The St. Vincent de Paul Society sponsors the Vocie of the Poor (VOP) which advocates for the underserved and vulnerable populations nation-wide including the homeless, poverty-stricken, and disabled. The following is a video produced by the national office of the VOP.

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“Never worry about the numbers. Help one person at a time, and always start with the person nearest you.”    Mother Teresa

 

Description of learning experiences in my clinical practice environment:

I completed 16 hours volunteering my expertise as a registered nurse (RN) in the Free Medical and Virginia G. Piper Dental Clinics (FMVPDC) offering nursing care for the working poor, the uninsured, and the indigent populations surrounding Phoenix metropolitan area.

What was the best/worst/most challenging thing that happened this semester?

The most challenging experience in the FMVPDC happen during my first 4-hour shift in which I triaged and cared for Mr. X, a 38 year-old Native American man who was complaining of a fever, night sweats, weight loss, poor appetite, and a persistent productive cough. He admitted to smoking 1 pack/day x 20 years, drinking 1 pint of alcohol/day for 8 years, and being an IV drug user. He had been seen previously in the clinic for ETOH abuse, tuberculosis (TB) treatment, and dental care. His clinical presentation included being gaunt, having tremors, febrile, hypotensive, hypoxic, tachycardic, and tachypneic. He was immediately referred to the staff physician for evaluation. He was also placed in a negative pressure isolation room and masked. I inserted an IV and gave him a fluid bolus. In reviewing at his previous work-up, he was referred to the county health department for Multi-Drug Resistant TB (MDRTB) and being HIV positive. This patient also received an antipyretic, an anxiolytic, and oxygen therapy. After he was stabilized he was transported to the emergency department of a nearby hospital for further evaluation and treatment.

On my third 4-hour shift in the clinic (1 month later), I encountered Mr. X in triage complaining of pain in his right antecubital area which revealed a hard mass over the right antecubital vein which was thrombosed and reddened. Once again, he was evaluated and sent by ambulance for further evaluation at a nearby emergency department.

Through dialogue with the social worker and Indian Health Service, we found out the patient was eligible for healthcare at the HIS hospital and eligible to receive public assistance and additional health care coverage for TB and HIV with the state and county agencies. The patient received long-term treatment with the Maricopa County Health Department and Phoenix Indian Medical Center. Additionally, the Centers for Disease Control (CDC) interviewed this patient because his strain of TB was unique. Furthermore, we were able to get Mr. X the treatment he needed and protect the other vulnerable populations from the spread of  MDRTB.

Examination of my experiences:

What did I accomplish?

I provided quality and effective care to an underserved population (indigent) which stabilized and improved the care at least one person received. I made the difference in people’s life, one person at a time. I was able to positively intervene in healthcare situations to affect outcomes. I provided a health care safety net to those without one. I enhanced my community by using the expertise of nursing.  

How did this experience affect my interactions with others?

I was able to be part of a community of caring individuals with similar goals who want to help the underserved and vulnerable populations in our society. Working with the social workers, clinic providers and nurses, and the others allowed me interact positively with community partners such the United Way, Salvation Army, Catholic Charities, and the Maricopa County Health Department.

What have I done differently as an individual and as a professional to support and advocate for some of the issues I encountered during your service learning experience?

Becoming a member of the Voice of the Poor (VOP) chapter in Phoenix has given me a platform for advocacy concerning human dignity and caring. The VOP works with state and federal agencies to provide a communal network to keep the “safety net” intact through policy and legislation at the municipal (local) level while being a base for issues related to poverty, immigration, and social justice.

Articulate learning of my experiences:

What did I learn?

Human caring is central to nursing interactions and is essential to optimizing health care delivery. In this environment, one must 1.) clear the mind; 2.) desire to understand; 3.) affirm the presence of the receiver; 4.) establish confidentiality; 5.) prepare to hear anything; 6.) actively engage in and encourage dialogue; 7.) avoid assumptions; 8.) follow intuition; and 9.) never give up (Schwerin, 2004). These attributes created an environment that was conducive to the clinic staff and the patients that received care.

How did I learn it?

I learned this through experience, the clinic staff members, and the clinical manager. Additionally, Schwerin (2004) states these tenets are the necessary building blocks of creating a caring connection.

Why does it matter?

Social justice— preserving of human dignity, protecting the poor, promoting solidarity and human equality—requires us to be kinder than necessary through the use of empathy, compassion, and resilience through adversity. Employing the techniques of human caring increases the interaction and responsiveness of the community to help each other and preserve human dignity.

What will I do in light of this?

Continue to serve my community and use my expertise to ensure access to healthcare for the underserved and vulnerable populations.

References

Schwerin, J. (2004). The timeless caring connection. Nursing Administration Quarterly, 28(4),

            265 – 270.