The Next Page: A new level of care for Robert Morris students in Nicaragua
Robert Morris University’s nursing students long have traveled to Nicaragua to provide free health care. Now, Holly Hampe says, students studying to be healthcare administrators will have their own opportunity to serve.
January 4, 2015 12:00 AM
Top: Children in Managua, Nicaragua. Right: Nursing students assess patients before they see Carl Ross, professor of nursing at Robert Morris University, voluntering in Nicaragua.
From left, Jose Santos Latino, codirector, Hospital Bautista de Nicaragua; Juan Carlos Solis Paz, director; Carl Ross and Holly Hampe.
Mother and new baby with Ms. Hampe.
Entrance to Escuela Technico De La Salud Yolandis Magurga Hospital.
By Holly Hampe
In November, I traveled to Nicaragua with 22 nursing students from Robert Morris University in a trip led by my colleague, Carl Ross, professor of nursing. He has made the trek 88 times in what has become the signature program in our School of Nursing and Health Sciences. RMU faculty and students provide health care to poor families in the barrios of Managua, both in their homes and in a clinic that our students run.
The trip traditionally has been available only to undergraduate and graduate students pursuing a nursing degree.
But as the director of the Health Services Administration Program at RMU, I want students studying to be health care administrators to have a similar experience. I want my students to get a taste of the clinical experience but also be able to compare and contrast the private and public hospitals in Nicaragua with those in the United States. What issues there can teach us about problems in American hospitals and vice versa? What can Nicaragua tells us about the American health care system at large?
I will lead my own students to Nicaragua in June. My visit in November helped set the stage for the travel to come and gave me insights into the work my students might do there.
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At the Hospital Bautista de Nicaragua, I visited with the director, Juan Carlos Solis Paz, as well as his co-director and chief nursing officer. This full-service, private hospital has 130 beds and receives a little more than half of its funding from the Nicaraguan government. A majority of the patients receive free care. Before joining RMU, I was vice president and chief quality officer at St. Clair Hospital in Mt. Lebanon, so I was surprised to discover that Dr. Paz and his colleagues confront many of the same problems as American hospitals.
“My biggest challenge is economics: How will we keep the doors open? ... The hospital has been faced with nursing shortages. Nurses need to work two to three jobs in order to make ends meet. The average salary for a nurse is $200 a month and for a physician is $400 a month. Families in Nicaragua live on $2 per day on average,” Dr. Paz said.
Like many American hospitals — including those in the Pittsburgh region — Hospital Bautista de Nicaragua is bedeviled by patient infections, particularly respiratory infections, which are Dr. Paz’s biggest patient-safety concern. That a hospital in what Americans regard as a Third World nation should wrestle with similar problems as hospitals in the United States was simultaneously comforting and, quite frankly, depressing because they did not have the same means to combat the situation. This trip humbled me in more ways than one.
• • •
The RMU team also visited a public hospital. Leading our tour was Flo Martinez, a registered nurse and the facility’s chief nurse. The hospital has 260 to 280 beds and provides free care to the community.
Ms. Martinez told us that the facility’s greatest worry is mosquito-borne diseases, such as chikungunya and dengue. A lack of central air-conditioning forces the hospital to leave its windows open in much of the building, so mosquito nets must be placed over patients’ beds. A nursing shortage confronts the hospital, with one registered nurse and one nursing assistant for every 60 patients. Cleanliness is a concern, and much of the hospital relies on antiquated equipment, except for its modern dialysis unit — and good thing, too, as kidney disease, resulting from a high concentration of diabetic patients, is one of the hospital’s major diagnoses.
What about infections? “We don’t feel we have any problems with infections or hand washing. However, we don’t collect any data,” said Ms. Martinez.
No data? That was a revelation to me, one answer to what my students, as health care administrators, could provide to the health care system in Managua that might compare to the value of the medical care provided by RMU’s nursing students. My goal, when I return to Nicaragua with my students, is to work closely with local hospitals to help in setting up a quality improvement program that would include collecting data on infections, hand-washing compliance and other important areas of concern. Perhaps we will learn something that will help hospitals in the United States as well.
• • •
In 2010, the Nicaragua trip was featured in an iconic commercial for what was dubbed the “Change A Life” advertising campaign at Robert Morris. Indeed, everyone who participates in the Nicaragua experience is changed — the students, the faculty and the people they help. The last day of the trip, I watched an RMU student give her new Nike sneakers to the mother of the family the student cared for in Managua. We left our families with barrels and lids to collect rainwater, mattresses to replace sheet covers, stove tops to accompany fire pits for cooking, cement to build bread-baking ovens and metal roofing to protect from rain.
Those were essentials identified by the students, and we believe the items will make a sustained difference to those families. When I return to Nicaragua in June with my own students, many of whom already work in hospitals and other health care facilities, I hope to take with me the lessons we’ve learned in the American health care system – and still are learning — to make the same difference in the lives of the Nicaraguan health care system and caregivers.
Holly Hampe (firstname.lastname@example.org) is the director of the Health Services Administration Program and an assistant professor of health sciences at RMU. She received her doctorate in information systems and communications from RMU and has more than 30 years of health care experience.
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