It seems appropriate to talk about alumna Ashley Lair's experience in Honduras at
this time, since the school's
nursing brigade just returned from Honduras and would have special interest in Lair's
experience. Lair not only
traveled on such a brigade herself during her schooling at the University of Wyoming,
but was hired by
Shoulder to Shoulder to work in Honduras following her graduation from the BSN program.
We asked her
some questions and noted some of her answers in our fall Alumni Newsletter, but there
wasn't room to tell
her whole story. So enjoy her full answers to our questions below.
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What were your reasons for going to Honduras to work as a nurse?
I minored in Spanish while studying at the University of Wyoming and traveled abroad for a summer to the Dominican Republic. The program I studied through included community health rotations, and I stayed in a rural clinic with two other students for about a week. My host family also took me to their in-laws house in the Dominican countryside, and I was amazed by how welcoming the locals were to me and the other students-strangers. During that time so many people who I barely knew took care of me, inviting me into their homes, taking me on motorcycle rides and hikes through the jungle to some awe-inspiring places and even throwing a going away party on our last night in the community. That experience really planted a seed. I wanted more adventures like that! After that summer I knew I wanted to learn to speak Spanish more fluently so I could actually communicate with locals, but more so, I knew that I wanted to experience rural life in a developing country. Going to Honduras with the UW School of Nursing and meeting the volunteers with Shoulder to Shoulder made me realize that my interest could be a reality. I look back on it and think that my reasons for going were actually a bit selfish. Of course I wanted to help people and learn about nursing, but I also wanted the unique experience of doing so in a rural clinic in a foreign country.
What were your main responsibilities as a nurse in Honduras? What population did you work with in Honduras?
The answer to that is a bit complicated! My role as a volunteer with Shoulder to Shoulder was a bit loosely defined. I worked as a nurse in the clinic, which operated as a “mini-hospital.” We did everything from basic primary care for patients of all age groups, to prenatal care, to emergency and trauma care, and delivering babies. We would keep moms and babies overnight for observation, as well as general medical patients as well. I didn’t spend all my time in the clinic though. I assisted the nursing manager with some of her administrative duties, assisted with community outreach clinics, organized and requested medical supplies, and worked on nurse education.
What are the main differences in healthcare between the US and Honduras?
I can’t speak for all of Honduras, but only the rural area where I was practicing. Resources were limited. Our clinic was equipped with x-ray and ultrasound. We had the ability to transport emergent patients in our ambulance, but didn’t do that often. A lot of times we would start an IV and fluids and load critical patients into the bed of a truck and send them to the nearest hospital with CT or surgical capabilities--about a four-hour drive away on dirt roads. We didn’t have narcotic pain medication. Staff members lived at the clinics for the majority of the time, which kind of gave everything a different feel.
What are the main differences in the responsibilities of a nurse between US and Honduras?
The levels of education were a bit different. “Licenciadas” or licensed nurses were kind of like the equivalent to nurses prepared through a Bachelor’s Degree program in the US. Those nurses were able to practice at a higher level than BSN nurses in the US. It was within their scope of practice to prescribe medications and basically function as a midlevel provider. The nurses who worked primarily in the clinic finished their nursing programs as early as age 19, and functioned as an RN in the US would, and then some. They were able to suture wounds and deliver babies. I was really blown away! We had some smart, smart nurses at our clinics, and they helped me so much. I was really lucky to be able to work in that environment as a new nurse; everyone had complete confidence in my abilities--at times more confidence than I had in myself--and kind of showed me the way.
What did you learn from the people of Honduras?
The people I encountered while I was there were absolutely incredible. You hear a lot about Central America being a dangerous place to travel, but I never really got that sense. If anything, I felt like people went out of their way to help me and make sure I was comfortable and safe. Seeing the things that patients experienced in Honduras, the pain and discomfort that people would endure without really complaining was eye-opening, and at times I still struggle with working in the US where we are able to do so much for our patients, some of which can seem excessive at times. Just two very different worlds.
What did you enjoy most about your experience in Honduras?
Undoubtedly the thing I enjoyed the most were the relationships I formed. There were six or seven other US volunteers who arrived around the time I did, and we all shared an apartment with one bathroom and no hot water. Internet access was limited and dependent on a satellite. We didn’t have cable, so we found ways to entertain ourselves. We really did become like a big family. It’s hard for me to convey what those friendships still mean to me to this day. I formed some bonds with some of the Honduran staff as well. We went back for a visit two years ago and were greeted with open arms, which is just the coolest thing! I feel like I literally have family members all over the world because of this experience. Learning Spanish, nursing, a different way of life, and traveling through Central America were also amazing!
What is one piece of advice you would give another nurse thinking about doing work in an underdeveloped (impoverished) country?
I could write pages of advice, but without making this too long, I think the most important thing someone (nurse or not) wanting to work in a developing country needs to do is to have realistic expectations and be flexible. Don’t go into it with the mindset that you are going to save the world. Just take it in, observe, and contribute what you are able.
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December, 2014