My First Year on the Op Walk PGH Team: A Nurse’s Perspective

Antigua, 2019 was my first mission with Operation Walk Pittsburgh, and in the months leading up to the trip, I was excited but apprehensive. 

After spending nine years as a bedside nurse, caring for trauma patients with complex orthopaedic and burn injuries, I thought nothing could scare me.

I have taken care of very sick patients, managed all aspects of their care, ensured their families were up to date and comfortable and worked endless hours with teams of professionals to help people overcome seemingly insurmountable medical odds.

But then I decided to go to Antigua.

I worried about what skills I might lack in an international setting, the language barrier and being the “new” nurse in a well-established team. The truth was, I didn’t know what to expect, and I was nervous about how I could contribute. 

In the U.S., we have the benefit of so much at our fingertips: labs and basic diagnostic tests can be completed in minutes. Every supply you need is down the hall or a phone call away. Patient education, histories, half-lives, compatibilities –– all the information you need can be viewed instantaneously on your screen. Every move you make is preceded by policy –– designed by practitioners and assessed by legal–– to ensure that your care is thoughtful and protected. 

But this all creates a prescriptive environment that takes many frontline caregivers far away from where and why we started to care. 

Despite my worries, I committed to going to Guatemala and had to prepare to practice nursing there. I talked to everyone who knew about the work I would do there and asked many questions. What will our ratios look like? How do I know physician preferences for wound care and dressings? How do we handle code situations? 

I made Spanish medical terminology flash cards. I read and printed and punched holes in and bound the official “Antigua 2019 Travel Guide.” While lying awake at night, I pondered how I’d assess patients and how to ask all the right questions while being thorough, critical, and thoughtful. 

I was unsure, but I was determined to be prepared.

Traveling to Antigua was exciting, but exhausting. Between departing early, navigating crowded airports, barely resting on two flights, slogging through TSA checkpoints, and riding the bus from Guatemala City to Antigua, I was happy to reach the hotel and sit outside in the fresh air. 

At the team dinner on Saturday night, I quickly learned who the Operation Walk veterans were, and noticed that instead of feeling worn out, their energy was building as they came together.  Each member of this team willingly sacrificed their time and resources to come on this mission, even though that meant leaving their families and jobs to be a part of something bigger. 

As I made my way around the room, team members greeted me and smiled. They asked me where I was from and what I’d be doing in Guatemala. “Is this your first trip?” they’d ask. “Just wait. We are going to have a great week. It’s going to fly.”

I wanted to be a part of this mission, and I wanted to be a part of this team.

As we assembled for clinic on Sunday morning, I realized: no one was on this mission alone. Newcomer or seasoned vet, we each had important roles to play. I felt the support of every person around me. I was advised, included and involved in details, and this set the stage for my success. Every task was an opportunity to form relationships with caregivers that had come here for the same reasons I did, and who faced the same barriers I did. 

My confidence grew as I started to believe I was truly a part of the 2019 team. 

My first post-operative patient was Alfonso, who had received bilateral knee replacements. We admitted him to the floor, and I immediately recognized that he was very much like my American patients: relieved his surgery was over, excited to see his daughter, thirsty. He was quiet and smiled at me across the room every time I looked his way. 

Not even an hour after we met him, he wanted to know when he could get out of bed. “Quiero jugar futbol!” he said to me, laughing. An hour post-op from bilateral knee replacements and he wanted to play soccer. He made a joke, and just like that, all my apprehension went away. 

Connecting with Alfonso at that moment, I was back in my comfort zone, caring. As more patients came to the floor following surgery, those moments multiplied. Being with a patient as she cried when Dr. O’Malley held her X-ray up to the light; she saw her implants in place and knew “all of the pain is over.” Getting a hug every morning from Juana’s daughter who stayed three nights at her mom’s bedside and never complained. Seeing Erculano up and walking independently the morning after surgery. Saying goodbye at the end of a long day and seeing three of the men, lying in their hospital beds, holding hands and praying.  

Looking back, I know there were things no one could tell me ahead of time. Things like yes, you need strong clinical judgment and critical thinking skills because you will be working in an environment without the crutches of the American medical experience. You will need confidence and energy and flexibility. 

But you won’t need a translator when a patient takes your hand and starts thanking you and praying. You won’t need a policy to know how to care about people. You won’t need quick access to labs or easy conversions or ready-made flushes or fancy supplies to do this work.  Be vulnerable and trust that the people who have done this work for so many years before you will support you as you learn. Go back to the roots of when and why you became a caregiver and you will succeed.

By the end, I found all of the courage and flexibility and humor and grace I needed, all that goes along with working in an environment where we were all just visitors, privileged to have this experience. As it turned out, I needed to go far away just to come back to true nursing care.