Home

10%

‘It has left such a deep impact on me’

Nursing students reflect on outreach trips to Costa Rica, Micronesia

By California State University, Bakersfield

September 26^th, 2023

This summer, two groups of California State University, Bakersfield nursing students left town for different corners of the world.

With one group in Costa Rica and the other in Micronesia, their outreach trips varied in many ways, but for both sets of students, their time abroad gave them more than just an opportunity to practice their skills.

“I knew I was going to be interacting with people from a different culture and learning new things from them,” said senior Jaspreet Kaur, who went to Micronesia. “Now, I feel like it has left such a deep impact on me. I think I’ll never be able to get it out of my mind, how just 10 days can have such significant mark on you.”

From June 3-11, 15 students went to Costa Rica, with another 18 students taking the trip to Micronesia from July 21-31. The only overlap of the two groups was Nursing Professor Krystal Ball, who organized these trips and last year’s inaugural global outreach trip to Peru. These trips take students away from their hectic nursing curriculum and reconnect them with the reasons they want to go into the medical profession.

“This is just one-on-one serving another human being and learning how to really connect,” Ball said. “The hope is that while they learn doing this on the trip, that they bring it back to their nursing career and they find better ways to connect to their patients, especially patients who are different from themselves.”

In addition to the life-saving skills and knowledge they learn in CSUB’s nursing program, another key learning objective for students is cultural competence. That’s something real-life experience can teach much better than any textbook or simulation.

“The main goal is to show them a different culture, to show them, ‘How do we care for a patient that speaks a different language? How do we care for a patient whose home life is so different from ours?’” Ball said.

Costa Rica

Carl Allen, a second-year nursing student, had always wanted to study abroad but knew anything resembling a traditional study abroad experience wouldn’t really work for a nursing student with a strict class schedule and heavy curriculum. When he was told at orientation to talk to Ball about the program’s occasional outreach daytrips to Mexico, she told him about the then-upcoming trips to Costa Rica and Micronesia. He put in requests for both trips, hoping to be chosen for either one.

“It was drawn literally out of a bag,” Allen said, adding that being chosen for Costa Rica worked in his favor since it gave him a chance to practice his Spanish. “I couldn’t visualize too much of what I thought it would be like. I was hoping obviously that I would get to do skills. I really wanted to practice my skills.”

Working with an organization called Maximo Nivel, students on the Costa Rica trip spent four days seeing patients in a pop-up health fair. For adults, they screened for blood pressure, blood sugar and cholesterol; for children, they focused on education for properly brushing their teeth and washing their hands. In addition to toothbrushes, toothpaste and bars of soap, children were also given socks, underwear and books, generously donated by CSUB faculty and staff who answered the nursing department’s call for items.

Allen recalled the first day of outreach, when they set up at a daycare center and saw patients of all ages who gathered there. His group was setting up and didn’t know what to expect.

“We just know there’s a daycare on the other side of this door,” he said. “They opened the door, and you hear the kids coming, and one little kid comes out screaming, runs up to me, grabs my leg and gives me the biggest hug. I was like, ‘OK, we’re about to do something they’re going to really benefit from.’”

Students did the same health fair at another children’s center, a senior center and a remote village on the trip. They also toured a clinic to see what health care is like in Costa Rica. For Allen, building a rapport with patients — many of whom had never had medical care before — reaffirmed his decision to pursue nursing.

“For me and a couple other people, we realized after doing this that we definitely chose the correct path for our career,” Allen said. “We know this is hands down the appropriate place for us. When you get those really good interactions with patients, it just cements it.”

After surpassing their goal of seeing 400 patients by 17, the students enjoyed some recreational time in Costa Rica. They took a salsa class with other study abroad students, visited a coffee plantation, animal sanctuary, Poás Volcano and La Paz Waterfall gardens.

Along with Ball and the students, CSUB Nursing Instructor Jocelyne Ceballos and Associate Professor of Spanish Maryann Parada also joined the trip to Costa Rica. Ball hopes to bring Spanish graduate students to help with translation for future trips to Spanish-speaking countries.

Students heading to Costa Rica start their journey.

Nursing students in Costa Rica; Carl Allen is second from left in back row.

Nursing professor Krystal Ball, far left, and students snap a group photo at one of their outreach sites.

A nursing student checks a patient's blood sugar.

Carl Allen, nursing student in center, checks a patient's blood pressure.

Students package and distribute over-the-counter medicines and vitamins for patients.

Nursing students listen to their patients' lungs.

Nursing students visit a clinic in Costa Rica.

After their outreach work was done, students visited an animal sanctuary.

Micronesia

For many students, the trip announcement was the first time they had heard of Micronesia, but that didn’t stop them from jumping at the chance to go and help the people there.

Micronesia is a region made up of more than 2,000 small islands in the western Pacific Ocean, around 2,500 miles east of the Philippines and 1,000 miles northeast of Papua New Guinea. The trip was organized with help from MAHI International, and the students were joined by nurse consultant Kristi Libby, who previously helped on last year’s Peru trip.

The students on this trip had a unique opportunity to work in a Micronesian hospital side-by-side with the staff there. Split up into smaller groups, students spent two days floating between different units of the hospital, including the emergency room, the operating room, medical-surgical unit and labor and delivery. Although the hospital lacked the resources students have gotten used to in U.S. hospitals, it had a team of doctors and nurses working together in a way that inspired them.

“They’re always there for each other,” Kaur said. “They would get so excited when our group would go to the hospital. They welcomed us as a family; we didn’t feel like we were any different. They were very welcoming and taught us so much about their health care system.”

Much of what the students saw at the hospital was tough for them to take in, like amputations done while a patient was awake. On the second day at the hospital, a patient came in suffering a cardiac arrest. Two students were working in the ER and took the lead when the local hospital team wasn’t sure what to do. Kaur and her classmate, both of whom had been working nearby in triage, ran in to assist. The patient ended up dying when the family called off further resuscitation efforts.

The experience shook the students but led to important conversations.

“It raised a lot of really good questions about the difference in cultures and the difference in how we see death,” Ball said, mentioning how in the U.S. death is often seen as a failure but in other cultures it’s seen as a natural process. “We view it differently here, but it doesn’t mean one is right or wrong. It just means they’re different, and it’s OK that they’re different.”

Kaur said a death was not something she expected to happen on the trip but that she was grateful to have friends there to talk to about it. Outside of lab simulations, Kaur had never dealt with a “code blue” before, but said she knew what to do from all the practice. The experience also made her reconsider a limitation she’d previously put on herself.

“At one point, I was thinking about going into ER, but then I thought, ‘Will I be able to function in that much chaos?’” said Kaur, who is also considering becoming a labor and delivery nurse. “But going through that situation in Micronesia, I was so surprised how I acted. So quickly I just took over the role that was assigned and did it. I was like ‘Oh, I can do it.’ I remained so calm and collected that I know I can handle the situation.”

Like the students who went to Costa Rica, the Micronesia team also did health screenings for patients. The remote islands they visited for two days of outreach were accessible only by boat, and they had to hike through the jungle to get to the villages. These visits taught students about the barriers some patients have to health care.

“We make assumptions when patients are not compliant with care that they don’t care about taking care of themselves,” Ball said. “Well, when my students saw, ‘Oh my gosh, in order to go to the doctor, they have to take a boat and they have to hike through the jungle and then they have to get to the hospital. No wonder they have trouble seeing a medical professional!’”

Ball knows the lessons students learned on both trips will make them better nurses back at home. Like the patients they saw in Micronesia or Costa Rica, patients here might also have transportation or financial challenges preventing them from following through with treatment plans, or different perspectives on health issues that could impact their lifestyles.

“It’s very important for us to understand and respect different cultures, because we’re going to be treating patients coming from all different races, cultures, religions,” Kaur said. “I feel like I’m very fortunate that I got to experience this outreach. It just grounds you and teaches you how to take care of them while being respectful to their needs and respecting their point of view.”

The Micronesia group saw 504 patients, just over their goal of 500. They celebrated a job well done with a trip to the Nan Madol ruins on Pohnpei, snorkeling and waterfall hikes.

The journey to Micronesia started with a 3 a.m. bus trip to the airport.

Nursing students stop for a quick group photo before beginning their day of work.

Students traveled by boat to reach remote villages where they held pop-up health clinics. Jaspreet Kaur is pictured on the far right.

The group heads out on the water toward an island where they will help more patients.

Students snap a quick photo before starting their day at the hospital.

When the nursing department sent out a call for donations of socks, underwear, books and other items, CSUB faculty and staff answered the call.

Students prepare bags of vitamins for patients.

Future trips

More outreach trips are already in the works, though Ball is keeping their destinations under wraps until an information session being held on Sept. 28.

“I wish I could take everybody and travel internationally, because I think it would create a different perspective of how blessed we are in our country,” she said. “The goal is to train more faculty to open up additional trip opportunities for students. We have a lot of students that are interested in these trips.”

This year’s trips were funded in part with money from California Department of Health Care Access and Information grants and a portion of the $6 million funding secured by Assemblymember Rudy Salas in 2021, along with private donations from the Nursing Student Global Outreach Fund. Students also paid for one-third of their trip themselves.

Meeting the Nursing Department’s goal of providing trips for up to 50 students each year will cost around $120,000 to $150,000. Anyone who would like to help support future outreach trips can do so by visiting the CSUB’s School of Natural Sciences, Mathematics and Engineering donation page and selecting "Nursing Student Global Outreach Fund" in the "I want to support" drop-down menu.

Both Allen and Kaur said they hope to go on another outreach trip. Students who have already gone have a smaller chance to go again, but Ball brings a few to help in leadership roles with their classmates. Whether they get to go again or not, the two both said they would recommend their classmates take advantage of the opportunity to go on future outreach trips.

“I was just telling a group of other students that they should sign up for it,” Allen said. “It’s a great experience and can help those people who are kind of blind to how others live.”

Professor Ball and one of her students lead a CPR refresher course for the medical staff at the Micronesian hospital.

At a Micronesian hospital, students floated between different units, including the emergency room, the operating room, medical-surgical unit and labor and delivery.

Students label and package over-the-counter medicines and vitamins for patients.

Getting to the outreach sites on remote islands required students to walk through the jungle.

Students take a photo wearing floral crowns.

Students show patients how to properly wash their hands.

Jaspreet Kaur takes a selfie at the Nan Madol ruins on Pohnpei.

A quick dip in the water helped students cool down on the first day of their trip.

Support CSUB — Give now

Footnotes

Story by Kelly Ardis, communications specialist, School of Natural Sciences, Mathematics and Engineering (NSME); Photos courtesy of Krystal Ball and nursing students

Button Label

FootNotes

Story by Kelly Ardis, communications specialist, School of Natural Sciences, Mathematics and Engineering (NSME); Photos courtesy of Krystal Ball and nursing students

California Energy Research Center to hold expanded conference

‘It has left such a deep impact on me’

Nursing students reflect on outreach trips to Costa Rica, Micronesia

FootNotes

April 9 event now features two tracks, student ticket

Gift will establish Wonderful Scholars Center in Rohan Building

Dahna Stowe and sister Dorie Gutierrez donating $125,000 over five years

Janie Flores to be inducted into Alumni Hall of Fame

Awards honor CSUB alumna and beloved Bakersfield community member

Fred Plane to be inducted into Alumni Hall of Fame