My first clinical experience here in SA

Today was the first day of clinical, and I was at Caprisa, which actually stands for the Centre for the AIDS Programme of Research in South Africa. I didn't know what to expect so I guess you can say that I was ready for anything! :) Caprisa, begun in 2002, is a research-based HIV clinic providing services to patients who have tested positive to HIV/AIDS with a CD4 count under 200. They also screen for HIV/AIDS, as well as provide immunizations and vaccinations for other diseases, but their main work is with HIV/AIDS patients. This clinical agency is funded by PEPFAR, which essentially is US money. Patients who qualify can receive their ARV's at Caprisa, as well as medications or referrals for other diseases/conditions. The head nursing supervisor is Gugu, and the nurse that I spent most of my time with was Sister PK. Meeting Sister PK and getting the opportunity to work with her was the best thing about today's clinical experience. She is so passionate about what she does, and she is extremely knowledgeable! She did such a great job with teaching me all that she was doing, as well as translating to include me in the the day.

At Caprisa, there is a team of workers. There are doctors, nurses, counselors, individuals working at the pharmacy, etc. I was surprised how organized the clinic was, and it ran quite effectively. All of the patients I saw today were HIV/AIDS patients and some were or had been infected with TB. I administered Depo, pregnancy prevention, injections as well as performed assessments, wrote diagnoses, and created treatment plans. I felt really confident in my clinical skills, and I felt like a real nurse! :) The visits comprised mostly follow-ups on the patient's ARV medication regimen, as well as check-ups on their overall health.

There are many differences among the patients and the nurses here in SA in comparison to the patients and nurses in the US. One of the differences that I saw in the patients here was that they come from more rural areas. Another major difference was that a couple of the patients we saw today had sent other family members on their behalf for the visit, because they could not come due to their work schedule. This is quite different than the States, because that would not really be allowed. At Caprisa, they highly stress compliance with appointments, medication, and so on; so it is better for someone else to come for you rather than no one to come at all, on the one condition that the person who is absent is healthy and well. Also, the nurses here do diagnosing and treatment planning like how an NP would do in the states. It felt really good for me to be able to write down the medication that I thought the patients needed for their other medical issues, such as fungal rashes, diarrhea, aches/pain, and then the patients go to the pharmacy to pick them up. I can feel the confidence in me growing, as well as the skills and knowledge I have learned from nursing school thus far being applied.

What surprised me, as well at the same time, caused me dismay was the knowledge that I learned about HIV/AIDS from one of the doctors at the clinic. Some 6 million people are infected with HIV/AIDS here in Africa and at one point in time the heaed of the government did not support the use of ARV's for treatment. This stigma that was present on receiving treatment for the disease made me feel frustrated and discouraged that the problem will never be eradicated; but it also ignited in me a passion to learn more about HIV/AIDS. The matter that I will commit to study is learning more about the epidemic of AIDS in the area. I will commit to prayer all the staff at Caprisa, as well as the people of SA who are suffering from this epidemic. Overall, my first clinical experience here in SA was AMAZING, and I already can't wait to go back! Until next time....

-Chels