Safety First Blog

The Wrong Dose: A True Story of Medication Error

Safety Nurse sat down with Margo, a fantastic oncology nurse, who talked about the night she gave a patient too much insulin, and he coded. He lived, and Margo is still at the same job. The hospital where she worked supported her and included her in a Root Cause Analysis of the event. Margo is now a well-respected nurse leader at her place of work. In the interview, she opened up about how the error went down, and we talked about the inevitability of error.

Click HERE to read the full story.

You can listen to the podcast of the interview at THIS link on iTunes

Or you can listen to it on Stitcher

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Safety First Blog

I've Been "Invited" To A Root Cause Analysis, Now What?

I’m blogging for allnurses!

allnurses is the leading social-networking site for nurses and nursing students. People from all over the World come to allnurses to communicate and discuss nursing, jobs, schools, NCLEX, careers, and so much more.

Click HERE for an article about what to expect from a Root Cause Analysis

Did you like this content? Donate TODAY to support Rose Katiana on her journey through nursing school, and let me know what other content you want covered.

 

Safety First Blog

The Origin Story of Safety Nurse: How I Got Here. Pt 1

I’m blogging for allnurses!

allnurses is the leading social-networking site for nurses and nursing students. People from all over the World come to allnurses to communicate and discuss nursing, jobs, schools, NCLEX, careers, and so much more.

Click HERE for an article about the origin story of Safety Nurse!

The origin story of Safety Nurse, who, garbed in turquoise scrubs, a white cape, a 50’s style nursing hat and sensible, orthopedic shoes, walks hastily through the galaxy providing assessment skills, education, wound care and safe medication administration!

Did you like this content? Donate TODAY to support Rose Katiana on her journey through nursing school, and let me know what other content you want covered.

Safety First Blog

Rose is learning English ~ Update on Safety First Nursing in Haiti

Listen to the podcast HERE

Or you can listen to it on Stitcher

Did you like this content? Donate TODAY to support Rose Katiana on her journey through nursing school, and let me know what other content you want covered.
Rose is learning English ~ Update on Safety First Nursing in Haiti

Welcome back to Safety First Nursing, the home of the patient safety specialist. It is my passion to bring you education, research and resources supporting patient (and nurse) safety. It’s been a busy week preparing for my first seminar for Vyne Education (for 6 CEU!). I will be facilitating in Indianapolis, Cincinnati and Columbus – a whirlwind tour of the Midwest (but I get to see my mom!) and I get to interview Lorie Brown, a nurse who is also an attorney. I am really looking forward to sharing info about her story and how she can support nurses who have to go before boards of nursing.

I am counting the days until school starts again (18, in case you were wondering). My kids have been going to Ultimate Frisbee camp, and I have been plugging away looking for venues to get my message out there. My mission is to bring the best patient safety information to nurses around the globe, hoping to prevent future incidents of harm. My business coach suggested I look for speaking engagements; so we are working on that – if you know of anyone who would like me to talk about patient safety, please contact me! And a free bar of soap from Essential Journeys to anyone who meets with me in person to discuss how SFN can support patient safety for you or your organization!

This week will be a short article– just updating you on Rose’s adventures with English school. As you may know, Rose is the Haitian student that SFN is sponsoring through nursing school in partnership with Consider Haiti. If you want to know more, you can read previous blogs about this incredible adventure.

 

The class, and nursing school this fall, are in Saint-Marc, which is about a 45 minutes “drive” from where Rose lives. I put drive in quotes because it is really a wild ride. There was a ride at Disney World called Frog and Toad’s wild adventure – driving in Haiti reminds me of that. Everyone drives as fast as they can, honking and veering wildly around cattle, goats, people and giant pits or rocks that appear in the road out of nowhere. The road is used by cars, “tap taps” (cars that have been painted with bright colors, operating like taxis)

busses, trucks, pedestrians, scooters, motorcycles (motos), bicycles, donkeys, horses and anything else you can possible think of. These vehicles are loaded with a creative and unbelievable amount of people and goods. There are no streetlights or street signs, no guard rails, no sidewalks.

Accidents are common and can be deadly. One day last fall when I was working at the clinic Esperance, 3 boys were brought in after being in a horrible motorcycle accident. I have included photos from both my trips to Haiti so you can see the eclectic mix of transportation.

The fewer back and forth trips Rose has to make the better. She doesn’t know anyone in Saint Marc other than her fiancé and his family and she doesn’t feel comfortable staying with them. We are looking for a room for her to rent so she won’t have to go back and forth every day. Nursing school is from 2p-7p M-F.

I asked Rose to share something interesting about Haitian culture. She shared with me that every January, families in Haiti cook pumpkin soup or soup joumou to celebrate Haitian Independence, which was won in January of 1804. Prior to that, Haiti had been colonized by France and they had forbidden Haitian slaves to eat any foods with pumpkin in them. To Haiti, pumpkin symbolizes freedom. There is a documentary about Haitian Pumpkin Soup called Liberty In A Soup by Dudley Alexis, a Haitian-born Miami filmmaker.

My most recent email from Rose was August 6th, I asked her about nursing in Haiti, and about the amount of diabetes in Haiti, as well as medication management/polypharmacy. Remember that the translation is mainly google translate, with some help from Maggie (who founded Consider Haiti) – so I do my best to keep the flow of her words but make it understandable.

Hi Miss Kristi Miller,

That is Rose. How are you? How is your family?

I thank you for your last letter. Thanks for the pictures too. You and your family are really nice.

 

I am pleased to be able to practice English together, which will allow me to go faster in learning the language.

 

To answer you about nursing in Haiti, I contacted a nurse and asked about it. He told me that nursing in Haiti is no different from other places. It is such a universal thing that there may be some minor deviations in how to teach this science or practice. The main role of the nurse is to execute the Dr.s orders, because the nurse has limits and must stay within this limit.

 

Abel’s father has had diabetes for 7 years and it is really sad for him because he has suffered all his life. He takes 8-10 daily medications, which is not easy because many times this person can be discouraged and decides not to continue the treatment. Talking about diabetes reminds me of my father, who suffered much from it.

Sincerely, I do not have much information about this disease especially on the type of diabetes. I know it makes the patient sick on some parts of the body that don’t ever heal. It often happens that the doctors have to cut off a limb of the infected person. I would like to know how many types of diabetes there are, I would also like to know if American doctors cut off the legs of people with diabetes. I hope my nursing studies will support my ability to relieve the suffering of people with diabetes and help in the fight against illness.

Rose included some great pictures of her classroom and of her textbook – I am looking forward to getting my first note from her in English. October and nursing school will be here before we know it! To get the latest updates on Rose, as well as info on new patient safety education, research and resources, sign up for the safety first nursing newsletter.

 

Safety First Blog

Safe Medication Administration: Following the Checklist Manifesto

Listen to the Interview on iTunes

Or you can listen to it on Stitcher

Did you like this content? Donate TODAY to support Rose Katiana on her journey through nursing school, and let me know what other content you want covered.
Welcome to Safety First Nursing and my fourth blog/podcast. This one is just a short summary of my first continuing education activity: Safe Medication Administration: Everything you need to know to improve your practice. You can find the full-length video, podcast and transcript on my website, but just in case you don’t have an hour, I really wanted to give you the checklist info, because that’s the pay-off.

The mission of SFN is to support the physical, psychological and emotional safety of patients and nurses through education, research and resources. I started SFN after being involved with a patient safety incident at my former job, and I was actually going write on that for episode 4, but I found myself being drawn to something light and easy. After the huge amount of work I put into episode 3, on continuing education, including a review of sites that offer patient safety courses, I needed a break before the psychic challenge of finding a way of telling you about the patient safety incident I was involved in. I want it to be honest, and I want you to still trust me when I am done. I am not sure that is possible, but it’s my goal, so stay tuned, and I will very much look forward to having it done and out there so I can hear back from you. What I really hope to do is start a conversation about nurses involved in errors, near misses, mistakes and “incidents”. I want to talk about the emotional and psychological impact being involved in all that stuff lays on you – it can be incredibly painful, and incredibly isolating – we don’t want to talk about it because we are ashamed, because we are worried someone will judge us. Because we know, deep down, that the first thing most nurses think when they hear someone else made a mistake is, “she wasn’t trying hard enough” or “bad nurse”. Golly, I can’t wait to get started! But seriously, I know it will be healing to write about it…just need to get the first words on the page.

I’m going to offer a wide variety of presentations on safety, some of them for patients and nurses, but also some for anyone interested in the concept of safety. Some of the presentations on my website are geared towards nurses looking for high-quality continuing education on the topic of patient safety – like the one on safe medication administration: everything you need to know to improve your practice, which is available for one CE, and one on how to do Root Cause Analysis is coming soon. Others, like episode #2 on my relationship to nursing in Haiti would be of interest to anyone interested in patient safety. I’m gearing up to do some interviews, and very much want to hear from you about topics you are interested in – do you have something you would like to share? Please contact me through my website at www.safetyfirstnursing.com, or email me at safetyfirstnursing@gmail.com, I am on twitter @safetyfirstNRS, facebook, linked-in and instagram.

So I am going to give you a quick summary of the continuing education activity about safe medication administration and then direct you to all the good resources and checklists I have created. The activity is worth 1 CE and is available as a podcast, video and transcript – and should take just over an hour to listen to or watch. In it I review the impact of medical error on the healthcare system, including the new proposition that medical error may be the third leading cause of death if we look at the numbers from a fresh perspective. I also talk about why medication errors occur, and how nurses are involved, as well as the impact on patients, families and healthcare providers. I talk a great deal about systems issues, with the goal of helping people understand that error is going to happen, no matter what we do to prevent it, and the best we can hope for is to prevent harm. The best part of the study is the discussion of solutions and strategies focused on preventing harm. The strategies focus on what systems theorists call “the blunt end of the stick” – the end where changes in policies, technology and leadership can prevent the likelihood an error will occur; as opposed to “the sharp end of the stick” – the end where nurses actually make mistakes with sometimes horrible consequences. Firing the nurse has been the traditional response, with little effect on error rates. I present definitions (confusing and conflicting), how error is measured (poorly and inconsistently) and the complexity of the task of medication administration (truly mind-boggling). James Reasons theory of “Swiss Cheese” is discussed, with illustrations to show how plugging the holes in the cheese can prevent harm from error. Using case studies from literature, and the most up-to-date resources from the best patient safety organizations (see my resource list), I present how a change in perspective from blame and shame, to one of a just culture can reduce the risk of harm to patients. I present several tools to assess blameworthy behavior, an important first step in dealing with error, as well as multiple checklists that address the many holes in the “Swiss Cheese”. I have been reading Gawande’s “The Checklist Manifesto” (2010) and have take his advice to make some checklists. There is even a checklist for Nurse educators, based on my 2016 publication: Educational Strategies for Reducing Medication Errors Committed By Student Nurses: A Literature Review from the International Journal of Health Sciences Education

I hope you will use the resource list, the checklists, the references and all of the information presented in the full continuing education activity. Most of all, I hope you will participate in some discussion! I would like to know what I left off the checklists, what I missed, what I messed up, and what I can add to support patient safety. As your ideas and suggestions come in, I will make edits and revisions as needed and send out new and improved checklists as we co-create a safer world for patients.

Wanted to give you an update on Rose, the wonderful woman that SFN is sending to nursing school. You may recall from episode 1 about Haiti that Rose is an orphan. She shared with me that her mother died from complication due to diabetes and hypertension. During my two visits to Haiti as a nurse at multiple mobile clinics, about 50% of the people we saw had some combination of diabetes and hypertension. You can’t tell someone whose main diet is starch to eat “low carb” – protein is a rare and highly valued commodity, and not something widely available to Haitians. You also can’t expect them to reduce sugar and salt intake – two relatively inexpensive and widely available substances that make a Haitian’s day a little brighter. And don’t get me started on medications – when you don’t have a regular food source, purchasing medications isn’t on your to-do list. Rose’s mother would be alive if she lived in the US, because we could feed her good food, give her some metformin, and some ACTZ and get her blood pressure down. It is so frustrating. Her father died of a broken heart. He was a farmer and often worked in the fields around the clock ensuring his crops had enough water to grow – irrigation is a HUGE issue in Haiti – the weather is amazing for growing plants, but there is no way to irrigate the fields – no pumps, no way to dig wells. He became paralyzed – still getting the full story – and slowly wasted away lying in bed, wishing he was out in the field working. Last but not least, in episode 1, Rose told us a story about her friend Sandra – the little girl she helped by buying her some clothes. I asked about Sandra and found out she died in the Earthquake in 2010. I wish I had some good news. I guess the only good news is that Rose has some hope. She is getting English lessons, and will be going to nursing school in the fall. Remember, SFN donates 10% of all profits to Rose’s education through Consider Haiti. I hope you will consider a donation as well.

Resources

Certified Professional in Patient Safety – CPPS

Agency for Healthcare Research and Quality

Understanding Patient Safety – 2nd Edition, Robert Wachter

Institute for Healthcare Improvement – Global Trigger Tool

AHRQ Patient Safety Indicators

ProPublica Patient Safety Community

Medically Induced Trauma Support Services

Wall of Silence – The Untold Story of the Medical Mistakes that Kill and Injure Millions of Americans

CANDOR toolkit – AHRQ

forYOU team – University of Missouri

Show Me Your Stethoscope

National Patient Safety Foundation

Institute for Safe Medication Practices

National Coordinating Council for Medication Error Reporting and Prevention

NCC MERP Index

Medication Error Reporting

Lippincott Procedures – Safe Medication Administration

Institute of Medicine (is now called The National Academies of Science, Engineering and Medicine; Health and Medicine Division)

North Carolina Board of Nursing Complaint Evaluation Tool

The Professionalism Pyramid

The Patient Advocacy Reporting System

Centers for Medicare and Medicaid Services (CMS)

Quality and Patient Safety – State Regulations by state

Policy and Advocacy for Nurse Staffing Ratios – American Nurses Association

The Joint Commission

The American Association for Accreditation of Ambulatory Surgery Facilities

The National Quality Forum

The Leapfrog Group

Partnership for Patients

Medication Without Harm – the World Health Organization

Tort Reform

The Checklist Manifesto

Measuring and Benchmarking Clinical Performance- AHRQ

HRSA Data Warehouse

HRSA Uniform Data System

National Center for Quality Assurance

DARTNet

SAFTINet

IHI – Leadership Guide to Patient Safety

Crew Resource Management

teamSTEPPS

Failure Mode Effects Analysis

Root Cause Analysis

AHRQ Survey on Safety Culture

Safety Attitudes and Safety Climate Questionnaire

MEDMARX Reporting

Incident Reporting to ISMP

ProjectRED

Medications At Transitions and Clinical Handoffs

IHI – SBAR Techniques for Communication

CUS Tool – AHRQ

Consumers Advancing Patient Safety

Patients for Patient Safety – WHO

Speak up – The Joint Commission

Teach Back – AHRQ

Ask me 3 – NPSF

What should patients do to help make care safe? NPSF

Safety First Blog

Consider Haiti – Making a Difference

Listen to the Interview on iTunes

Or you can listen to it on Stitcher

Did you like this content? Donate TODAY to support Rose Katiana on her journey through nursing school, and let me know what other content you want covered.
First things first: Bonswa!

Welcome to Safety First Nursing.

My name is Kristi Sanborn Miller and I started this company to support the physical, psychological and emotional safety of patients and nurses. I will be bringing you continuing education and patient safety resources based on up-to-date research and information on patient safety. All blogs are also podcasts, and you can find references and resources for everything I talk about on my website at SafetyFirstNursing.com. You can comment on social media: facebook and linked in, as well as twitter (@safetyfirstNRS) and you can email me at safetyfirstnursing@gmail.com. I welcome and encourage your feedback. I am collecting stories of safety and harm – please share with me so we can turn your story into a learning experience that might support patient and nurse safety.

There are so many things I am working on right now, but the most important is sending Rose Katiana to nursing school. I will tell you more about this delightful, intelligent Haitian woman, after I talk a bit about my motivation and give you some background on Haiti.

I have always wanted to make a difference. I am the child of a left-wing, liberal, tree hugging hippie who continues to write her representatives about the environment, march on Washington, and create shows about endangered species for local public radio. I could have done an Alex Keaton from Family Ties, but instead I have basically become my mother – with perhaps a more well-rounded, open minded sense of other ways of knowing and being (no offense, mom). I try to see all sides of an issue, maybe to a fault.

I ended up as a molecular biologist in my first life, macerating zebra fish heads to extract DNA, looking for molecules that might make a difference. I filled a garbage bin daily with plastic and radioactive refuse from my quest. I eventually ended up teaching biology and as I got to know my students, became increasingly intrigued by the field of nursing. Here is a way to get my hands dirty, I thought – to really make a difference on a tangible, physical level. The idea of becoming a nurse gave me a sense of efficacy. Whenever I would see a disaster on the television, I would wish I had something to offer – a real skill that might help people recover from difficult situations. I never felt like my arrival brandishing a pipette and a rack of test tubes would comfort someone whose house had just been swept away in a flood.

And so my second life as a nurse began, and what an experience that was (more on being a scientist in a nursing classroom later). After finishing nursing school, I felt ready to embark on my lifelong dream of DOING SOMETHING, not just sitting by and saying “someone should DO SOMETHING”. I took a job as an oncology nurse in a local hospital, on the night shift, and learned to give chemo, hang IVs, change a Foley and do a head-to-toe assessment proficiently, but mostly I learned how to listen and be present for people in the unhappiest, most frightening moments of their lives. I fought so hard to support a patient’s goal to live with dignity and independence, and then supported them as they died, helping family members to understand the process so they could be really present for an event as important and momentous as birth.

My husband supported me through all of it…I have to tell you about Wes, because none of this would be happening if I hadn’t met him. We met mountain biking heart break ridge – I beat him up the mountain (it’s important to him that you know his back was injured) followed by asking him out – who wouldn’t want to

date a bald guy with a goatee? Eventually we got married, as people do, and then got pregnant, as people do, and the SOMETHING I ended up DOING was having the baby in Chicago while my husband did a year-long fellowship in manual therapy at the University of Illinois (he is an amazing physical therapist who treats chronic pain – more on THAT later as well).

While we were living in Chicago, a magnitude 7.0M earthquake decimated Haiti in January of 2010, when our daughter Riley was only a few months old. By January 24, 52 aftershocks measuring 4.5 or greater were recorded. The death toll was somewhere between 100,000 and 316,000. Haiti is a country plagued by national debt, with poor housing conditions and a high level of poverty that contributed to the death toll (Human Rights Watch – Haiti World Report – 2017). When we finally returned to Asheville, North Carolina in the summer of 2010 I was determined – NOW I WILL SAVE THE UNIVERSE. I contacted a group called Mission Manna (which later became Consider Haiti) and asked how to get over there and help. In the spring of 2011, when Riley was only 19 months old, I finally realized my dream and travelled to Haiti as part of a medical mission trip in April of 2011 while my husband stayed home with the baby (thank you times 10, my love). The trip was based in Montrouis, about an hour from Port-au-Prince. I

have never worked so hard in my life. I will blog some more about that trip, but for now – let’s just say it was incredible, and hard, and dirty and rewarding and everything I had hoped it would be. I felt like I was really making a difference as I fed children worming medicine, slipped a $20 into the purse of a woman who had lost her entire family in the earthquake, and weighed and measured babies showing great

improvement from malnourishment. And then we left. I got to go home to my warm bed, roof over my head, running hot and cold water and easy access to health care, and Haiti remained. I wasn’t sure I wanted to return, feeling like the most important way I could support Haiti was through fund raising for Consider Haiti. And we got involved in making a difference at home by adopting a very white, very local sibling group of three, surrendered to foster care due to parental drug addiction.

Fast forward to fall of 2016 for my second trip to Haiti, this time with a group of RN-BSN students getting clinical hours for community service. I went to show them how to do mobile clinics in rural areas. We went right after large floods from Hurricane Matthew caused death and damage to much of western and central Haiti. We didn’t know what to expect when we arrived in the northeastern part of Haiti – at a clinic in Terrier Rouge. Luckily that part of the country was spared the devastation of the flooding. My experience on my second trip was completely different (again, more on that later) in some aspects, but the same in that I put bandages on deep wounds that would likely re-open after we left.

I made a difference in the moment, but what about long term? In the 5 years since I had been to Haiti before, not much had changed that I could see. Daily, grinding poverty was the norm. According to Haiti net, Haitian women have a life expectancy of 62.8 years, but women in neighboring Dominican Republic live an average of 75.5 years. The infant mortality rate is one of the highest in the world at 630 per 100,000 live births. Women delay seeking treatment due to the time it takes to reach a clinic, the lack of available resources or physicians at clinics, and lack of funds. I came away with a renewed sense of purpose that if we don’t help Haitians make a difference in Haiti, nothing will ever change.

I returned home and started Safety First Nursing. The definition of safety that I have adopted is to keep people free from harm. I am a big fan of the Patient Risk Detection Theory by Despins (2010), stating that education and training can reduce harm to patients. Additional research (Progress of the World’s Women 2015) shows that when we train WOMEN, we are even more likely to reduce harm. According to USAID Empowering women, investing in gender equality and women’s empowerment can unlock transformational human potential. Women account for one-half of the human capital in any economy and Haiti is no different. Women make up more than 40 percent of the agricultural workforce, but only 3-20% are landholders. Only 22% of women in Haiti go on to Secondary school, but studies have shown an extra year of secondary school can increase future earnings by 10-20 percent. Countries investing in girl’s education have lower mother/baby death rates, lower AIDS and HIV rates and better child nutrition. When women participate in politics, governments become more open, democratic and responsive (Poto Mitan – Haitian Women – Pillars of the Global Economy).

Starting a business is terrifying. My husband had started his business, AntiFragile Physical Therapy, 3 years before and it has been a big success. It is “our” business, but it is really “his” business. At first I didn’t think it was even possible, and I will blog about the process and journey of being a nurse entrepreneur, but let’s just say that without the support of my friends, family and Mountain Bizworks (including my coach, Emily Breedlove) I wouldn’t be writing this blog. One of the things I did first was to search the internet for likeminded people and businesses to see how they operate. I was incredibly inspired by Bombas – they make socks and for every pair they make, they donate a pair to someone in need. I thought, why can’t I do that? And so I am. 10% of all my profits will go to Consider Haiti. And then I thought, instead of just a generic donation to CH, why not send a Haitian woman, to nursing school? She could be from the communities CH serves, providing a much needed additional community health worker. Would that be a wacky idea?

When I first met with the board for Consider Haiti, they weren’t sure if my idea of sending a Haitian woman to nursing school would be the most helpful thing to the communities that are served by Consider Haiti. We talked to Eddy (CH Staff, and all around amazing guy) and asked for his input. He loved the idea, and within 24 hours had found both a candidate for the SFN scholarship, and a nursing school. The funds needed to send Rose to school for the first year are $2400 – this includes room and board, books, tuition and other costs. I went ahead and sent half to secure her a spot in the upcoming class beginning in October of 2017. She will be attending UNASMOH (Facebook page) – the American University of Modern Sciences in Haiti in Saint-Marc. I haven’t found an up-to-date webpage for UNASMOH (Universite Americaine Des Sciences Modernes D’Haiti – this page is outdated, and doesn’t list the 4 year program for infirmiéres ~ French for nursing), but will post when I do.

Consider Haiti is a non-profit organization based in Asheville, North Carolina with one objective – to promote the health and welfare of children in Haiti. Efforts are concentrated on medical care, community health agents, sustainable nutrition and clean water programs. They have been working for over 15 years to empower Haitian communities to help the future of their county by supporting grass roots efforts. The people of Haiti are the best agents to serve their people, so Consider Haiti provides resources and support. 95% of all contributions are utilized directly in Haiti. Consider Haiti is a 501C3, and all donations are tax deductible. All Consider Haiti staff are volunteers, and they are a local charity with local support.

Rose has given me permission to share her story and photos with you; she wants to do whatever she can to encourage more support for Consider Haiti. She is a 23 year-old woman, whose parents have both died (I have asked for that story when she is ready to tell it). She was born in Lanzac, a small village in Montrouis, and has completed her “classical studies” (similar to High school in the US). She lives with her older sister, two cousins and a niece in a house that she says is “under construction” – pictures coming soon. A typical day may not involve food – they sell goods at the local market, but I don’t yet know what those goods are or where they come from.

I asked Rose to tell me a story about helping someone else so you can see what kind of person she is. Here is a translation of that story:

I was 12 years old (and my mother and my father were still alive at the time this story happened). The neighbors had a little girl named Sandra, who was 8 years old, we were close; her family could not afford to gave her everything she needed. So I had known for several months that she had only 2 small dresses. I asked her father about this. He tells me that his family had no money to buy other dresses for her. That made me feel so badly -I was constantly thinking about it. When my birthday arrived sponsor me gave me $ 100 as gifts. Immediately I thought of Sandra, I told myself it is not necessary for me to celebrate when my friends do not have clothes to wear. So I decided to go to give Sandra all what I received as gifts for birthdays-my godmother gave me $50 as a gift also. I was all set with $150 in an envelope and I gave it to Sandra’s mother. I said “here is money for you to buy clothes for Sandra”. Sandra’s parents were weeping to see how Sandra had a good friend. I was also crying but also I was delighted – I helped someone in need.

I have been communicating with Rose and she is excited about going to school and about giving back to families in need in the community of Montrouis and surrounding areas. I am still learning about her – she doesn’t have her own email account, so I am talking to her through a Consider Haiti staff member, Eddy in Haiti. Both times I was in Haiti, the nurses I met did not speak English, so conversation was limited. The ability to teach the Haitian people what we know is limited by translators. It is so frustrating to have 15 people ready to help, and only one translator – the bottleneck means patients wait for hours to talk to a Doctor at the rural Haitian mobile clinics run by the Consider Haiti team. The only translators I have met so far have been male. I am interested to see how compliance with medicines and healthcare treatments changes when information is presented by a female.

Rose says she likes to read books about health and the bible and participate in debates, watch documentaries and she listens to gospel and American-style music. This seems like pretty generic stuff right now – I am sure she is nervous about opening up to a complete stranger. I am looking forward to getting into the details – to the part where we open up to each other and share the interesting bits. I have been telling her my story as well. Questions I am asking Rose: Where did you go for your “classical studies” and did you like school? Tell me about how your parents died. Do you have any brothers and sisters? What sorts of things do you sell at the market? Please send pictures of your house and family. Right now we are working on getting her set up with English lessons. I will update this blog regularly with information about Rose’s journey, including more photos.

I am inserting snippets of some of our letters back and forth as translated by google translate for your amusement– I am glad we have bilingual friends to help, because I am pretty sure Rose is not in Armenia (for some reason Google translates “Consider Haiti” to “Consider Armenia”). My Haitian is good enough to get me in a lot of trouble, and it allows me to find out where it hurts, when to change the bandage, and when to go to the clinic…but daily conversation is beyond me. Rose and I both have a lot to learn! She has asked me when I will be visiting Haiti again, and I am hoping to go next year for a visit – I want to see how Haitian nursing schools are run. I want to meet Rose and her family and give them all big hugs. I want to follow

along as we see how Rose is making a difference in Haiti. Maybe she will become a nurse practitioner and deliver babies safely; maybe she will run the Consider Haiti clinic some day. SFN is her sponsor, but I want for her, whatever she wants for herself – empowerment is the goal. As I get to know her, and I see the pictures she is sending of herself, I feel a strong sense of hope that she will kick some serious ass; that she will make a difference.

“Nothing that happens in Haiti would ever happen in the United States. The depth of human suffering is unimaginable. In the mountain villages where we hold pediatric clinics, we are the only healthcare these children receive each year.”

Brenda C.

Board Member & Spring Trip Volunteer – Consider Haiti

Mési anpil.

Kristi

Resources and References

Earthquake – 2010

Hurricane Matthew – 2016

Consider Haiti

USAID Empowering women

Progress of the World’s Women 2015

Human Rights Watch – Haiti World Report – 2017

Haiti net – about Haitian women and women’s rights groups – Northeastern University, Boston MA

Poto Mitan – Haitian Women – Pillars of the Global Economy

Partners in health – Haiti

World Health Organization – Haiti

UNASMOH – Universite Americaine Des Sciences Modernes D’Haiti – this page is outdated, and doesn’t list the 4 year program for infirmiéres (French for nursing)

UNASMOH Facebook page

Haiti Nursing Foundation

Despins, L. A., Scott-Cawiezell, J., & Rouder, J. N. (2010). Detection of patient risk by nurses: A theoretical framework. Journal of Advanced Nursing, 66(2), 465-474. doi:10.1111/j.1365-2648.2009.05215.x

Suzata, E. (2011). Education in Haiti: An Overview of Trends, Issues, and Plans. World Innovative Summit for Education. Retrieved