NUR 4116P

Call to Make a Difference: POST-PRACTICUM REFLECTION

I was part of a small team from Bon Secours Memorial College of Nursing that went to

Warsaw, Virginia. Warsaw is am old, small, predominantly rural riverside town of about 1,500

people located in Virginia’s Northern Neck; farming, fishing, and forestry form the pillars of the

town’s economy (“Economic Development”, 2013). While I noticed many “going out of

business” signs and unoccupied storefronts, there were several small businesses and restaurants

in the downtown area of Warsaw and it seemed to be quite a lively little place. After a

conversation with our server at dinner one night, I found out that Warsaw is primarily full of

aging adults and there are not many activities in town for teenagers and young adults. The server

did note that a brewery was being built in the area to try and attract younger crowds and

stimulate the economy. Warsaw is a small town, but it looked to be nicely maintained despite its

age. The closest hospital is about an hour away and I did not notice many health provider offices

in town, so I wonder about the general health status of the town’s population.

Our team traveled to Warsaw to participate in Remote Areal Medical clinic (RAM) over

the course of a weekend. RAM is a nonprofit agency that stages huge mobile clinics to provide

free healthcare, especially dental and vision services, to different vulnerable and underserved

populations around the United States. Our team helped with clinic set-up on Friday and we

worked at the clinic all day Saturday. All the volunteers present were eager to help and happy to

be playing their part. Clinic set-up was hard work! RAM took over a local elementary school

and turned it into a massive clinic. We unloaded a tractor trailer that was filled to the brim with

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medical tools, dental tools, tables, chairs, supplies, and more. We transformed the school’s

gymnasium into a large dental clinic with over 30 dental stations. Student classrooms were

reconfigured and became specialty rooms. There were rooms specifically designated for patient

registration, triage, blood pressure management, diabetes management, women’s health, and

specialty medical problems. An entire hallway of classrooms was dedicated to vision services,

taking patients all the way from a visual acuity test to having custom glasses fitted to their face.

It was amazing to see how quickly we volunteers transformed the school into a clinic.

On Saturday, we arrived early to the clinic and prepared for incoming patients. As they

rolled in, they were registered, triaged, and screened. I started off my day working in the dental

clinic, escorting patients to different areas and assisting the dentists with new patients. Standing

near the dentists, I learned a lot about the struggles the patients were facing. Most of them could

not afford dental care and were living with extreme tooth pain. Many of the patients got

cleanings and fillings and over half of them had teeth extracted. It really blew my mind to

discover the problems these people were living with due to financial strains.

After spending time in the dental area, I was relocated to one of the medical rooms and

helped diabetic patients. I took blood sugars, administered insulin, and provided diabetes

management education. I could not believe the blood sugars some of these patients were

walking in with. I noticed a great need for education. One man came in with an elevated blood

sugar and kept saying “I don’t know why it’s so high. I promise I took my insulin this morning

just like I do every morning!” Turns out, he had misinterpreted his physician’s instructions and

his prescription; he was only administering one-fourth of his prescribed basal insulin dose. It

made me so sad to see his reaction. He truly thought he had been staying on top of his

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medications; I think it was a big blow to his confidence and feelings of self-efficacy to learn that

he was not properly managing his condition.

Lastly, I moved to the vision clinic area where I performed visual acuity tests, operated a

lensometer to perform lens prescription measurements, operated an autorefractor, which

measures a person’s refractive error and prescription, and helped people pick out eyeglass

frames. This was a really fun section to work in. I enjoyed talking to people, learning about the

different optometry tools, and helping them try on different frames. I loved watching the

patients’ faces light up when the volunteers complimented their new glasses.

One patient that really stuck with me was a teenage boy who came in for a vision

screening. He was 75% blind in one of his eyes. I did his visual acuity test and in his good eye,

he couldn’t see the giant E at the top of the acuity chart, even when we brought him 50% closer

to the chart. He told us that he had never been able to afford glasses. This poor boy couldn’t see

anything and heaven only knows how long he had lived like that. I am happy to report that he

walked out of the clinic with a brand-new pair of glasses, but I still feel sad when I think about

the fact that those may be the only pair of glasses he ever owns. His story really struck a chord.

My heart broke for him and I still think about him often. It is extremely saddening and

frustrating to see that happen to people. We live in a country of immense excess, yet we cannot

take care of the least among us. It’s not right. People shouldn’t have to live like that boy.

This was an extremely eye-opening experience for me and it will definitely impact the

way I care for my patients in the future. Patients are amazing – they teach us so much and I am

eternally grateful to them for that. I learned a lot about the population of Warsaw and the

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surrounding areas by spending time with patients in the RAM clinic. I hope that I taught them a

little something too, or at the very least, exemplified kindness, non-judgment, and compassion to

everyone that crossed my path.

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 References

Economic Development. (2013). Retrieved November 18, 2019, from

https://www.townofwarsaw.com/economic-development.

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