Nursing Experience in Nicaragua

 Arboles de la Vida (trees of life)

O-H-I-O outside the Nueva Vida Clinic

Name: Hannah Kayuha

Type of Project: Education abroad

  1. Please provide a brief description of your STEP Signature Project. Write two or three sentences describing the main activities your STEP Signature Project entailed.

My STEP project was a nursing study abroad in Nicaragua. Throughout our time in Nicaragua we mainly worked in a clinic just outside the country’s capital, Managua. In the clinic we helped check people in, worked in the pharmacy, went on home visits, and sat in with the doctors in the clinic.


  1. What about your understanding of yourself, your assumptions, or your view of the world changed/transformed while completing your STEP Signature Project? Write one or two paragraphs to describe the change or transformation that took place.

This project was very eye opening despite having visited family in Peru throughout my life. Working in the clinic and visiting Managua’s children’s hospital really showed me what their healthcare system is like and what equipment is available to them. I loved working in the clinic because we were able to see how the people in the community lived and cared for each other despite what little they had. The Nueva Vida Clinic is located on the outskirts of Managua in an area called Ciudad Sandino and it is one of the poorest neighborhoods in the country. When hurricane Mitch hit Nicaragua in 1998 it devastated Managua leaving many homeless. The families that were displaced were given two pieces of tin and a tarp by the government and told to make a home in the Ciudad Sandino community. The people in this community started with nothing and built a beautiful community where they care for each other, despite the fact that their homes are still made from tin and tarp. This experience affirmed my belief that one can always find beauty and should always look past the poverty.

When we first arrived in this community one would think that they have nothing and wonder how they survive, but upon working in the clinic and interacting with the people you realize that they love their lives and make the most of the resources they have available. One of the most valuable parts of this experience was learning to provide good patient care without the advantage of advanced technology. For example, I learned to rapidly find a fetal heart beat by palpating the mother’s abdomen to identify the best location to listen with a Doppler. In the U.S. I would have wanded the abdomen with an ultrasound machine and allowed the machine to find the heart beat.


  1. What events, interactions, relationships, or activities during your STEP Signature Project led to the change/transformation that you discussed in #2, and how did those affect you? Write three or four paragraphs describing the key aspects of your experiences completing your STEP Signature Project that led to this change/transformation.

For our first few days in Nicaragua, our knowledgeable guide and driver took us around Managua to learn about the history of the country, so we could better understand the culture and people throughout our trip. For example we visited the house of the old dictatorial president and learned about the current political and economical standing of Nicaragua. Their current president elected his wife as vice president and instead of helping the poor people she has spent millions on unnecessary things such as the 134 metal “arboles de la vida” (trees of life) that are lining the street of Managua. When we arrived in Nicaragua it was late at night so we were able to see the arboles de la vida lining the streets. Each tree stands 17 meters tall, costs $20,000, and because they light up, roughly $1 million more in electricity each year. Nicaragua is the second poorest country in the western hemisphere, so the majority of the people don’t like the trees. Had I not known the story behind the “Arboles de la Vida”, I would have felt they made Managua unique. Having a tour guide that was able to explain the history of many different sites allowed us to connect with the culture and people on a deeper level.

In the clinic we worked in the pharmacy by filling prescriptions for the people of the community. The pharmacy had wooden shelves along the walls and didn’t have near the medications we have available here. At the clinic, we were also able to sit in with the physicians such as the gynecologist, podiatrist, pediatrician, radiologist, dentist, etc. The doctors were so eager to teach us examination techniques that they offered to let us examine some patient’s; we respectfully declined as it was out of our scope of practice. I learned a great deal from the doctors, such as measuring a fetus’ bones on the ultrasound to determine the approximate week of gestation. They also taught us a simple math equation to determine the week of gestation with just a few pieces of information.

The final part of our work at the clinic included home visits into the community that consisted of checking on people with chronic diseases such as hypertension and diabetes; we also check on pregnant women and newborns. These visits are brief checkups with the patients to make sure everything is well. When we checked on the chronic disease patients, we would take their temperature, blood pressure, blood sugar, answer any questions, and give them advise on how to better manage their disease. The pregnancy visits consisted of taking the mother’s blood pressure, measuring the abdomen to determine the week of gestation, and finding the fetal heartbeat. The newborn visits consisted of checking their reflexes and making sure they were feeding well. The people were very welcoming of us into their homes and allowed us to examine them and/or their babies in order for us to learn and to help them. Everything we did throughout the trip affirmed my goal to become a pediatric nurse and to continue to do more medical mission trips abroad.

  1. Why is this change/transformation significant or valuable for your life? Write one or two paragraphs discussing why this change or development matters and/or relates to your academic, personal, and/or professional goals and future plans.


This experience made me appreciate how fortunate I am to have grown up in a home where I have endless necessary resources available. It also made me realize that we live in a consumer-driven nation, yet the world doesn’t have the resources to sustain that way of life everywhere. By vising Peru and now Nicaragua, it has become abundantly clear that a materialistic way of life is unnecessary in order to also have a happy life. I am much more appreciative of what I have, but I also realized that I could live a simplistic life and be just as fulfilled and happy.

This transformation is also significant to my life because ultimately I would like to become a pediatric nurse practitioner and go on more medical trips abroad. It is my passion to help people and learn about other cultures, so this experience was the perfect mix of what I love. I have not had my pediatrics or obstetrics clinicals yet, so this experience allowed me to learn a great deal about the population that I am most interested in working with. Most mothers would be hesitant about handing their newborn to strangers, but the mothers in Nicaragua were proud to have us hold and learn from their children. This experience will make me a better nurse because I will be more understanding of my patients no matter their situation.

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