During winter session, School of Nursing 2020 DNP graduate Andrew Burns, BSN, RN, CCRN, traveled alongside a team of healthcare professionals on a medical mission trip to San Pedro de Macorís, a municipality in the Dominican Republic.
As a nurse anesthetist student, Burns worked under an adjust professor, who coordinated all anesthesia care. While the trip wasn’t organized by the university, he wasn’t the only Bull on site.
“There was a good amount of UB representation,” Burns says. “I was there from nursing, along with the nurse anesthetist faculty member, but we were also with UB pharmacy students, a faculty member from public health and a few dental and pharmacy alumni.”
Burns participated in this trip through The Chapel, a non-denominational church headquartered in Getzville, New York.
“This really was a multi-team effort,” Burns says. “The Chapel organized the surgical and medical teams and collected supplies and donations before the trip, and SCORE managed the logistics once we got there.”
This was the eighth time that The Chapel participated in this trip. They’re involved through a partnership with SCORE International, a full-service mission organization that organizes short-term medical outreach trips, among other efforts such as anti-human trafficking, clean water initiatives and orphan care.
“We packed most of our own medications that we worked with,” he says, “including anesthetics, propofol, lidocaine, antibiotics, steroids and antiemetics. The pharmacists also brought antibiotics and other medications and the mission group brought personal care items such as tooth brushes and vitamins.”
While they had access to some surgical instruments stored at the SCORE facility from previous missions, they also traveled with their own equipment and supplies, including laparoscopic machines, surgical instruments, sterile gowns, endotracheal tubes, airways, medicines and other disposable supplies.
“SCORE owned the accommodations we stayed in and had drivers and translators on staff for us,” Burns says. “They have relations with doctors there, so they handled the logistics we needed to get into the country with our medications and practice in their hospitals.”
The group spent the majority of their time at the San Pedro Hospital, where they performed 22 surgeries with cases ranging from laparoscopic gallbladders and hernias to hydroceles and cyst or lipomas removal. All cases were done under general anesthesia, monitored anesthesia care or local anesthesia, as they did not perform any regional anesthesia.
“We saw people ranging from 25 years old to their mid-eighties,” Burns says. “These individuals were underserved and had received very minimal healthcare, which meant they also suffered from chronic conditions such as hypertension and diabetes.”
“Most of the patients we saw traveled from far-away villages to see us,” he adds. “They couldn't stay overnight in the hospital—and some even had to get right back on their motorcycles—so we had to make sure their pain was well controlled and that they were safe to travel home.”
In addition to working with a group of support staff who hadn’t worked together before, the team ran into some unexpected obstacles—like sudden power outages and door-less elevators.
"Monitoring was also a little substandard, and everything ran off tanks because there was no wall suction or air oxygen,” Burns says. “It definitely wasn’t what we were used to, but the hospital was great. They had somewhat modern anesthesia machines and really good sterilization.”
After working in the hospital, Burns and 14 other medical and dental providers traveled to San Pedro Prison to volunteer in the clinic, where they provided medical care to about 300 of the 900 people in the prison.
“We saw everything from hypertension to scabies and hernias at the hospital clinic,” he says. “The surgeons were able to perform minor proceures and the physical therapists were able to provide some exercises to ease back and other body pains. We were also able to work with the doctor on staff to recommend and provide medications.”
While they spent the bulk of the local hospital and prison clinic, they were able to volunteer with SCORE's other partnerships in the area.
“We traveled to villages they have relationships with and setup medical and dental clinics,” Burns says. “We also visited some other places they support, including churches, homes for handicap children and all-girls homes. It was a great opportunity to see all the places they had an impact on.”
Burns learned a lot about himself on this trip—and was able to grow in both his technical and soft skills.
“The lack of monitoring meant I had to rely on my assessment skills, which was great practice,” Burns says. “Plus, this trip gave me the opportunity to practice to the fullest scope, which you don’t always have the opportunity to do as a student in a hospital setting. Being one of only two anesthesia providers also allowed me to develop leadership skills as I had to clearly delegate in order to get a patient safely through an operation.”
He received $2,000 funding for his trip through Niagara Frontier Anesthesia Services, which supported his flight, food, boarding and other travel costs. He plans to work with the group upon graduation.
“You definitely come away from doing a mission trip with a feeling of how fortunate we are to have everything that we have in our hospital settings in the United States,” Burns reflects.
Published May 22, 2020