting differences arose in the process of the physical assessments. For example, EVERY child in the school came out of class and sat patiently while they waited to see the nurse. During the health screening, the University of Michigan and Thai students were able to do a number of assessments on each child: skin, teeth, hair, heart and lungs, and scoliosis checks. Many of us have limited experience working with children, so it was very helpful to get the opportunity to do SO MANY child assessments in a row. We were able to evaluate many normal assessments as well as identify potential health issues, such as dental caries. Although this appears to be a more common problem in Thailand than in the United States, free fluoride and dental work are provided to children at the community health promotion hospital. This is an interesting difference from the United States as many people cannot afford dental insurance and forgo treatment of dental issues. When we compared the assessments of dental hygiene in younger children versus the older children, it was clear that the kids here are participating in the dental care that they need as they age. </span><br />
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<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">With the help of our Thai brothers and sisters, we were able to identify a severe heart murmur in a 15-year-old student. More history revealed that it was a new murmur, and while the student reported feeling well, his heart rate was significantly elevated. Our Thai colleagues were able to identify the abnormal finding and, with our help in history taking, elicit more details. It was a first time for us to hear a murmur this pronounced and palpate a thrill, but it was a valuable learning experience for all of us, Thai students included. We were also able to educate and reassure the student while ensuring that he would follow up with the local hospital the next morning, although in the US this probably would have bought him an E.D. visit. Since the health promotion hospital works very closely with the school, we learned a couple of days later that he was admitted to the larger hospital and would be having surgery the next day. The school health assessment was invaluable in identifying and coordinating treatment for this young man, particularly because he was not symptomatic. We were impressed by the collaboration within the community, the Michigan students and the SUT students to follow up with his care.</span><br />
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<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">At the end of the day, we were able to observe a small Loi Krathong ceremony put on by the school children. This festival thanks the river for providing life to the fields and forests and asks for forgiveness for the polluting ways of the humans. Beautiful handmade boats, made of banana leaves, flowers, and candles, were placed into the river by the students. It was a perfect end to a unique and insightful couple of days. This entire day was a great reminder of the valuable experience that we have gained thus far while in Thailand, gaining knowledge about another culture while also furthering our skills as future nurse practitioners.</span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-31071017662393183632016-11-17T09:32:00.000-05:002016-11-18T09:20:54.543-05:00The Siamese Fireback and the Bees<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">During our first week in Don Kwian, two of us accompanied our Thai sisters to a primary/secondary school in a nearby village. The purpose of our visit was to assess the community health needs of the children, of which many were identified. At the end of the meeting, we were asked to collaborate with our Thai sisters to develop a sex education program for the secondary school students, to be taught four days later. In Thailand, comprehensive sex education is expected in schools, and we were elated to be included in such a unique opportunity!</span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">(Two of our Thai sisters holding a banner they created for the day.)</span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">When collaborating, we were astounded at how dedicated the Thai students were to this assignment. They quickly produced an intricately detailed schedule for the sex education session, and created high-quality, engaging posters on contraception, puberty, and sexually transmitted infections. Not only are these young women phenomenal students, they take an incredible amount of pride in the education they receive. They exert gratitude and respect for others at all times, even when they are exhausted from sleep deprivation, immersing themselves in a new community for six weeks, and working diligently together through all hours of the day and night. </span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">(Julia introducing the sex education presentation with our Thai sisters, Eve and Ped. Notice Gel rocking out on the drums!)</span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">Moreover, our Thai sisters seem to work magically well together. They fall into an intricate rhythm of enthusiasm, warmth, and supporting each others' strengths. This fostered an open, accepting environment for teaching and learning about such a potentially sensitive topic. </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">Their work was well-organized and thorough, and they were dedicated to using multiple teaching modalities to effectively communicate with the adolescents.</span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;"> </span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">On the day of the presentation, our Thai sisters impressed us all with their ability to garner and maintain the interest of skeptical, reserved adolescent students. From the ages of 12-17, children present unique challenges to teaching that force educators to devise creative solutions. The topic of sexual education is not exempt from this and is arguably an even more difficult subject to teach due to the potential for awkwardness or discomfort. </span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;"><span class="">(One of the fantastic posters our Thai sisters produced!)</span></span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">Nonetheless, our Thai sisters excelled in teaching sexual education and "bringing it all together" by playing a game with the secondary school students. After being seated in a circle, a balled up piece of paper was passed among the students in a quick fashion a la hot potato-- a game our Thai sisters called "cabbage." Music and dance accompanied the object being passed, provided live by our Thai sisters, and a stop to the music meant whomever holding the ball at that moment would be brought into the middle of the circle. After entering the middle of the circle, a layer was removed from the ball of paper like an onion shedding skin, and the piece of paper contained a scenario. The scenarios reinforced and applied knowledge taught in the sexual education lecture, challenging the secondary school students to synthesize and practice with new information. Audience members cheered and chuckled as the student in the middle navigated the scenario. </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">The sheer ingenuity of this game cannot be overstated, and e</span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">veryone involved seemed to enjoy the game tremendously!</span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">Creativity in the classroom is decreasing as teachers and parents are more reliant upon technology to educate students. However, technology is </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">often </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">exclusionary and alienates the human element of learning. In this sexual education lesson, our Thai sisters inspired us to implement innovative thinking when teaching. As healthcare providers, much of our teaching occurs in the office setting. This activity demonstrates that opportunities for teaching extend far beyond clinic hours. Most importantly, constructing clever ways to communicate health information is tremendously beneficial for learners and teachers. </span><br />
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<span style="background-color: white; color: #222222; font-family: "arial" , sans-serif; font-size: 12.8px; white-space: pre-wrap;">The dedication and compassion towards community health exerted by our Thai sisters was tremendously inspiring. </span><br />
<span style="color: #222222; font-family: "arial" , sans-serif;"><span style="background-color: white; font-size: 12.8px; white-space: pre-wrap;">As future Nurse Practitioners, we will incorporate and apply all we have learned throughout this experience as we strive to provide a platform for open communication, acceptance, and comprehensive education.</span></span><br />
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With love Aubree, Cassie, Jordan, Julia, Lizzi, MishaUnknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-26260739123619431042016-11-15T08:09:00.001-05:002016-11-15T08:09:23.987-05:00Happy World Diabetes Day...from Thailand<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Arial, sans-serif; font-size: 11pt;">Today we celebrated World Diabetes Day from an international location, Nakhon
Ratchasima, Thailand. While we didn’t spend the day treating diabetes specifically, </span><span style="font-family: Arial, sans-serif; font-size: 11pt; text-indent: 0.5in;">I was able to reflect on the diabetic population in Thailand as well as at home. </span></div>
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<span style="font-family: Arial, sans-serif; font-size: 11pt; text-indent: 0.5in;">We are quickly
learning how differently this disease is managed around the world. While it
seems Europe and the US are using cutting edge technologies for management, rural Thailand seems
to have a different approach. In fact, regular insulin is still used for management. </span></div>
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<span style="font-family: Arial, sans-serif; font-size: 11pt; text-indent: 0.5in;">Similar to America, type
2 diabetes is the most prevalent type in Thailand. However, I will always have the
type 1 population in the forefront of my interests, and closest to my heart. I
am so fortunate to celebrate this day from such an exotic location across the
world while learning about different approaches to care.</span></div>
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<span style="font-family: Arial, sans-serif; font-size: 11pt;">Wishing my
colleagues and friends a happy Diabetes Day! I encourage everyone to learn
something new about this disease process today!! </span><o:p></o:p></div>
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Admin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.com1tag:blogger.com,1999:blog-5397289090277530820.post-14106869033104009852016-11-12T00:02:00.000-05:002016-11-12T00:02:02.449-05:00Patient Centered Care: Crossing Borders <div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: .5in;">
<span style="color: #3a3e44; font-family: "times"; mso-bidi-font-family: Helvetica;">One of the distinctive events of our clinical immersion is that we have the opportunity to tour our community, on foot and bike, and meet patients in their home. During this process, we came across a very sweet family, who had just
finished bathing their elderly mother.<span style="mso-spacerun: yes;"> As we approached the home w</span>e observed flies swarming around her feet that were covered by a
blanket. When we removed the blanket we noticed that her left second toe
was discolored and appeared to be ready to fall off. <o:p></o:p></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijqo-mB1OTrfs06iIa4jo2qUjGswMThW4XhDnElMCxDd6CqXDv-Q7jNjbXeyaTO-P4VbXXdcAHAdHJGGr3ZXjGMkqgMcGJNv9gV6HAv1xHEGj0cWcxiSdgxFdmQyCvn3vScK_NWIPMSUB1/s1600/thai+toe+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijqo-mB1OTrfs06iIa4jo2qUjGswMThW4XhDnElMCxDd6CqXDv-Q7jNjbXeyaTO-P4VbXXdcAHAdHJGGr3ZXjGMkqgMcGJNv9gV6HAv1xHEGj0cWcxiSdgxFdmQyCvn3vScK_NWIPMSUB1/s320/thai+toe+1.jpg" width="176" /></a></div>
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<span style="color: #3a3e44; font-family: "times"; mso-bidi-font-family: Helvetica;">With interpretation by the Thai students and professor who were with us, we worked to do a thorough evaluation of the patient. She stated that the toe was once painful but she now had limited sensation and no pain. When asked why she did not seek care for this issue, she replied that she thought it would cause more pain.<span style="mso-spacerun: yes;"> </span>The family stated that they had taken
their mother to a health care provider, but were unsatisfied with the treatment plan offered. These feelings have continued to impact the way that the patient and family utilize health care services. </span><br />
<span style="color: #3a3e44; font-family: "times"; mso-bidi-font-family: Helvetica;"><br /></span></div>
<div class="MsoNormal" style="text-indent: .5in;">
<span style="font-family: "times";">During the home visit we, along with our Thai brothers and sisters, developed a plan
that included the priorities and values of the patient and family.<span style="mso-spacerun: yes;"> We were able to work with the clinic and the community to provide transportation to this patient who had limited mobility. Once she arrived at the clinic, w</span>e were able to not only complete the dressing change without pain to the patient, but we were also able to teach the family
how to help care for the wound while at home.<span style="mso-spacerun: yes;"> Our Thai sisters also used an innovative method to catch bugs as an additional method to keep the wound clean. </span></span><br />
<span style="font-family: "times";"><span style="mso-spacerun: yes;"><br /></span></span>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijBhhdGXg_8UYJnPzFxjEVhIurfzn3-w5rbvP5GerhBTJsOnHqYd5oZnvVzTaxErIgzXB9nvQcALhyphenhyphenx_R0geh1XmLY2C-xqnsTMcRLMRW_4BUvlBnNaSiP9fSvFNrTXUiM_pyQgsDAVTWL/s1600/Thai+bug+trap.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijBhhdGXg_8UYJnPzFxjEVhIurfzn3-w5rbvP5GerhBTJsOnHqYd5oZnvVzTaxErIgzXB9nvQcALhyphenhyphenx_R0geh1XmLY2C-xqnsTMcRLMRW_4BUvlBnNaSiP9fSvFNrTXUiM_pyQgsDAVTWL/s320/Thai+bug+trap.jpg" width="320" /></a></div>
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<span style="font-family: times; text-indent: 0.5in;"><br /></span>
<span style="font-family: times; text-indent: 0.5in;">As providers, our priority was not only to provide a painless dressing change, but to also develop a plan that was acceptable to the family and patient. Regardless of culture or country, patients and family members seem to be more invested, have more trust, and are more willing to participate in their health care if providers are able to communicate and demonstrate that they value the opinions, values, and needs of the patient and caregivers. </span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAfnF5KTvOsDwO9BJ87J9omrl4tFPxg6xM0008K1TelmVjezq-7Gvq8CVBYTmpnKCXiBr69PSOgZsYYEvX6yNwQFiQ4Qah-8SlwfrFGupNbOOBOIkGxSgQNgLTQY10ce_CCUhCaaqO5kaI/s1600/foot+dressing+change.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAfnF5KTvOsDwO9BJ87J9omrl4tFPxg6xM0008K1TelmVjezq-7Gvq8CVBYTmpnKCXiBr69PSOgZsYYEvX6yNwQFiQ4Qah-8SlwfrFGupNbOOBOIkGxSgQNgLTQY10ce_CCUhCaaqO5kaI/s320/foot+dressing+change.jpg" width="240" /></a></div>
<span style="font-family: "times";"><span style="mso-spacerun: yes;"><br /></span></span>
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<div class="MsoNormal" style="text-indent: .5in;">
<span style="font-family: "times";">Upon reflection of this experience, we were able to recognize some similarities and
differences with wound care in the United States.<span style="mso-spacerun: yes;"> W</span>e appreciated the fact that the
process of dressing changes was different; t</span><span style="font-family: times; text-indent: 0.5in;">here is a greater appreciation and conservation of dressing supplies
without compromising the need of the patient. </span><span style="font-family: times; text-indent: 0.5in;"> In the US, we tend to be less thoughtful with our supplies or resources. </span><span style="font-family: times; text-indent: 0.5in;">Unfortunately, we have observed instances in the US and abroad in which people are prescribed treatment plans that
do not fit in to their lives or their belief system and therefore fail.</span><span style="font-family: times; text-indent: 0.5in;"> </span><span style="font-family: times; text-indent: 0.5in;">We have witnessed fear and lack of trust in
our health system act as barriers to care. </span><span style="font-family: times; text-indent: 0.5in;"> While t</span><span style="font-family: times; text-indent: 0.5in;">hese are very complex issues and lack a simple solution, working to be inclusive with your patient's needs, priorities, and values is an excellent start to decreasing these barriers and improving overall care and patient outcomes. </span><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-79739952472722815712016-11-10T08:49:00.001-05:002016-11-10T08:49:48.536-05:00Thailand: Relearning fundamentalsToday marks one week since my initial arrival in Seoul, South Korea, but with every day that passes I continue to re-learn behaviors that have been ingrained since toddlerhood. From the moment I arrived in southeast Asia, it was immediately clear that this way of life is much different.<br />
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<h3>
America is loud!</h3>
After deplaning in Seoul, I entered an airport environment that was distinctly different from any United States airport I have encountered. The airport looked the same externally and internally, and the weary travelers didn't look much different than those of America. But it sounded so drastically different that it demanded my attention even in a jet-lagged state. It was <i>silent</i>!<br />
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Hundreds of people were lined up to board the train to transport travelers from one end of the Incheon airport to another, but nearly everyone was silent.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZjnYGc6ssMAlOh6h0uRpiJ06Cu5o4HbAECsDb0RTpfmKRBalhLzzBJ4RViKS7XJKVkjYR45ZxvZ4xpydUb5uCsAo842nghYeU1OJVKPFy75HUADez9fFRSLEAk021umEarSZp3dCaHE8/s1600/IMG_1306.JPG" imageanchor="1"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZjnYGc6ssMAlOh6h0uRpiJ06Cu5o4HbAECsDb0RTpfmKRBalhLzzBJ4RViKS7XJKVkjYR45ZxvZ4xpydUb5uCsAo842nghYeU1OJVKPFy75HUADez9fFRSLEAk021umEarSZp3dCaHE8/s320/IMG_1306.JPG" width="320" /></a><br />
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Not to mention the bathroom that had a small soap dispenser attached to the wall with instructions to clean the seat before sitting, and the array of mysterious Korean labeled buttons attached to the toilet seat (which I later learned to be a bidet).<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiczjHGQDbHb3ISQgC95aFvV35ecLHbT7wbZctZs7lv7-yir4FDy8nQClOaCXoRGgO-2d6mIGAIlKdMX-_Dix_M7n3uoUmbEV297unbu-puIhkUlcfMIqGvhQVXJG6q0AMIUsb7-086R_k/s1600/tsc.PNG" imageanchor="1"><img border="0" height="254" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiczjHGQDbHb3ISQgC95aFvV35ecLHbT7wbZctZs7lv7-yir4FDy8nQClOaCXoRGgO-2d6mIGAIlKdMX-_Dix_M7n3uoUmbEV297unbu-puIhkUlcfMIqGvhQVXJG6q0AMIUsb7-086R_k/s320/tsc.PNG" width="320" /></a><br />
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Which brings us to our next topic...<br />
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<h3>
Don't sit on the toilet!</h3>
In Thailand, I don't have to worry about enigmatic Korean buttons on the toilet, because many toilets are simple 12" tall rectangular pieces of porcelain better known as "squatty potties".<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgffCtQKcXHBJ0Yusnlix9eTtxUgwqkkMnT78R02Z0VnzN4x73hNg_lHaX7W1E-Gj1luQ2gMTshsKDjHBO0o9lrq22wUqsbXd5zaNyhO1UbWROwXXZMx3Aww1g1OEPYDhg9fYoLCTw7Ouc/s1600/IMG_1538.jpg" imageanchor="1"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgffCtQKcXHBJ0Yusnlix9eTtxUgwqkkMnT78R02Z0VnzN4x73hNg_lHaX7W1E-Gj1luQ2gMTshsKDjHBO0o9lrq22wUqsbXd5zaNyhO1UbWROwXXZMx3Aww1g1OEPYDhg9fYoLCTw7Ouc/s320/IMG_1538.jpg" width="240" /></a><br />
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While city and well-developed areas in Thailand usually have access to western toilets, most developing or rural areas of Thailand rely on the more traditional toilet. There is no handle to flush, either. The small spicket on the right (photo above) is used to fill a basin with water. Pouring the basin down the potty is what flushes the waste.<br />
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<h3>
Don't put toilet paper in the toilet!</h3>
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If you ever want to feel confused at the most primitive level, try re-learning how to use the toilet. Due to the dated and struggling water treatment system that Thailand utilizes, toilet paper cannot be flushed. This includes both western and traditional toilets, although I have been told that large new developments, like swanky hotels, can handle toilet paper being flushed. There is usually a sign by the toilet warning you to not flush toilet paper. This is all assuming you remembered to bring toilet paper with you - notice the absence of a toilet paper dispenser in the bathroom?<br />
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<h3>
Adventurous eaters welcome</h3>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8DNp1VIy2V4zpsxyqMCZVEq1VRenqyovhsH3TT_3RxW96UVIneMSKIsKj6Lq1kOg2Hc_QaLHWD9nxliGpNUrf3VJWKXBfCRY7EgTKYav7R0QSg_u20XOU5Fabmma2ST6dP1NpmqVHNks/s1600/IMG_1490.jpg" imageanchor="1"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8DNp1VIy2V4zpsxyqMCZVEq1VRenqyovhsH3TT_3RxW96UVIneMSKIsKj6Lq1kOg2Hc_QaLHWD9nxliGpNUrf3VJWKXBfCRY7EgTKYav7R0QSg_u20XOU5Fabmma2ST6dP1NpmqVHNks/s320/IMG_1490.jpg" width="320" /></a></div>
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Ok, enough toilet talk. If you are someone that finds the thought of exotic dishes like chicken heart, coagulated blood, or <a href="https://en.wikipedia.org/wiki/Lansium_parasiticum">langsat</a> enticing, you will enjoy Thai cuisine very much! The crucial re-learning process of eating in Thailand has revolved around two things. </div>
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First, try a <i>small</i> bite, and be ready for some spice. Many of the flavors are brand new to American palates, and spice is used liberally in Thailand as the essence of flavor. Second, get used to using a spoon. Rather than forks, Thais traditionally use a spoon with raised edges (seen in photo above). If forks are provided, they are traditionally used to scoop food onto the spoon.<br />
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<h3>
Smile</h3>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOkINNOrSrC71VTzatvNSg7I07UOnyhQfzrptDgGw6JCeN9phcw8wlJjpWEmrmY9E33kbAcn-v6HvMTuHZgGzm1qpjnbGh8egkFrsGGjmnsreK4sJHkbOV9OqEMKGWNjqZe_wxn4uey8w/s1600/15016176_10202163684729590_880978285235498704_o.jpg" imageanchor="1"><img border="0" height="148" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOkINNOrSrC71VTzatvNSg7I07UOnyhQfzrptDgGw6JCeN9phcw8wlJjpWEmrmY9E33kbAcn-v6HvMTuHZgGzm1qpjnbGh8egkFrsGGjmnsreK4sJHkbOV9OqEMKGWNjqZe_wxn4uey8w/s320/15016176_10202163684729590_880978285235498704_o.jpg" width="320" /></a></div>
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Last but not least, smiling is the foundation of socializing in Thailand. Natives have smiled at me and my American colleagues with every encounter, and they always start with saying hello in the native tongue; an enthusiastic <i>sa-wat-dee-ka</i>! This is a stark contrast to how strangers are greeted back home in America. </div>
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Yes, we are visitors here, and that could be responsible for some of the friendly welcoming. Nonetheless, I constantly observe natives greeting each other in the exact same way - a warm smile and a happy hello. Thai people are kind, welcoming and selfless. We have traveled from bustling Bangkok, to small urban cities, to rural villages. Everywhere we go, the warm embrace of friends and strangers remains constant. It's a very special feeling to feel welcome everywhere you go.</div>
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The Thai culture is simply beautiful, and we are truly privileged to be here.</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-41066052818417595152016-11-07T05:20:00.003-05:002016-11-08T08:05:03.630-05:00Culture & Tradition 101<div class="separator" style="clear: both; text-align: center;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVX9QVThE3O9u_Qx_HKEAI9uJ4pqD7xKTTc3S8kBC4SvU1FF1TkrFf37PsCafw_uer1bdzwoB1SJqKOsMZxrrze06CvYDcZjRQSla8gbr859UeX7xIOnt0DjTKaq0qWbP85b-Z7yM2l4UP/s1600/manda+graduation.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVX9QVThE3O9u_Qx_HKEAI9uJ4pqD7xKTTc3S8kBC4SvU1FF1TkrFf37PsCafw_uer1bdzwoB1SJqKOsMZxrrze06CvYDcZjRQSla8gbr859UeX7xIOnt0DjTKaq0qWbP85b-Z7yM2l4UP/s320/manda+graduation.jpg" width="240" /></a></div>
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The University of Michigan School of Nursing has returned to Korat and <a href="http://www.sut.ac.th/sutweb/sutinfo_en.html">Suranaree University of Technology</a> (SUT) for another global clinical immersion. Our first days have been filled with opportunities to experience culture and tradition. While the students were learning about Thailand and Thai history in the community, the faculty had the opportunity to participate in graduation ceremonies on campus.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcuuOuM0uyyZkSqSW8o-dtz_71TRZzGTY1MkI8GFSsXmtR8vyC2jf1zzHPMkypbyViMMcX6J_1nqcrvGd187QNghUtq7_E0ZvA7NtDIQEyWyKmqrevWzQ28nUcgQ-lTeICFsCVPGHf4QoW/s1600/m+and+a+with+rector.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="179" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcuuOuM0uyyZkSqSW8o-dtz_71TRZzGTY1MkI8GFSsXmtR8vyC2jf1zzHPMkypbyViMMcX6J_1nqcrvGd187QNghUtq7_E0ZvA7NtDIQEyWyKmqrevWzQ28nUcgQ-lTeICFsCVPGHf4QoW/s320/m+and+a+with+rector.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Discussing Michigan and B1G football with SUT Rector and Dean of Nursing</td></tr>
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SUT graduated over 2500 students from several different programs. This year the students received their certificates from the Crown Princess who was present on behalf of King Bhumibol. As a cultural outsider, it was amazing to be able to witness the respect, tradition, and honor that was palpable across campus. Similar to a graduation in US, the faculty and students wore gowns that represented their levels of education and programs, they marched into the auditorium, and students were presented with diplomas and awards. In contrast, the families were seated outside of the building during the ceremony and there was no clapping at any time (out of respect for King Bhumibol).<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmAeRufpoiMdH7mJLyNKa37l3UOHS3KEn-7Veh0QremCxBT06VLYgHv1ErQohbCQIDBgWVgQuqkbvLuI9Hl5MeHRULgxz7eFcW8SJ44EkXmZ1COVyYEvFCbrHafYjkf5aEisRwWMFd51Ze/s1600/student+inside.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmAeRufpoiMdH7mJLyNKa37l3UOHS3KEn-7Veh0QremCxBT06VLYgHv1ErQohbCQIDBgWVgQuqkbvLuI9Hl5MeHRULgxz7eFcW8SJ44EkXmZ1COVyYEvFCbrHafYjkf5aEisRwWMFd51Ze/s320/student+inside.jpg" width="320" /></a></div>
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Despite there being thousands of students who's names were read, the ceremony was quiet and respectful. As the students moved across the stage to receive their certificates, it was like watching a performance where students bowed and stepped as if they innately knew a graceful dance of tradition.<br />
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<tr><td class="tr-caption" style="text-align: center;">Tribute to <span style="font-size: 12.8px;">King Bhumibol</span></td></tr>
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It was such an honor to be included in the graduation. We love our time at SUT and our Thai colleagues and students. The last few days have provided a glimpse into Thai culture and tradition and is a reminder that students gain so much more than patient contact hours. Intangibles such as tradition, honor, respect, and value have the potential to impact our students not only in the short term during the clinical immersion, but can also carry over into clinical practice far after graduation.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjksrVaKt_C9hLbyGvbDgy7EJ20AR9HeTQ1EP9xz_SxDjEFjearQgEa39KMwT9ojoPY5okSKZ_Iqr7P_LUyDhYf5jTLrF_YWOS1XQmCitO9sWE8ylUZniW_3h2mK8cydlrcQ3ZKjv_9Q5iD/s1600/nar+michelle+april.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjksrVaKt_C9hLbyGvbDgy7EJ20AR9HeTQ1EP9xz_SxDjEFjearQgEa39KMwT9ojoPY5okSKZ_Iqr7P_LUyDhYf5jTLrF_YWOS1XQmCitO9sWE8ylUZniW_3h2mK8cydlrcQ3ZKjv_9Q5iD/s320/nar+michelle+april.jpg" width="320" /></a></div>
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<i>We are our culture and tradition; if there is no culture or tradition we are no one. </i><br />
--Tamerlan KuzgovAdmin-Aprilhttp://www.blogger.com/profile/16057274483400098750noreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-46500779137131609852015-11-23T11:05:00.000-05:002015-11-23T11:05:26.363-05:00An Unforgettable Farewell Celebration<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal;">
On our last day of clinical in Korat, we were honored to be invited to celebrate the evening with the SUT faculty and students, as well as the community members. The celebration took place in the center of the village, and many of the patients we had seen during home visits and in the clinic were in attendance to see us off. It was the perfect ending to an unforgettable clinical experience working closely with our Thai sisters and the community. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvmi91f6LFHNhj8ubtk6Pi-eCDAUz21q-1Q9MLDV8Wv1RqN6SimXgKHJ0q7UbFsbOd5yrmA0_OpW8FoKz-tL3rpuKzLOIXvl0t7wvdiWcsrLEyJAc2Mm7H-_v2kQlMrKefuhUJRUc6lePH/s1600/Community+decorations.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="216" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvmi91f6LFHNhj8ubtk6Pi-eCDAUz21q-1Q9MLDV8Wv1RqN6SimXgKHJ0q7UbFsbOd5yrmA0_OpW8FoKz-tL3rpuKzLOIXvl0t7wvdiWcsrLEyJAc2Mm7H-_v2kQlMrKefuhUJRUc6lePH/s320/Community+decorations.jpg" width="320" /></a></div>
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During the afternoon leading up to the celebration, we had the opportunity to assist our Thai sisters and the SUT faculty in preparing a meal to bring to the evening celebration. Our Thai sisters showed off their skills cleaning and shredding coconut, and we helped them to make fresh coconut milk for a panang curry dish. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpX4HM_IjUZmIO_d-Eqv-n4K0UEgSTo0lS1BajoSojh4WYIAnQ-sDCwz64yxNp04sK1_AIXbcJTyMMXRj3i3ASIKy8H1S38lIwct6cKnsbBFI_iRnx71mdmtA5MWH36kG0myFdfZpozb6X/s1600/IMG_2223.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpX4HM_IjUZmIO_d-Eqv-n4K0UEgSTo0lS1BajoSojh4WYIAnQ-sDCwz64yxNp04sK1_AIXbcJTyMMXRj3i3ASIKy8H1S38lIwct6cKnsbBFI_iRnx71mdmtA5MWH36kG0myFdfZpozb6X/s320/IMG_2223.jpg" width="240" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj24X2OaFr83dCSjlhPZyS-E_bFXPFiKsQbiz7CIMuDVoaz4fXIgw37exARqL3TLeQrN5mbWyV_sKYqGedPsvmw0tOSh66gT2LQtlidGUbkwyDLNI2KVtB6gBNFThdfXVEqUvltW_Coy48P/s1600/IMG_2218.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj24X2OaFr83dCSjlhPZyS-E_bFXPFiKsQbiz7CIMuDVoaz4fXIgw37exARqL3TLeQrN5mbWyV_sKYqGedPsvmw0tOSh66gT2LQtlidGUbkwyDLNI2KVtB6gBNFThdfXVEqUvltW_Coy48P/s320/IMG_2218.jpg" width="240" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiID9b3QMDpS9YYaD3Xt1GOBO5gBqAxWRYDlPCwH84xZjERN27FzeqDRYp0ivYsHxFRkSjPePJw7Qmgnsb00WCNuow_cWPUQ4e5EWtBShOY2raKsiXcsUPVqN1x1v1KKgZTcIJC8ZyuHcvD/s1600/IMG_2202.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiID9b3QMDpS9YYaD3Xt1GOBO5gBqAxWRYDlPCwH84xZjERN27FzeqDRYp0ivYsHxFRkSjPePJw7Qmgnsb00WCNuow_cWPUQ4e5EWtBShOY2raKsiXcsUPVqN1x1v1KKgZTcIJC8ZyuHcvD/s200/IMG_2202.jpg" width="200" /></a></div>
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<span style="font-size: xx-small;"><i>Michelle and Nar shredding coconut</i></span></div>
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: xx-small;"><span style="font-family: "helvetica";"><span style="-webkit-text-stroke-width: initial; font-size: 11px;">We all got dressed in our traditional Thai outfits in preparation for the celebration - thank you to the sophomore SUT nursing students who lent us their clothing for the event! We bonded with our </span><span style="-webkit-text-stroke-width: initial; font-size: 11px;">Thai sisters as they braided our hair to help us get ready for the event (excluding the guys of course).</span></span><span style="-webkit-text-stroke-color: rgb(157, 69, 185); -webkit-text-stroke-width: initial; color: #9d45b9; font-family: "helvetica"; font-size: 11px;"> </span><span style="font-family: "helvetica";"><span style="-webkit-text-stroke-width: initial; font-size: 11px;">After two weeks of hard work, it was very fun to see our Thai sisters get a well-deserved break and enjoy the afternoon cooking with us. While we were occupied with coconut shredding contests, hair braiding, and cooking </span><span style="font-size: 11px;">panang,</span><span style="-webkit-text-stroke-width: initial; font-size: 11px;"> other members of the village were preparing handmade decorations and traditional Thai dishes for our community dinner.</span></span></span></div>
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<span style="font-size: 11px;"><span style="font-family: "arial" , "helvetica" , sans-serif;">In the eve</span></span><span style="font-family: "helvetica"; font-size: 11px;">ning, we walked to the center of the village together to begin the celebration. The community members had elaborately decorated the bridge and center of the village for the event. Yards of vibrant colored fabric were draped over the bridge, with hanging decorations creating the perfect centerpiece for the party. The older adults in the community lined each side of the bridge, seated in chairs. The first part of the celebration was very special, as we were honored to participate in a Baci ceremony. During a Baci ceremony a white thread of silk or cotton is tied around the wrist of the individual who is being wished well-being and good luck. The white thread symbolizes peace, harmony, good health and fortune, and community. The thread is to be worn for at least three days, and untied or allowed to fall off on its own thereafter. During our Baci ceremony, an elderly community leader (who has often been a Buddhist monk at some stage in his life) performed a blessing and tied a thread of cotton around each our wrists, one at a time.</span><br />
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<span style="font-size: xx-small;"><i>Baci Ceremony</i></span></div>
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<span style="-webkit-text-stroke-width: initial;">Following this initial blessing, we moved down the line of elders in the community who each said a personal blessing and offered well-wishes as they tied more threads around our wrists. We cannot describe how meaningful it was to us to look up into the warm, sincere faces of these older adults as they each said a blessing and wished us safe travels. It is something we will never forget. </span></div>
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<span style="font-size: xx-small;"><i>Making our way down the line for the Baci ceremony</i></span></div>
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After we completed the Baci ceremony, we were each presented with a traditional Thai krathong. Loi Krathong is a Thai holiday celebrated on the 12th full moon of the Thai lunar calendar and typically falls in early November. “Loi” means “to float,” while “krathong” is a small wreath-like raft constructed out of intricately folded banana leaves. The krathong typically includes flowers, candles, and incense sticks. The krathongs were all different and very beautiful.</div>
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After the candles and incense were lit and a blessing jointly recited, we were instructed to make a wish as we placed the krathongs into the river. The act of floating the krathong is symbolic of letting go of any grudges and anger, allowing one to start life anew on a better footing. </div>
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<span style="font-size: xx-small;"><i> Clare during Loi Krathong Ceremony Community Clinic Nurse Practitioner</i></span></div>
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<span style="-webkit-text-stroke-width: initial;">Dancing, led by the older adult women of the community, followed the Loi Krathong ceremony. They individually invited us to dance with them and did their best to teach us traditional Thai dance. When the music stopped, we knew it was time for us to perform the dance we had prepared for our Thai sisters’ entertainment. We took the stage and did our best to impress during our short choreographed dance. After we were finished, our Thai sisters performed a variety of songs and dance for us as well. After two weeks of hard community clinical work, they also dedicated themselves to planning and preparing these performances for our farewell. They are truly an amazing group of women and future nurses! </span></div>
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<span style="font-size: xx-small;"><i>Our group in traditional Thai outfits with our SUT sisters and faculty</i></span></div>
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After our group performances, we enjoyed a variety of authentic Thai dishes, including fresh noodles, prepared by the community members. After spending so much time in the community the past two weeks and seeing how much work goes into meal preparation, we cannot thank the SUT faculty, our Thai sisters, and the community members enough for the wonderful authentic Thai food!</div>
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Following dinner, the dancing continued into the evening with the older adult women outlasting all of us on the dance floor. I don’t know how they keep it up in the heat and humidity, but we all got some good exercise for sure! The presence of many village members and the sense of community throughout the evening was unbelievable. When the evening came to an end, it was especially difficult to say goodbye to our Thai sisters whom we’d grown to know and trust over the past two weeks. As we drove away, they lined the streets waving and shouting goodbye. It was an emotional yet perfect ending to our final evening among our Thai sisters and the community. </div>
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As we travel back to Michigan, we want to say thank you again to the SUT faculty, our Thai sisters, and all of the community members who made the evening one that we will never forget. It was so meaningful for our group to be able to participate in these Thai cultural traditions with you. We cannot thank you enough for your kindness and for welcoming us into your community during our short time in Thailand.</div>
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<span style="font-size: xx-small;"><i>Saying farewell to SUT before the drive back to Bangkok</i></span></div>
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-Mary Beth, Hanna, and Clare</div>
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<br />
<div class="MsoNormal" style="text-indent: .5in;">
There are three types of people
that you encounter as a traveler: missionaries, mercenaries, and misfits. I’m
not sure where nurses fall in this spectrum. For a good portion of this month I
have had the honor of participating in a program that pairs advanced practice
nursing students with bachelor level Thai nursing students through a
collaboration between the <o:p></o:p></div>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-FkuDqACYVgIrQkqqOLZnFN0bt6l3w3lG3vXMjvTVTn4GxR97kCmNoDMmrNCLO0_W1Uy972CWFTHHsXnm4qGdHemDE0GjAsQYEDGohtXpy4C6Rp69LItkuL1v4VZPpfe3QR5O3NLyELI/s1600/_1070909.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-FkuDqACYVgIrQkqqOLZnFN0bt6l3w3lG3vXMjvTVTn4GxR97kCmNoDMmrNCLO0_W1Uy972CWFTHHsXnm4qGdHemDE0GjAsQYEDGohtXpy4C6Rp69LItkuL1v4VZPpfe3QR5O3NLyELI/s320/_1070909.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sometimes travel is a leap of faith.</td></tr>
</tbody></table>
University of Michigan (U of M) and the Institute of
Nursing at Suranaree University of Technology (SUT). <br />
The SUT students are
completing a community health course, which entails completing a through
assessment of the health status and history of nearly every individual, family,
and village serviced by the district clinic. They are doing a proper
assessment; they are placed in a foreign community and spending nearly six
weeks living and working in these communities. Additionally they have been
taking on the role of medical interpreter as we conduct physical and
psychosocial assessments in both clinical and home settings.<br />
<div class="MsoNormal">
Although we
are students ourselves we have been assigned the role of expert clinician, a
role that we have been prepared for. Our program has taught not only the
importance of clinical assessment skills, but also the importance of
considering our patients as people. We look at their needs and desires, assets
and barriers to health care. We are trained not to only diagnose and treat
illness, but also to promote health and help in eliminating the barriers to
health. We have been gifted a skill set that transcends borders and language
barriers.<o:p></o:p></div>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiW3-Cg5D1i06mvOLCYb3S8aOJioDi1nn8LQss-h5snUmnPk100ig1vz7urvIH_ODdmecGCeLegaGrhUtAdAvARWdgFjXbkOZg3K0fhLTz9HNraeJ_8fI4e4r71Ze136pD5RyiaBVwHv4Q/s1600/_1080222.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiW3-Cg5D1i06mvOLCYb3S8aOJioDi1nn8LQss-h5snUmnPk100ig1vz7urvIH_ODdmecGCeLegaGrhUtAdAvARWdgFjXbkOZg3K0fhLTz9HNraeJ_8fI4e4r71Ze136pD5RyiaBVwHv4Q/s400/_1080222.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Other times it is PowerPoint longing for coffee in a bag, as our Thai Sisters demonstrate.</td></tr>
</tbody></table>
<div class="MsoNormal">
Our Thai
brothers and sisters as well as the communities we served have welcomed us
graciously. Huay Tai, a small village about 45 minutes south of Nakhon
Ratchasima, (or Korat) has been our base of operations. We’ll call it Village
11, as there are 15 villages that are served by the clinic… and I usually spell
and pronounce the names incorrectly, and confuse them with the province,
district and each other. Village 11 is amazing. The health problems that we
encountered are pretty standard, the same kinds of illnesses that you’d see in
any clinic or home visit the world over, but they have just been managed a bit
differently. Of course there are a couple of region specific problems that we
don’t really come across in the States – dengue fever, typhoid fever, betel nut
related complications, and healthy food choices in Buddhist monks, to list a
few. <o:p></o:p></div>
<div class="MsoNormal">
The team
dedicated to Village 11 consisted of three U of M NP students, whose
specialties include adult/gerontology primary care, pediatrics, midwifery,
occupational health, and international health (we like school, what can I say?)
and seven Thai students, who are finishing their BSN degrees. Like all teams
that matter it took awhile for everyone to work well together but in the end we
were a solid team that worked well together in increasing our own knowledge as
well as assessing and assisting our community. A community that embraced us
from the beginning; I’ve lost count of the number of new grandmothers that have
claimed us as their own.<o:p></o:p></div>
<div class="MsoNormal">
<o:p></o:p></div>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-v2n3d_UMyFzzj8kh7-O_n5ld-edb9ZHDghfExeYs9Vv-iUbypoe8g5PTA1W5OYLk_pVZVUvP6VsYTwd6MCKbBN_gOs9xa5iBGjFoStxpcYrSzC8d4KvHB0glzBwrvfSBR-GUo-w2wSs/s1600/P1080290.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-v2n3d_UMyFzzj8kh7-O_n5ld-edb9ZHDghfExeYs9Vv-iUbypoe8g5PTA1W5OYLk_pVZVUvP6VsYTwd6MCKbBN_gOs9xa5iBGjFoStxpcYrSzC8d4KvHB0glzBwrvfSBR-GUo-w2wSs/s400/P1080290.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">I told you it was a left at the Mango tree next to the <i>chicken</i>, not the duck.</td></tr>
</tbody></table>
A home
visit in rural Thailand isn’t quite the same as a house visit in the US. In the
US visits are planned well in advance (usually), have specific billing
criteria, and tend to focus on a specific problem: post discharge follow up,
acute care, wellness visits, medication review. Here we show up sometimes without a formal appointment.
There is of course more to it than that but essentially we knock doors and
people welcome us in (usually) they are open to share their stories, just like
in the States people will talk if you give them freedom to do so and just like
in the States you kind of have to keep them on track or a 20 minute visit lasts
two hours. Our patients here give us access to there medicine, log book (each
provider encounter is summarized and noted in little note book that the patient
keeps with them and brings to each encounter – America I’m looking at you for
this as it beats a eMAR any day), the even let us roam around their homes and
look in their food (a great way to measure sodium intake). The patient’s here
are open to suggestions (and just like the States knowledge doesn’t equal action).
That’s the beauty of this program, the Thai students gain a bit more knowledge
of assessment and the types of questions to ask from us and then they have
another month to follow up with the patients.<br />
<div class="MsoNormal">
As our time
in Thailand comes to an end I feel like I’m grieving. The community threw us a
party, complete with locally sourced food. <o:p></o:p></div>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSE27N3_XoYSIxZNBX8mgupS3XnbTsiHFFsRPn_xpEQdJFp-V15dsQpVnd-Ut_51Mt3wxE8g4eelrCUA5xVYGk0CKbzbunSXXNPk_pRp9hrebtSj8NIxUj4Op1yVCORKI5eYJnuG23HVc/s1600/P1070071.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSE27N3_XoYSIxZNBX8mgupS3XnbTsiHFFsRPn_xpEQdJFp-V15dsQpVnd-Ut_51Mt3wxE8g4eelrCUA5xVYGk0CKbzbunSXXNPk_pRp9hrebtSj8NIxUj4Op1yVCORKI5eYJnuG23HVc/s400/P1070071.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Noodles first, we'll address that burn after lunch.</td></tr>
</tbody></table>
There was a mom and pop noodle
factory that I assessed and have been trying to sample for the last two weeks,
high risk for thermal injury but world-class noodles. We had a early
celebration of Loi Krathong, the annual river festival where decorated baskets
are placed in the river and wishes are made as the basket floats away. Our
group was blessed by a traditional healer and received Sai Sin, or blessed string
bracelets, from the village elders (we did health assessments at two different
temples and I can tell you that performing a health assessment on a monk with
an audience of ten or more requires a new level of cultural competence. That
and monks tend to be stoic so don’t take offence if your jokes are met with
silence). And there was a three-way dance off between the community, the Thai
nursing students, and the U of M nursing students. While it wasn’t a contest,
they watched us Whip and Nae Nae. We nailed it.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmfGBziGx4ha316s5y6ckVYHrLarsAy8k7_UuxTW3UnQSmfGadocQpME42Pi3ZBwzwrgpsNL6xmQaqinapyFTimUQTvwMSCPmowNduD9Kt_LxjdhNVWcpgFqD8UpQw8lHNBgudLZMu0eA/s1600/_1080655.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmfGBziGx4ha316s5y6ckVYHrLarsAy8k7_UuxTW3UnQSmfGadocQpME42Pi3ZBwzwrgpsNL6xmQaqinapyFTimUQTvwMSCPmowNduD9Kt_LxjdhNVWcpgFqD8UpQw8lHNBgudLZMu0eA/s400/_1080655.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">...and that is how the Thai Family Functioning Scale was validated.</td></tr>
</tbody></table>
<div class="MsoNormal">
I’m sad to
leave but the community is in good hands. Nursing is hard to define, just sit
through one of our theory courses and you’ll understand, or actually not
understand. We enter the profession for various personal reasons (we hate the
‘Why did you become a nurse?’ question) and soon realize that it’s a hard job
that’s rewarding spiritually, and every once in a while financially. Nursing
takes us places if we are willing to step through the doors that it opens. So
yes the next time you are out in the world and trying to decide if that quirky
person with the dark sense of humor is a missionary, mercenary, or a misfit…
maybe they are all three because they just might be a nurse.<o:p></o:p></div>
<!--EndFragment--><br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-64920053283106120402015-11-23T10:54:00.001-05:002015-11-23T10:54:52.717-05:00Adventures in Thailand<div align="center" class="MsoNormal" style="text-align: center;">
<div style="text-align: left;">
I am going to write about one of my experiences during
the best clinical ever.<span style="mso-spacerun: yes;"> </span>I
had the privilege of seeing many patients in Nakhon
Ratchasima, one in particular had a great impact on me.<span style="mso-spacerun: yes;"> "</span>C", a 60 year old woman living in my assigned village.<span style="mso-spacerun: yes;"> </span>C was recently diagnosed with stage five kidney failure.<span style="mso-spacerun: yes;"> </span>Her physician recommended immediate dialysis however C was very reluctant.<span style="mso-spacerun: yes;">
</span>She did not understand dialysis and was afraid.<span style="mso-spacerun: yes;"> </span>On initial visit, the talented and
dedicated Thai students and I assessed her current health status.<span style="mso-spacerun: yes;"> </span>We found her to be doing remarkably well for
a patient with advanced renal failure and not on dialysis.<span style="mso-spacerun: yes;"> </span>C attributed her well being to the tea she drinks
several times per day. This tea is made from traditional medicinal Thai herbs, a subject I plan research further in the future.</div>
</div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<o:p> <table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-1zS2wK5KJbs/Vk3PHJ_kMYI/AAAAAAAAAgI/0Sfvs8q-z3s/s1600/_1080109.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="212" src="http://4.bp.blogspot.com/-1zS2wK5KJbs/Vk3PHJ_kMYI/AAAAAAAAAgI/0Sfvs8q-z3s/s320/_1080109.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Phyllanthus amarus</td></tr>
</tbody></table>
</o:p></div>
<div class="MsoNormal">
Together with the Thai students, C was educated on chronic kidney
disease and how important dialysis is for her health.<span style="mso-spacerun: yes;">
</span>We explored her concerns and found she had limited knowledge about dialysis.<span style="mso-spacerun: yes;"> </span>Additionally she
was afraid about getting an infection that would cause her to die quicker than not receiving dialysis.<span style="mso-spacerun: yes;"> </span>The Thai nursing
instructors and students decided to present her case to the village
elders for assistance.<span style="mso-spacerun: yes;"> </span>Once her case was
presented, it was decided that she would receive whatever assistance was necessary.<span style="mso-spacerun: yes;"> </span>I was amazed and delighted as I watched an
entire community coming together to help one of their own in need.<span style="mso-spacerun: yes;"> </span>I guess if one member of the village is sick,
they are all sick.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-GnpsnwwMc_g/Vk3TL2b4ybI/AAAAAAAAAg4/SfZe1QASbZ4/s1600/_1080104.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="213" src="http://4.bp.blogspot.com/-GnpsnwwMc_g/Vk3TL2b4ybI/AAAAAAAAAg4/SfZe1QASbZ4/s320/_1080104.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Renal Failure Education</td></tr>
</tbody></table>
The village leader arranged for C to talk with a
member of the community who was already receiving dialysis.<span style="mso-spacerun: yes;"> </span>We found ourselves there the very next
day!<span style="mso-spacerun: yes;"> </span>He described the process to her and
explained he was still living a reasonably normal life.<span style="mso-spacerun: yes;"> </span>This went a long way to assuage C’s fears,
but she was still not ready to commit to treatment.<span style="mso-spacerun: yes;"> </span>One of the Thai nursing instructors
suggested we take her to the local hospital to see hemodialysis in action.<span style="mso-spacerun: yes;"> </span>Again, the very next day we were on the
dialysis unit at the district hospital.<span style="mso-spacerun: yes;">
</span>I watched happily as one of the patients utilizing a
dialysis machine assured C that this was not some horrible sentence,
rather a chance at prolonging her life.<span style="mso-spacerun: yes;"> </span>By
the time we left, C had decided to proceed with hemodialysis, and a vascular surgeon
consult was arranged for the following week.<o:p></o:p></div>
<div class="MsoNormal">
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-_tvcHqaJnco/Vk3c1zA1RfI/AAAAAAAAAhM/q23rl2xF4ZA/s1600/Community%2BForum.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://4.bp.blogspot.com/-_tvcHqaJnco/Vk3c1zA1RfI/AAAAAAAAAhM/q23rl2xF4ZA/s400/Community%2BForum.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Community Forum</td></tr>
</tbody></table>
<br /></div>
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<!--EndFragment--><br />
<div class="MsoNormal">
I have been pleasantly surprised at a great number of things during my
adventure here.<span style="mso-spacerun: yes;"> </span>Wonderful food (not the
same as Thai restaurants in the States!), beautiful temples, picturesque
countryside views, and the most courteous and welcoming people I have ever met.<span style="mso-spacerun: yes;"> W</span>hat stands out the most, for me, is the Thai peoples' ability and desire to come together and help each other when one of their
community is in need.<span style="mso-spacerun: yes;"> </span>I feel very
fortunate to have been part of this experience.<br />
<o:p></o:p></div>
Anonymousnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-22575746909047084362015-11-19T07:05:00.000-05:002015-11-19T07:21:04.584-05:00Compassion, Dedication, and Trust: The Heart of Community Nursing<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: Helvetica; font-size: 11px; line-height: normal;">
Prior to arriving in Thailand, I wasn’t sure what to expect during our two-week clinical experience. I anticipated feeling a bit of initial culture shock and assumed that the language barrier would potentially interfere with my ability to connect with patients as well as our Thai nursing student colleagues. </div>
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However, I was pleasantly proven wrong. Since day one, the Thai nursing students (our “Thai sisters”) and the SUT faculty have welcomed us and integrated us as part of their team. Our first clinical day we rode bikes into the community with our Thai sisters to perform a windshield survey and begin the process of assessing the community’s health problems and needs. Our Thai sisters were kind enough to share their bikes with us, even letting some of us ride on the back of their bikes to get to patient’s homes. While a few of us felt a bit shaky about our bike-riding skills, we felt reassured that we were in safe hands when out in the community with our sisters as they frequently looked back to check on our status or warn us of the presence of a potentially unfriendly dog. </div>
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<i> Biking to home visits in the community with our Thai sisters</i></div>
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When making home visits, our Thai sisters assist us in introducing ourselves to the community members and help translate our health questions. They help us learn basic Thai words and phrases so that we can better connect with the patients we see in both the clinic and the home. During home visits, they gather extensive data regarding individual health risk factors and community health concerns. </div>
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<span style="-webkit-text-stroke-color: rgb(0, 0, 0); font-family: "helvetica"; font-size: 11px;">Over the following days, we got to know the patients in the community better and begin to build more trusting relationships. They seemed to appreciate our attempts at learning their complex language and our eagerness to learn about their life and health status. And when we had difficulty communicating with words, a smile and touch seemed to go a long way in making a positive connection. </span></div>
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<span style="-webkit-text-stroke-width: initial;">As a healthcare provider, it really is a privilege to have the opportunity to see patients in their space, and the members of the community have been very gracious to allow us to enter their homes to learn from them. We gain a glimpse into their environment as we can see how they live, manage their daily healthcare needs, and explore what barriers and health risks are present. We can perform a thorough health assessment and medication review in the home, and when concerns are identified we can recommend that the patient come to the community clinic for further evaluation. During our days in the clinic, it has been encouraging to see these familiar patients from the community follow through and come to the clinic for further care.</span></div>
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I have greatly appreciated that the community clinic staff has welcomed us into their setting as well. In the community clinic, we work closely with the nurse practitioners and nursing staff, as well as the SUT faculty and nursing students who assist us with translation. They have an organized system for directing patient flow, even when well over 100 patients arrive at one time for chronic disease management day. The clinic staff, community members, and SUT students and faculty work collaboratively with us to develop individualized care plans and strategies to promote each patient and family’s unique health needs. </div>
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<i>SUT faculty, community clinic nurse practitioner, and Jason evaluating a complex patient in the community</i></div>
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As our time here in Thailand comes to an end, I continue to be extremely impressed by the hard work and dedication displayed by our Thai nursing student sisters. They stay up working late into the night, sometimes past 2AM, to ensure that they have complete data and a thorough assessment of the community’s main health risks and concerns. They frequently seek our feedback and suggestions on ways they can improve and prepare for community forums and grand rounds presentations on complex patients in their communities. Our Thai sisters will spend four more weeks living in these village communities after we return to Michigan, and I look forward to hearing about their progress as they strive to succeed in making a positive impact on the health of their communities.</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-48830138758028910212015-11-18T09:11:00.000-05:002015-11-18T09:11:07.673-05:00My 8 Thai Sisters <div class="MsoNormal">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgblsUyDwTIr4segY46TAPC2OEPPMop20XH-dpGBlqL54jA6L5G5b5f4xxwX9iiNWHh2Zu_0tLpNoM9zp9lzQ3HzhgzhfbA59Bk9AtY-T8Juh9jTtixQo-201N_GpeGaXM5hHwdwHk6dvsZ/s1600/IMG_3465.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgblsUyDwTIr4segY46TAPC2OEPPMop20XH-dpGBlqL54jA6L5G5b5f4xxwX9iiNWHh2Zu_0tLpNoM9zp9lzQ3HzhgzhfbA59Bk9AtY-T8Juh9jTtixQo-201N_GpeGaXM5hHwdwHk6dvsZ/s320/IMG_3465.jpg" width="240" /></a><span style="font-family: "times new roman";">This trip is my first time traveling internationally and I am in love. </span><br />
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<span style="font-family: "times new roman";"><span class="">I owe most, if not all, of my incredible cultural and clinical learning experience to 8 amazing students. </span><span class="">On the first day of clinical I was assigned to a village along with 2 of my fellow Family Nurse Practitioner classmates from the University of Michigan and 8 Thai Bachelor of Science in Nursing students from Suranaree University of Technology. </span>These 8 Thai students were embarking on a 6-week journey: living, learning, and providing care all in the same community. They all live together under one roof which consists of one room, one bathroom, and one kitchen. The room is approximately a 12 foot square where all 8 of them bring out blankets and pillows to sleep at nighttime and during the day bring out a table and 8 chairs to study and work on their community projects. </span><br />
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<span style="font-family: "times new roman";">Through the short time I had the pleasure of knowing and working with these students I learned quickly they are all brilliant, passionate, kind-hearted and extremely hard working. I honestly do not think "extremely hard working" is even a grand enough phrase to emphasize their strong work ethic. For example, I made it a routine to ask the girls every morning how many hours of sleep they received. On a good morning they would answer about 4-5 hours; <span class="">but more often than not they would respond with 2 hours. </span>Whatever their answer was to this question, everyday they would be prepared, smiling and ready to get to work.<o:p></o:p></span></div>
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<span style="font-family: "times new roman";">Working within the village has been a great learning opportunity. <span class="">The quality of community nursing care provided was remarkable. </span><span class="">I think the greatest aspect of community nursing in Thailand is the thorough screening and education on an individual, family, and community level. </span>In the United States access to home care and community resources are available usually only <i>after </i>a patient is diagnosed with a chronic disease or some sort of disability. In fact, the patient is usually the one that initiates the care through a clinic appointment or a hospital visit for a health concern. <span class="">Throughout this experience, however, these 8 girls were aware of all the 200+ people within the community. They went to the houses, met with the patients, and talked with them if they had an official diagnosis or not. </span>They became familiar with who had diagnosed hypertension, who has had a stroke and required assistance with activities of daily living, who was an uncontrolled diabetic and needed educating about their diet and disease management, and who had a newborn and when their next vaccinations are required. </span><br />
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<span style="font-family: "times new roman";">During the community visits we made sure to provide education where needed and involve the families. On many occasions screening of the family members was completed after learning of excess stress or certain symptoms they were experiencing. This sometimes led to recommending the family members to follow up at the local clinic for high blood pressure, pain management or symptoms that required further evaluation. Many times we were able to see them later in the clinic to truly have continuity of care. <span class="">I felt that during this process we were able to gain trust and build relationships with the people of the village and essentially became part of their community.</span><o:p></o:p></span></div>
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<span style="font-family: "times new roman";">As my experience is coming to an end I would like to thank my 8 Thai sisters for their incredible patience, knowledge, and kindness. <span class="">They have contributed more than they know to my Thailand experience and I am a better nurse and future family nurse practitioner because of them.</span><o:p></o:p></span></div>
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Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5397289090277530820.post-44181316601718967092015-11-15T08:28:00.000-05:002015-11-15T08:28:50.881-05:00Unexpected Culture<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO1U9dkEwLMI6IgO1a1T6QDg44OjfvaywfKTXjSE0bNAefm2E0FCyon9-sbt8rsvz6CrP_qd8tKWYgH54PsrdvvwWAuTyWwpE-44XrNxdi3Rb-Xoy3iaFL7DNAv6Eewhkzcg4RBPl5YaRw/s1600/IMG_4430.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO1U9dkEwLMI6IgO1a1T6QDg44OjfvaywfKTXjSE0bNAefm2E0FCyon9-sbt8rsvz6CrP_qd8tKWYgH54PsrdvvwWAuTyWwpE-44XrNxdi3Rb-Xoy3iaFL7DNAv6Eewhkzcg4RBPl5YaRw/s320/IMG_4430.jpg" width="240" /></a></div>
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Betel nut, also known as betel gum or Areca nut, is vibrant, red, tomato paste-looking substance. It is not actually from a "beetle," and it's quite alarming when you first see an adorable 90-year-old Thai grandma with an apparent bloody mouth. Similar to a baseball player chewing tobacco, betel nut is held in the mouth and is quite surprising if you have never seen it.<br />
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I'll never forget my very first betel nut encounter. I could not take my eyes off our patient's mouth. Her lips, gums, and even teeth were deep red and it was difficult to determine the cause. When I asked my Thai sister what the cause was she paused, glanced at her fellow Thai sisters, and giggled, "it is culture." <br />
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"Culture" is right. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxLZ5FwWmwGIyJGfQyC_hsBDzyTiioA_BFGGVJQEZ_o4xJVka6IHko180RyurEtrffnulk3XU-L6bIpG-_1IhThndsTWTLMVQv29dOL65TQoe0zobuDCDOE3lHccY6NKr_5hykQch5ZKvq/s1600/Betel+Nut.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxLZ5FwWmwGIyJGfQyC_hsBDzyTiioA_BFGGVJQEZ_o4xJVka6IHko180RyurEtrffnulk3XU-L6bIpG-_1IhThndsTWTLMVQv29dOL65TQoe0zobuDCDOE3lHccY6NKr_5hykQch5ZKvq/s320/Betel+Nut.jpg" width="240" /></a></div>
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Betel gum, consists of three main ingredients: bai plu leaf (betel leaf), limestone paste (calcium hydroxide, made from baked sea shells) spread thinly on the leaf, and betel nut (areca nut) which grows in bunches similar to grapes. Often tobacco is added to the betel gum, or used afterwards as a "teeth scrub" to freshen the mouth. Depending on preferences, other spices are added as well. Everything is pounded together, usually with a wooden or brass mortar first and then put into the mouth. A bucket or basket is usually close by, for the chewer to spit in. The aroma is pleasant, a bit like menthol, and younger Thais will tell you when they smell it they think of their grandparents. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2v8xab3DC5p2fWipJkhShi9lf7gBO9-BySFfA5xM0AkirkXTW6nAB2FwFgnNwBqIEgN9lJ8DS5ll5DfnaH5El5nCC99oDzDftWjyfAXLtFt9Fg8KfXE8Fq1hODg4j7QWxtQUDCXqnvnS_/s1600/Basket.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2v8xab3DC5p2fWipJkhShi9lf7gBO9-BySFfA5xM0AkirkXTW6nAB2FwFgnNwBqIEgN9lJ8DS5ll5DfnaH5El5nCC99oDzDftWjyfAXLtFt9Fg8KfXE8Fq1hODg4j7QWxtQUDCXqnvnS_/s320/Basket.JPG" width="240" /></a></div>
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I never encountered any discussion of betel nut in my research or preparation for my trip. Like most cultural education, however, nothing compares to actually seeing and experiencing culture first hand.<br />
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"<i>A nation's culture resides in the hearts and in the soul of its people." </i>Mahatma Gandhi</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-82353986213112075612015-11-15T06:40:00.001-05:002015-11-17T05:25:01.641-05:00Thai Traditional Medicine<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;">It has been an eventful trip so far! We were happy to have a
free day today and be able to take a rest from long van rides and hot days in
the community and the clinic. We went to the mall, which was slightly
overwhelming with four levels and tons of stores. We heard about a grocery
store in the mall so we hunted it down and stocked up on snacks (mainly nuts,
peanut butter, chocolate, and Nutella) which we are not getting in our Asian
buffets! (sigh)<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">In the clinic there is a Thai
massage therapist that also specializes in herbs and homeopathic medicine. Her
name is Sompont and she is available for all of the patients if they needed. I interviewed her with my wonderful translator, Dr. Patama, last week
and learned a wealth of information regarding traditional Thai medicine.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The massage therapist shared with me 5 concepts that are key
in Thai homeopathic medicine. The first is the use of herbs. Members of the
community will donate herbs to be used for different therapeutic modalities.
She also has a garden in the back of the clinic with some of the most commonly
used herbs: ginger, lemongrass, camphor, finger root, and turmeric. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The second concept of healing that is important to Thai
culture is food. Depending on your birth month there are certain foods that are
considered to be of most benefit. For example, since I was born in December, my foods are lime, strawberry, oranges and fish.
Guess I’ll be eating more of those!</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Another important concept to Thai people is the use of
massage. Unlike other types of massage, Thai massage uses fingers, elbows, knees, feet, and any body part that
can be utilized to release tension. Thai massage is unique in that they use
a lot of stretching techniques that are incorporated throughout the massage. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The fourth idea is the use of warm compresses. I was able to
see this done because there was a patient who had fallen a couple weeks
previously and she was in the clinic for her physical therapy, which included
the use of a warm compress being pressed into all parts of her legs and arms
and back by the massage therapist. The compress contains ginger, tamarind and
patchouli and the function of the compress is to relax the muscles of the body.
I was getting quite relaxed myself simply being in the room and inhaling the
delicious smell of ginger!<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Lastly, the use of steaming rooms is common. She had such a
room in her clinic area, and it consisted of a wooded area about the size of a closet with a door that trapped the heat. There was a seat inside and
beneath that she placed a boiling pot of water with the following herbs:
ginger, banana, lemongrass, zingiber and balsamifera. This room is utilized by
women who have just given birth. They come in 3-5 times and sit in the room for
30 minutes. Through the inhalation of the herbs in the boiling water the women
undergo vasodilation and increase their blood flow. It is also believed to
increase the flow of breast milk. This is a Thai tradition that goes back 1000
years!<o:p></o:p></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="background-color: #fefefe;">I</span><span style="background-color: #fefefe; line-height: 15.36px; white-space: pre-wrap;">t was very informative to be able to learn more about Thai traditional medicine and the aspects of care that are fundamental to this culture. It seems that homeopathic solutions have more of a place here in Thailand and the Asian culture in general than in western medicine. I will be excited to take this knowledge to my practice in the United States!</span></span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-77454970617837674872015-11-12T09:31:00.000-05:002015-11-13T18:13:02.822-05:00Gratitude At It's Finest<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhi9nVK1ZKQ0W7ln4hH_Rh9WJBi05ACmTw-_2HPZ7xjbgFTVn0Jc9ht2SL38djHm-cb2oz2NmtD9Q_oMJnEOr0DCRxDhZLEbtZGrs4i0mqRxzoNlxW1XskM5HPc8gIrsi57Qant29HMtYo/s1600/group+picture.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhi9nVK1ZKQ0W7ln4hH_Rh9WJBi05ACmTw-_2HPZ7xjbgFTVn0Jc9ht2SL38djHm-cb2oz2NmtD9Q_oMJnEOr0DCRxDhZLEbtZGrs4i0mqRxzoNlxW1XskM5HPc8gIrsi57Qant29HMtYo/s320/group+picture.jpg" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">First day of clinic</td></tr>
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<span style="font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">Upon arriving in Korat, our group dove right in and began working with both the Thai nursing students and the community. While working in clinic and providing health assessments in designated villages, o</span><span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small; line-height: 15.6px;">ur group quickly realized that the "Thai way" varies greatly from that of many other cultures. </span><span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small; line-height: 15.6px;">The primary aspect of the Thai culture that immediately stood out, was the level of gratitude expressed by all in the community. </span><br />
<br />
<span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small; line-height: 15.6px;">Gratitude is defined as "readiness to show appreciation for and to return kindness." </span><span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small; line-height: 15.6px;">Throughout our first week in the community, </span><span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small; line-height: 15.6px;">I found myself astonished at the level of gratitude expressed by the residents of the villages. The people of our community were both ready to have their health assessed and eager to learn about ways to modify their lifestyle choices. A</span><span style="background-color: white;"><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><span style="line-height: 15.6px;">fter completing community visits with residents who own very little and struggle to provide enough food to feed their families from week to week, many villagers would offer us food, drinks, and gifts to show their appreciation. Others offered to teach us their occupations, such as dyeing silk and making rice noodles to sell at market. </span></span></span><br />
<br />
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<tr><td class="tr-caption" style="text-align: center;">Learning the silk dyeing process</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Thai Nursing faculty- Nar learning to make rice noodles</td></tr>
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<span style="background-color: white;"><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;"><span style="line-height: 15.6px;">I found myself surprised at these heart warming gestures, as in the United States this is not always common practice. </span></span></span><span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small;">I hope to be able to embody this aspect of the "Thai way" into my daily life back home, and look forward to our second week working with the people of Thailand. </span><br />
<span style="background-color: white; color: #222222; font-family: "arial" , "helvetica" , sans-serif; font-size: x-small; line-height: 15.6px;"><br /></span>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-57833960267434525792015-11-11T18:32:00.000-05:002015-11-12T09:34:27.914-05:00Arms Wide Open<div>
In coming to Thailand, I was mentally aware that we would be faced with quite the language barrier. In preparation, I had made notecards with basic Thai phrases and rehearsed them in my spare time at work or sitting at home. Let me tell you, that pretty much got me through "hello" and "thank you." I quickly learned today, from our very patient Thai sisters, that the dialect and enunciation of Thai is a delicate and beautiful language that will take years of practice. Seeing that we only have 2 weeks here, I have never been more thankful for students willing to take on an American girl with a nasally Michigan accent.
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Today we had the opportunity to teach a morning class of Sophomore Thai nursing students basic physical assessment. We were greeted by excited, giggly students waiting with anticipation to learn in a lecture hall. After introducing ourselves, two of our gracious counterparts volunteered to demonstrate in front of the lecture, a head to toe phyical assessment (in English). Following that, we broke up into small groups in the nursing lab of one NP student from our group and about 6-8 Thai sophomore students. In teaching a head to toe assessment with no Thai experience, and minimal English from the other side - we became quite good at charades. The students were enthralled with learning how to look, listen and feel to assess their patient - many times that being me. Wrapping up the small group session, the group insisted that we take a picture 'selfie.' Once again, I realized we were being schooled in taking selfies - or any picture in general. In attempt to thank the students, I put my hands together and performed my best 'wai,' or Thai bow, while saying "khaawp khoon kah," or thank you. A symphony of giggles errupted from my group. Slightly befuddled, I asked if I said something wrong. Immediately one of the girls came over and pushed my elbows down closer to my sides and motioned how to bow correctly without looking silly. We all erupted in laughter as I tried again, apparently failing once more - hopefully I will catch on by the end of our stay. </div>
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<i> Our group in the lecture hall with the SUT sophomore nursing students.</i></div>
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Following lunch, we were introduced to our Thai sisters that we would be paired with for the remaining 2 weeks. Once again, we were split up into small groups to review a more advanced head to toe assessment. These SUT students are in their senior year, and have a much broader scope of practice in Thailand than our BSN students in the U.S. They are in their community clinical rotation, and plan to spend a total of 6 weeks in the villages we will be placed in learning every detail about each family dynamic along with chronic and acute disease management. Determined and meticulous would be two words to describe the group of Thai students we are placed with. Over the next couple of weeks, I am excited to learn more about the culture, language, and individualality of each student we are placed with. They call us "phie" (older sister) and they are our "noong" (younger sister). Today we were greeted with open arms, and together we plan to live and work together to build a stronger community.</div>
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<i> SUT sophomore students learning basic assessment</i></div>
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<i>Getting ready for orientation!</i></div>
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<i>Breaking into small groups to discuss community needs</i></div>
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Excited to learn much more,</div>
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H.</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-37436179291286466732014-10-27T11:07:00.001-04:002014-10-27T11:07:46.040-04:00Past, Present and FutureTo say today was another eventful day would be an understatement. I think we all expected to be changed after coming to Thailand but we continue to be surprised in the ways that it has already begun to shape us. For some, today brought about a new appreciation of acute care, others, a painful new experience, and for us all, a new perspective on ourselves and each other. Today was, above all, a poignant reminder of the fragile nature of life and why we became nurses.<br />
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But let's start at the beginning. We began our day touring the Ban Prasat archeological site in the Korat Basin. We toured the museum and excavation site, viewing the delicate remains of an ancient civilization. I was in awe of the relics, bangles and pottery and such, so well preserved over 3,000 years. We were able to see a burial site, the deceased were buried with belongings they might want in the next life, they believed in life after death. Their remains told us so much about who they were and how they lived. I was struck by the similarities between the present day culture in the villages we have been working and the prehistoric people. The use of spirit homes, which look like miniature temples, where the spirits of the deceased may live so they do not cause havoc, is a beautiful tradition that has been carried on for centuries. The style of homes in the villages were also very reminiscent of the early civilization. Coming from such a young country, it was an eye-opening experience to see exactly what it means to have a deep and rich cultural history that has persevered for thousands of years.<br />
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Next we traveled to the Phimai Historical Park where we walked the grounds of Prasat Hin Phimai, a beautiful one thousand year old Khmer temple. Our tour guides shared the temple's history with us, however we most enjoyed the numerous photo opportunities among the spectacular scenery. We were able to take our "U of M" photo wearing our university garb. This was followed by a trolley tour around the city, provided by a local businessman and his son. We toured another more modern temple, a magical feeling 350 year old banyan forest, and the hotel owned by the businessman. After a delicious lunch we headed off to our next destination.<br />
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Shortly after loading on to the vans we came across the scene of a motor vehicle accident that had taken place minutes before our arrival. Our vans pulled off the road and we unloaded, rushing to see what we could do. Our ER nurses sprung into action, assessing the scene for safety. We rushed to the side of a motionless victim, compiling what few supplies we had on us. My ER and ICU classmates began quickly and calmly working to assess the scene and plan the next steps. It was quickly determined that the person was alive, but had suffered enormous traumatic injuries, being thrown from a motorcycle without a helmet. It is in these moments that we as nurses feel lost, when we know there is nothing we can do although our hearts scream for action. The only comfort for us is knowing, that as this person passed, it was in a cloak of prayers and in the hands of those who cared, a final human right to which all should be afforded, although not always received. As we walked away from the scene once police arrived, we were thanked and offered prayers from the onlookers, a reminder that sometimes it is simply presence that is appreciated more than action and result.<br />
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We became stronger as a group by this shared experience. Our classmates who were on the front line of action were surprised by the ease with which they communicated and worked together, despite never having worked together before. Those of us, myself included, unfamiliar with this kind of trauma learned from our peers those essential first steps to consider when approaching a scene. We discussed how this experience, and really the entire past week, has revealed each of our individual strengths, to ourselves and each other, be it calmness under pressure, communication, assessment skills, teaching, patience, or flexibility and understanding when confronted with a new and unfamiliar culture.<br />
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The accident has lingered in our minds, our hearts a little heavier, our minds never far from the memory. However, as all nurses know, we must keep moving, we must keep our thoughts positive and persevere.<br />
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"There are uses to adversity, and they don't reveal themselves until tested. Whether it's serious illness, financial hardship, or the simple constraint of parents who speak limited English, difficulty can tap unexpected strengths." <i style="font-size: x-small;">Sonia Sotomayor</i></div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5397289090277530820.post-35142116718456469842014-10-26T09:04:00.000-04:002014-10-28T18:48:55.620-04:00Community: The Birthplace of Connection<div>
<span style="background-color: white; font-family: georgia, serif; font-size: 14px; line-height: 18px;">“I know there is strength in the differences between us. I know there is comfort where we overlap.” </span><br />
<span style="background-color: white; font-family: georgia, serif; font-size: 14px; line-height: 18px;">― </span><i>Ani DiFranco</i></div>
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This past Friday was the last day of class for our some of our Thai sisters that had been living in the Tajalung community for four weeks. For their last day, the students hosted Community Rounds, where the Thai and Michigan students, professors ("Ajahn" in Thai), and key community leaders traveled from house to house via van and bicycles to discuss the current status of each family's health and plans for follow-up.<br />
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In the span of the day we visited multiple community elders (called "grandmas" and "grandpas" with endearment by students and community members alike) with chronic diseases such as diabetes, high blood pressure, and high cholesterol. Throughout the day we helped create plans of care that involved creative use of available resources to promote positive health change. We witnessed a home-made "parallel bar" system that promotes physical activity, balance, and improves circulation to the feet.<br />
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Another patient reported to use that she lost 10 pounds in one month by reducing portion size and sugar intake and using a weighted hula-hoop for exercise 300 times per day (we got to trial the hula hoop and now have a fun new way to promote weight loss in our US patients!).<br />
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The Thai students used creativity to improve medication compliance for an illiterate patient by attaching symbols and pictures to medication labels. We acted as key agents for creatively coordinating access to healthcare resources by arranging transportation to and from clinic appointments, identifying ways for patients to seek health authorities through use of neighbors or family networks, and using community health volunteers to check-in on patients for blood pressure or blood sugar monitoring as well as to help ensure correct adherence to medication regimes.<br />
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While planning for health care in US homes may look different from what we see in our rural Thai community, there is a lasting sense of total partnership, trust, respect, and appreciation for the Thai students and healthcare team by the community members. Elders became very emotional when saying goodbye to their students (called look-nak-suk-sa) that had checked in on them, taught them about diet and medications, and lived as members of their community for the past four weeks. I can only hope that the love and respect earned by the community can be translated by us as future NPs in our US communities. I know that I have been personally inspired to carry that Thai spirit of creativity and connection in my future practice as a nurse practitioner in the US or wherever life's journey may take me.<br />
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