by Matt Batcheldor
Just weeks before the COVID-19 pandemic suspended international travel, Vanderbilt University Medical Center nurses completed two new educational initiatives in the South American country of Guyana, and a strong collaboration continues virtually in response to the coronavirus.
A nursing team from Monroe Carell Jr. Children’s Hospital at Vanderbilt and Emergency Medicine educated the nation’s entire EMS staff, about 100, about responding to obstetrical and neonatal emergencies and implemented a Pediatric Advanced Life Support (PALS) program by training 10 Guyanese PALS instructors.
It’s all part of an ongoing collaboration between Vanderbilt and the Georgetown Public Hospital Corp. (GPHC), a free public hospital in the capital and largest city in Guyana. Bordering Venezuela on the Atlantic Ocean, Guyana is roughly two times the size of Tennessee with a population comparable to Davidson County. Most patients receive care from government-run medical facilities in the capital, with some taking days to reach the city on unpaved roads from homes nestled in thick rainforest.
The focus on obstetric and neonatal emergencies is especially important, said program director Jessica Van Meter, DNP, RN. A disproportionate number of home births occur there, and ambulances and rural doctors are few. Emergencies often must be addressed in route to the hospital.
Guyana’s neonatal mortality rate is about 35 per 1,000 live births and is among the highest in South America, according to 2018 statistics from the World Health Organization.
Children’s Hospital’s education and outreach team, in Guyana for the first time, volunteered its time. They brought a similar educational model that they use for outreach in rural Tennessee, Van Meter said.
“They literally trained every EMT in that country in three days,” Van Meter said.
“I went to Guyana with no expectations and left Guyana with an overwhelming urge to come back and figure out what future skills need to be taught or reviewed with this wonderful group of medical professionals,” said Katie Judd, RN, Neonatal Outreach senior program manager at Children’s Hospital.
Added Mary Lee Lemley, MSN, RN, Neonatal Outreach senior program manager at Children’s Hospital, “I have provided education in 12 different international locations, but I believe the Guyana EMS staff were most appreciative, professional and eager to learn that I have ever taught. I hope there is a day we can return and add another chapter to their education and skills.”
Nurses Lee Blair, RN; Jennifer Dindo, RN; and Lacey Noffsinger, BSN, RN, were also part of the initiative in Guyana.
Vanderbilt has had a relationship with GPHC since 2009, when John Paul Rohde, MD, assistant professor of Emergency Medicine, started an emergency medicine residency program in Guyana. Rohde, whose parents were missionaries, spent his childhood in the country and wanted to give back.
“We are finally realizing our objective of fully establishing emergency medicine in Guyana,” Rohde said, “as Vanderbilt’s collaboration with the Georgetown Public Hospital and the University of Guyana to train emergency medicine specialists has resulted in the creation of an independent Department of Emergency Medicine at the nation’s largest hospital, which is now staffed 24/7 by fully trained EM experts.”
Since then, Vanderbilt nurse educators have also become active in the country, said Van Meter, who spent part of her time each month in Guyana prior to the pandemic and continues to interface virtually. She works closely with Sally Dye, RN, assistant program director.
VUMC nurses developed and are administering a bachelor’s degree in emergency nursing program for nurses at Georgetown Public Hospital Corp. (GPHC) in the South American country of Guyana, the first of its kind in the region. The program was developed in collaboration with GPHC and the University of Guyana.
In mid-March, not long after completing the pediatric educational initiatives, VUMC’s nurses and doctors had to convert activities on the fly to a virtual platform on Zoom as the pandemic descended on the country.
The doctor and nurse residency programs continued virtually, with an emphasis educating residents on protecting the community from COVID-19 and sourcing personal protective equipment. Vanderbilt’s faculty members interface with the students virtually at least once a week.
“I think both the nursing and emergency medicine residency programs have been integral in providing some of that education and providing education about how to care for our COVID-19 patients, in a respiratory capacity, emergently and then otherwise if they’re stable, how to triage them,” she said.
Guyana has had about 1,500 positive cases recently, Van Meter said. The country’s nursing residents are still on track for the regular November graduation, even if they may not have an in-person ceremony.
“We’re making it work,” she said. “I think it’s a true testament to our commitment to residency education, first and foremost — our commitment to this initiative and the people in Guyana that are a part of our residency programs. And I think that it’s a true testament to the commitment that these nurses and physician residents have to their own education, because I know that this has been really hard for them. I commend our emerging leaders.”