WVU Family Nurse Practitioner student Betsy Gambino conducts an assessment on a child during their time in Honduras.
Nurse practitioner students from the WVU School of Nursing recently traveled to Honduras as part of a medical mission team. The students worked with the Carolina Honduras Health Foundation (CHHF), a non-profit organization that provides continuity of care by sending 18 teams a year to Honduras to provide care and provide telehealth services.
The School of Nursing team included 14 members from the U.S., four of whom were Master of Science in Nursing-Family Nurse Practitioner students, including Betsy Gambino, Haley Hansrote, Rhonda Reid and Carol-Ann Thompson. This year’s team also included a family medicine resident for the first time. Together, they worked with Honduran team members who held clinical roles, such as director of operations, interpreters, records clerks, and lab technicians. The team cared for 405 patients and dispensed 1,771 prescriptions.
Aside from clinical care, the team was able to enjoy the nature of Honduras, going on a snorkel trip at Cayos Cuchinos, which included an educational presentation about the Garifuna community that lives there and about the Mesoamerican coral reef.
Associate Dean of Faculty Practice Dr. Emily Barnes said each of the four students logged 40 precepted clinical hours toward their practicum requirements, which helped meet a critical need of the MSN-FNP program. Students gained experience providing care with an interpreter, a learning opportunity that may or may not occur in other clinical experiences and often isn’t from someone who understands the unique local culture.
“The clinical experiences included caring for patients with urgent, acute, chronic, and health promotion issues,” Barnes said. “The health issues included both common primary care issues, such as hypertensive crisis, upper respiratory infections, diabetes mellitus, inadequate nutrition and tropical diseases, such as dengue, leishmaniasis and intestinal parasites. This range of concerns provided unique experiences to the students. They gained proficiency with health issues common in the United States and less common diseases that they may encounter as global migration continues to increase.”
Patient care covered a range of ages and people, from 21-days-old through 80-plus-years-old and included pregnant women. Students also experienced observing and performing procedures such as cerumen impaction removal, Nexplanon removal and joint injection. It can be challenging for students to gain experience with procedures, as the need for a procedure is unpredictable, Barnes said; therefore, this opportunity was highly valuable to their education.
When asked about their impact on the community, one nurse practitioner student said a memorable moment for her was “helping a man with extensive knee pain that works in the fields each day by administering a steroid injection under the supervision of the preceptor.”
Students also worked collaboratively with an interprofessional and international team that included a physician, a family medicine resident, a pharmacist, a lab tech, interpreters, nurses and nurse practitioners. The amount of collaboration on the team exceeds what is typical in primary care in the United States, which led to an appreciation for the strengths of the other disciplines. It also provided first-hand experience of how care is enhanced with interprofessional collaboration.
“The clinics are in resource-limited areas in which access to care is limited, and almost all patients live on less than the U.S. equivalent of $2 a day,” Barnes explained. “Many patients do not have access to safe drinking water and get exposed to many environmental hazards such as burning trash, cooking over open fires, poor road conditions and extreme heat. Providing care in this environment gives students experience with critical thinking and decision making related to resource allocation.”
Additionally, students must consider the impact of social determinants of health. While there, the students cared for a patient who had symptoms of a sexually transmitted infection. Testing was not available, so they had to consider the cost/risk versus the benefits of presumptive treatment or not. Without access to many diagnostic tests and imaging, students had to rely on their own advanced assessment and diagnostic skills to appropriately care for patients.
During their time, the team pharmacist provided a continuing professional development educational session for all team members regarding indications and precautions for specific medications on their formulary (a list of prescription drugs). This included learning how to use zinc to treat diarrhea in young children, which was very helpful as GI complaints were common in the patients they saw.
“The hypertensive crisis was another kudos to our pharmacist,” said Dr. Susan McKenrick, Clinical Assistant Professor. “She flew into action when I went to the pharmacy to ask for Clonidine, which we didn’t have. As we looked at the meds we did have, she quickly confirmed that labetalol was a good choice and the appropriate dosing schedule. The patient's headache abated within the hour — though blood pressure was slow to come down, it was coming down.”
During their time there, the Honduran community engagement coordinator had requested a presentation on oral health and hygiene. The four nurse practitioner students prepared a presentation, which was delivered to the first graders at the local school in Limon.
In Fall 2024, the WVU Pre-Dental Club partnered with them to do a donation drive. Because of their efforts, the team was able to provide all first graders in the Limon school with a toothbrush and toothpaste kit at the end of the educational presentation. Additionally, there were enough donated supplies that students at several other smaller schools also received toothbrushes.
To learn more about opportunities like these, please contact Dr. Emily Barnes at ebarnes@hsc.wvu.edu.
-WVU-
bc/6/12/2025
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