Rebecca M.

“This experience reinforced the humility I’ve learned working in other African countries. The U.S. health system does many things well but there is much we can learn from how things are done in other places.”

1. What got you interested in the Peace Corps, specifically the Response program?

Early in my nursing career, I was interested in serving as a Peace Corps Volunteer. That dream got put on pause after I got married and started a family, but during graduate school, I learned about the Global Health Service Partnership. I was attracted by the idea of a shorter term, high-impact assignment training the next generation of nurses.

2. What projects did you work on with your community?

Baylor College of Medicine Children’s Clinical Center of Excellence requested help to strengthen the capacity of their staff nurses to take on new responsibilities and projects. Through a collaborative assessment process, we identified key deliverables. I was asked to:

Help each nurse write standard operating procedures for their clinical area.
Support launch of a newly established quality improvement (QI) committee and mentor nursing personnel to develop a leadership role in QI.
Strengthen emergency response skills by developing tools and a hands-on simulation program to help the clinical team respond to clinical emergencies.
Improve the clinic’s health education program by adopting evidence-based practices.
Contribute to management’s plan for onboarding and performance review of nursing staff members.

Nurses Siniketiwe, Thobile, and Phindile collaborate on translation of health videos in Eswatini. — Nurses collaborate on the translation of health videos in Eswatini.

3. How did you leverage your previous professional experience and skills in your service?

My background as a nurse and midwife included clinical, academic, and administrative positions. All these experiences contributed to the success I had working at the clinic. More than 15 years of graduate education gave me insights into how to work with practicing health professionals. Teaching pre-service and in-service nurses in other African countries helped me understand health systems in low resource countries and set realistic expectations on nursing practice.

Helping to support QI work across a network of community clinics in northern California helped me introduce QI projects as manageable steps using “Plan-Do-Study-Act" (PDSA) cycles. The nurses at Baylor begin to realize that they had already been involved in QI work and could become more intentional about how to obtain the results they desired.

Working as the maternal, child, and adolescent health coordinator for the local health department gave me skills in program planning and implementation. I wrote and administered multiple grants so was able to introduce these processes to the nurse manager.

4. What was a highlight of your time in service?

I was excited to help facilitate changes to the clinic’s adolescent health program. With a team of doctors, nurses, and support staff we adapted an evidence-based screening questionnaire to identify and initiate early intervention with youth at risk for depression, alcohol and drug use and teen pregnancy. Implementing this program in PDSA cycles allowed the nurses to participate in quality improvement project firsthand.

Phindile, teen health officer holds privacy envelopes given to adolescents for completed clinic health questionnaires. — Phindile, a teen health officer, holds privacy envelopes given to adolescents for their health questionnaires.

5. What strategies did you use to meet the challenges of a Response Volunteer experience?

The short-term nature of Volunteer service, especially the Response program, has both positive and negative impacts. Its focus on skills you specifically bring to your site forces Volunteers to be organized in developing and implementing a workplan. Unfortunately, close of service comes just when you think you have relationships in place and are making progress. Will the work continue? Are the changes sustainable? I think the best way to navigate this is to focus on skill building and not on products. Empowering the nurses to do the work themselves was my best strategy. I felt satisfied when I learned that five months after my completion of service several nurses shared our work at a partner networking meeting.

6. What benefits did you gain from serving?

This experience reinforced the humility I’ve learned working in other African countries. The U.S. health system does many things well but there is much we can learn from how things are done in other places. For example, at Baylor Clinic TB care is provided in an open-air clinic space to reduce risk of transmission. Patients’ adherence to medical treatment, direct observed therapy (DOT), can be verified virtually, using iPad assigned to patients. Their TB program is continually looking for ways to improve early diagnosis and intervention.