In January 2020, I participated in a medical volunteer hosted by Blanca’s House, an organization founded by a New York nurse anesthetist in 2008. I participated in the 57th trip Blanca’s House has hosted with four of my fellow third year DNP nurse anesthesia classmates. We traveled to Loja, Ecuador, to perform pediatric plastic surgeries, as well as adult general surgery.
Over the five days we operated, I participated in laparoscopic cholecystectomy, burn releases, cleft palate reconstructions, polydactyl removal, hernias, and various pediatric plastic surgeries. While the hospital we worked in was fairly dated, the perioperative suit had recently been renovated and had modern features (anesthesia machine, suction, air conditioning). Our team worked out of two operating rooms, each room was divided in half, so that two surgeries could be performed simultaneously. This allowed us to perform more operations. We carried all of our supplies with us: medications, endotracheal tubes, intravenous fluid, and even our anesthesia machines. We set up a pharmacy in the back of one operating room, with all of our medication organized in a hanging shoe holder for easy access. Other supplies were also organized this way in order to find them quickly.
While the hospital anesthesia machines were modern, the two machines that our team brought were very dated. To use these machines, we would titrate anesthetic to clinical effect, instead of volume percent of anesthetic gas (like the modern machines). As a student, this was a great experience to combine clinical application with didactic knowledge of anesthesia.
The operating room flow was different from anything I had experienced in the United States. However, I was must struck by how resilient the patients were. They would walk into the operating room, where another surgery was underway, and get onto the operating room table for their procedure. Everyone was so appreciative of the surgeries they were able to receive, all free of charge.
I particularly enjoyed learning new techniques. The nurse anesthetists on the trip taught new regional anesthesia blocks. They also fostered independence in their students, allowing us to complete a majority of the case with little supervision. This independence helped me grow as a practitioner. With five months left until I graduate, I appreciated the increased autonomy. I also enjoyed the opportunity to teach nurses, nurse practitioners, and non-medical staff about airway management, anesthesia, and nurse anesthetists. I was able to assist nurse practitioners with their intubations, as well as provide them with tips and tricks for difficult airways they may encounter in their areas of practice.
Blanca’s House was one of the most spectacular experiences of my life. I am very grateful for the opportunity to impact the lives of the people of Loja, as well as participate in an amazing medical team.
Thank you to the University at Buffalo School of Nursing and the anesthesia program for assisting in my journey!