http://forums.nurse.com/blog.php?1038433-tonybonazzo This is a Nursing discussion forum. en Sat, 18 May 2013 18:32:59 GMT vBulletin 60 http://forums.nurse.com/images/misc/rss.jpg http://forums.nurse.com/blog.php?1038433-tonybonazzo http://forums.nurse.com/entry.php?1863-Quito-Medical-Mission-Photo-Link Mon, 29 Aug 2011 15:26:19 GMT Here is the photo link of the mission pictures. Thanks. Tony www.flickr.com/photos/quito2011 Here is the photo link of the mission pictures. Thanks. Tony
www.flickr.com/photos/quito2011 ]]> tonybonazzo http://forums.nurse.com/entry.php?1863-Quito-Medical-Mission-Photo-Link http://forums.nurse.com/entry.php?1857-Day-Five-Thursday-August-25-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador Fri, 26 Aug 2011 13:55:18 GMT "A Hurricane is coming tonight"! A Disco hit that is coming back to haunt me.

Day five was on auto pilot with the cases all going well and on time. We were able to start to add on plastic cases of the adults that needed scar and burn revisions that we added to our OR schedule. The hospital asks our team if we can fit in cases they are not able to take on. We are happy to accommodate them when our OR or a Doc”s schedule time is available.

Just as things were smooth sailing on a calm sea in all the OR rooms, we get an email message from our home office in MA that hurricane Irene is heading up the east coast and flights may be canceled. As this was announced to the mission team and the thought of being stuck in Bogotá Columbia or Houston, TX, our connecting cities to get back to the US, you could see the loss of focus and distraction this unsettling news has now taken on the team member.

As you may know, bracing for a Nor’easter to hit can cause havoc in any organization and the effect it has when it starts to consume everyone's thoughts. There was a definite loss of focus for the rest of the afternoon and having to worry about cancellations of flights, change of plans, work issues, wives, husbands, pets, etc. The mission nor patients were never at risk but a mood change was in the air.

To help out and try to calm everyone’s nerves, we set up an international skype account and I tried to be the on site travel agent to see what the options were for earlier and later departures back to the US. We have equipment and supply bags that have to get back to the US so this adds even more anxiety. Hurricane Irene is the monkey wrench that was thrown into our well oiled machine. You can't control Mother Nature.

This will be my last blog from Quito. I will have a photo gallery of the mission on Nurse.com so please check it out.
I will be back in the US as soon as Hurricane Irene lets me. Thank you, Tony Bonazzo

I received questions from this blog readers and I will answer a few:

What experience would one need to get involved and what are the various positions available on a mission for a RN?
You just have to simply want to give. I once had a surgeon tell me on my very first mission that once you develop a skill, it no longer belongs to you. It is to be given away because it is now a part of something bigger. This was one of the most sage advice I have ever been given. No matter what your skill, education or accomplishment, it is nothing until you give it away. It is what makes us human.

What is the cost to join the organization?
There is no cost. There is a fee to participate in the mission, but the flight, room and meals our covered by the organization.

How do I find out about going on a mission?
Please visit our web site mmfc.org and there is all the info on the mission and how to become a volunteer. Please check it out. You will see how wonderful and enjoyable mission work can be. The personal fulfillment you get from helping someone in need and only getting a thank you and a smile for your time is immeasurable. ]]> tonybonazzo http://forums.nurse.com/entry.php?1857-Day-Five-Thursday-August-25-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador http://forums.nurse.com/entry.php?1854-Day-Four-Wednesday-August-24-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador Thu, 25 Aug 2011 15:16:25 GMT I was so tired last night I fell asleep when I got to the hotel. So this blog is late. lol Day four was really very successful. We completed... I was so tired last night I fell asleep when I got to the hotel. So this blog is late. lol

Day four was really very successful. We completed another 16 surgeries and we have two “walk in” patients. The mother heard about our mission in Columbia. She and her two children took a 6 hour bus ride to get to the hospital. The first child had a cleft lip and the second had a cleft lip and palate that needed repair. Both children had eaten earlier in the day so we had to wait until the end of the day before they could have general anesthesia.

I have to say that for a group that many have met on this mission for the first time to get along so well for the greater good is just amazing. The mission has 5 team leaders and they are responsible for all the orders and direction for their team. My rusty Spanish is getting put to good use. I had to translate on the walk in cases, give post op and discharge instructions to the parents.

We were also so fortunate to find a young American RN from Minnesota that is working at this hospital for 4 months. She is with an international medical health organization. She has been so valuable to all of us on this mission. She was able to negotiate things we need or little things that came up during this week. She was a hospital insider. Thank you Emily! We are going to get our early tomorrow and see a little of the city if we can and a group dinner.

I received questions from this blog readers and I will answer a few:

4. Is there a fear of being outside your familiar hospital surroundings on your first mission or even on many numerous missions?
Sometimes. This is my first trip to Quito. I don't know the hospital or the surroundings. I do know a couple of the people on the team and that's about it but I know that we will all work well together in any circumstance or setting. That I know for sure.
I read about the places I travel to so I am as prepared as I can be but things happen everywhere.

5. What is a typical OR day or shift time wise? How many cases run in a day?
I love that nothing is typical in the OR. Here or abroad. Sometime we get ad on cases at the end of the day. They hospital may have a patient they can’t treat we will take the case over

6. Are all missions sites the same or are some more rural than others. What is the actual setting of the Mission Site a hospital or tents?
The mission and the work remain true. All else vary from mission to mission. Even the culture of each mission changes.
The first mission you go on is indescribable. I have never known such a rewarding and satisfying feeling as my first mission. It changed my life forever in all ways possible. It was Peru and we did great work all week. I traveled with two friends and we spent a few days after the trip in Machu Picchu. Rested and relaxed we headed home. So much so we missed our flight! Or so we thought. We got the next one out and on that flight a baby went into distress. We had no supplies, nothing. We did all we could with CPR and asked to land the plane but to no avail. The baby died mid-flight. We were helpless and shattered by the experience. We had worked so hard all week on children with no complications and this horrific event happens. It seems we were on the flight we were meant to be. It took weeks for me to get back to my life when I returned. ]]> tonybonazzo http://forums.nurse.com/entry.php?1854-Day-Four-Wednesday-August-24-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador http://forums.nurse.com/entry.php?1840-Day-Three-Tuesday-August-21-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador Wed, 24 Aug 2011 02:10:15 GMT Day Three Tuesday, August 21, 2011 from Hospital Padre Carollo in Quito, Ecuador. Day three started a little late due to the Monday morning city... Day Three Tuesday, August 21, 2011 from Hospital Padre Carollo in Quito, Ecuador.

Day three started a little late due to the Monday morning city traffic. We did not get to the hospital until 9 am and this I thought was really going to throw us for a loop in the day’s schedule. We made up the time during the day when two cases turned out to be tonsillectomies and not cleft repairs. The tonsils needed to come out on the kids before any attempt of a repair could have been considered. These relatively simple 30 minutes cases got us back on tract.

I felt we hit our stride today on the mission. We were running on all cylinders of a well oiled machine and it was great. Our PACU nurse is still down for the count and is very upset that she is not feeling well enough to get out of bed and join us at the hospital.

The cases of the day were all completed as scheduled and we were able to leave the hospital at a reasonable time.

This first day was tough and the second worked our smoothly so I hope the pattern is set for the rest of the week to run like clock work. We shall see.

I received questions from this blog readers and I have the answers from a few of the Missions RNs :

1. How different is it working in an OR on PACU unit on a mission from your familiar OR or PACU work environment?
There are no personal agendas. Everyone comes together and does whatever needs to be done for patients and team members. No politics, just good work. This happens in urgent or emergent situations in everyday life but it’s every case, every day on missions.
2. Is the equipment the same as in the US hospitals you work at?
Sometimes the same, sometimes similar, sometimes it requires resourcefulness and creativity. We try to keep the same standards we use in the US as best we can and make due when we can't. Many of us accept donated materials and products fro the institutions we work at.
3. Do you always feel a difference on the mission as compared to your work in your own facility? Do you become engaged enough with patient care to forget for a moment you are on a medical mission when you are working?
Yes, it feels different because we are working in countries that we may not have been to before and frequently we don't speak the language. Given that and the culture we feel the mission but at the same time caring for patients in the best way possible is universal. Even the language becomes secondary. A smile, a hand shake and a hug is a language understood by all in giving comfort. The parents of these children go to extraordinary measures in caring for them and getting them to our facilities for surgery.
I have had patients travel days to get to us by walking, buses and any other way they can. I once had a teen walk for 2 days by himself to get to us for his palate repair. These are extraordinary people and it is truly an honor to be a part of their lives for this brief time. We help change lives. How lucky is that? I have never known such gratitude as from the parents and families of our patients abroad. In the US we have expectations that simply don't exist in some countries. They are so grateful for any service we provide.
Coming home or reentry as we call it is often difficult. I always feel so humbled and grateful and ife is so hard for others. I have a bed and indoor plumbing. I can drive to any store anytime and buy what I need or want.
I'll be somewhere and hear someone complaining they don't have enough milk in their coffee or they didn't like their steak. Seriously? I can not walk by a scrub sink running with no one at it! I have to turn it off because I have seen women walk 2 miles to fill up a gourd of water. How dare we squander it and take what we have for granted. It changes you forever. Mission work has made me more generous and giving every day.
It is I who is grateful beyond measure for the privilege and honor to be able to do what I do. It is such a small gift in some ways but it is what I can do. ]]> tonybonazzo http://forums.nurse.com/entry.php?1840-Day-Three-Tuesday-August-21-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador http://forums.nurse.com/entry.php?1838-Day-Two-Monday-August-21-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador Tue, 23 Aug 2011 02:05:25 GMT Day two started at 7:30 am and unfortunately one of our three PACU RNs became ill and was getting her own IV fluids and having to be confined to bed... Day two started at 7:30 am and unfortunately one of our three PACU RNs became ill and was getting her own IV fluids and having to be confined to bed rest. So since there in not a float pool or back up coverage, we just had to deal with it. Lightening hit the hospital and it knocked out the air conditioning in the ORs.

With our three ORs running and the dental clinic cases we had everyone was doing double duty. I even donned a pair of scrubs and was circulating the ORs to get the new surgical kits into each room and remove the old kits from each case to be cleaned for the next usage.

At the end of the day we completed 16 cases and every happy mom and dads was glad to have their children back in their arms again. These parents could not hide their tears of joy for the new life of their child with the completion of the surgical procedures.

The last cases ended at 8:30pm due to being a little more complicated that expected. The on call team is on place and we have all been on our feet for 13 hours straight. As we boarded our bus back to the hotel everyone was happy how well the cases went and how we all need to get some rest to start all over tomorrow. ]]> tonybonazzo http://forums.nurse.com/entry.php?1838-Day-Two-Monday-August-21-2011-from-Hospital-Padre-Carollo-in-Quito-Ecuador http://forums.nurse.com/entry.php?1830-Blogging-from-a-Medical-Mission-in-Quito-Ecuador Mon, 22 Aug 2011 01:24:46 GMT Day One Sunday, August 21, 2011 from Hospital Padre Carollo in Quito, Ecuador. Today was screening day and we had our whole team of 38 Docs, RNs... Day One Sunday, August 21, 2011 from Hospital Padre Carollo in Quito, Ecuador.

Today was screening day and we had our whole team of 38 Docs, RNs and volunteers
hit the ground running. We were able to take the 3rd floor of the new addition to the hospital under our control and did we need it. We had 120 people show up for surgical procedures on our pre screening day. Through out the year our local Quito coordinator lets the people know our surgical and dental team is coming in Aug and they are ready and waiting when we get there at 7am. Some came as far a Columbia to be seen by our team.

The procedure screening process consisted of the local hospital initiating the patient chart and took the basic patient information and then it was passed on to our intake room where I was positioned. At this location we had two RNs and a volunteer and me. At our location we checked the patient chart, took vitals, all pre op photos. Once completed at our station I directed the surgical candidate to the next stop which was one of the 4 surgical review rooms for a consult with a surgeon. We are also running a dental clinic on this mission for extractions and other dental procedures. After the surgical/dental consults the patients were sent to the 4 anesthesia review rooms for their pre op anesthesia consults. The last stop on the patients world wind pre screening day tour was back to our intake station for their final go or postponement decision on this trip. All scheduled surgeries are listed after everyone has been seen so the parents and patients had to wait until the end of the day for their surgery day and time to be posted in the hospital lobby.

I kept the patient flow going as best I could. At the busiest time of the day, I had every surgical and anesthesia consult room holding 15 deep outside the door. The parents and little patients could not have been more understanding and could not have thanked us enough for all the organized craziness and perseverance that was going on all day around them. They all had kindness and hope in their eyes.

While all this was going on upstairs the rest of the mission team was creating (3) ORs and a PACU unit. Since all our equipment is brought in for each missions with us, there was a lot of unloading, unpacking, equipment testing and stocking the ORs for the surgical procedures starting at 7am on Monday morning.

All in all, it was a great day and everything we wanted was accomplished and ready for the new day tomorrow

email me your questions @ abonazzo@gannetthg.com Thanks Tony ]]> tonybonazzo http://forums.nurse.com/entry.php?1830-Blogging-from-a-Medical-Mission-in-Quito-Ecuador http://forums.nurse.com/entry.php?1747-Medical-Mission-NY-amp-New-England-RNs-journey-to-Quito-Ecuador Wed, 10 Aug 2011 13:14:49 GMT Medical Mission: NY & New England RNs journey to Quito, Ecuador

Take a virtual journey with New England and New York RNs on a medical mission to Hospital Padre Carollo in Quito, Ecuador. Follow their Aug. 22-26 blog about Medical Missions for Children based in Woburn, MA. This surgical mission will repair approximately 60 cleft lips and palates. Send us your mission questions and we will try to answer them while we are there.

Email your questions to abonazzo@gannetthg.com

Tony Bonazzo New England Sales Manager Gannett Healthcare Group
Northeastern Continuing ED Specialist ]]> tonybonazzo http://forums.nurse.com/entry.php?1747-Medical-Mission-NY-amp-New-England-RNs-journey-to-Quito-Ecuador