NEW YORK NURSE: July/August 2009
by Randi Hoffman
In September 2007, Gary Stephens, a cardiothoracic surgeon at Maimonides Medical Center in Brooklyn, asked registered nurses Rookmin Rampersaud and Rosamond Bobb to travel with him to Guyana to help open the Caribbean Heart Institute (CHI) and assist him in the country’s first open-heart surgeries.
That was the first of six trips by the NYSNA nurses, who went back to their birthplace to help set up the country’s first open heart surgery center at Georgetown Public Hospital, the largest public hospital in Guyana.
Guyana is an English-speaking country on the north coast of South America, located on the Atlantic Ocean between Venezuela and Suriname.
The two cardiac care nurses provided immediate post-op care and treatment for surgery patients. “At first, it was an adrenaline rush,” said Bobb, “and at first it was difficult getting the supplies we were accustomed to in New York. It was very limited. Rookmin is very good at that.”
“They had no working defibrillators or pacemakers. Here pacemakers are a dime a dozen,” added Rampersaud. “Prior to the opening of CHI in 2006, Guyana did not have accessible, advanced cardiac care. Patients with advanced coronary artery disease and valvular dysfunction were relegated to medical management and limited mobility, often awaiting death.” The nurses explained that before CHI, the few people with heart conditions who could afford it traveled to Trinidad, Barbados, or India for cardiac care.
“Initially, we came to provide immediate post-operative care to the patients and to teach the nursing staff the skills they would need to independently manage post-surgical care by themselves eventually,” said Rampersaud. “We soon realized that, while the surgical aspects of performing the procedures were well-developed, the nursing care and competencies were not. The nurses did not have ICU nursing skills. The care of cardiothoracic patients was unlike anything they had ever seen or done.”
“Also, we were very surprised to find that the nurses’ perspective in Guyana was that of 30 years ago,” Rampersaud continued. “They saw themselves as caregivers. Modern nurses are not just caregivers, we’re facilitators. We had to teach them what to inform and report to the doctor.”
Bobb added, “The nurses were used to always seeking the doctor’s plan of care. We taught them critical thinking skills, and also how to interpret lab values and read EKG strips. Now they develop their own plan of care. They’ve become much more independent. We have created a new generation of cardiac nurses.”
“While we are in Guyana, we stay in a hotel with a clean bed and a clean shower, Rampersaud said. “But we usually end up eating and sleeping at the hospital. We go for a week at a time. By the time we leave, the patients have been discharged.” Bobb still has family members in Guyana, whom she sometimes sees when she is there. “Maybe we get one night out,” she said.
So far, Rampersaud and Bobb have worked on 14 cardiac surgeries in Guyana, on six different trips. A team of eight to ten volunteers accompanies them each time. They returned from their most recent trip on July 15.
They have trained other nurse volunteers from Maimonides to make the trip. These nurses do not always have the same Guyanese heritage. “We were familiar with the culture, the activity and the people,” said Rampersaud. “We taught the new nurses the cultural vernacular, which is similar to Creole.”
“Now there’s a long list of nurses who want to go,” said Bobb. “As for me, who could resist an offer to give back to the country where you were born? It’s a great honor, a privilege and a blessing to be part of the history of Guyana.”