Behind the Podium: Getting to know Dr. Lynda Puhek

This post is written by guest writer, Melissa Dempsey, 1st year MEPN

Lyn PuhekDr. Lyn Puhek

Nurse, secretary, or teacher. Those were the three options that Dr. Lynda Puhek was presented with when she went in to meet with her high school guidance counselor to plan for her future career. How did she end up in nursing? “Well, I got a D in typing. It really narrowed my options down!” When asked to describe her nursing career, Dr. Puhek replied, “it has been a very long road.”

After her father passed away when she was 16 years old, Dr. Puhek went to CNA school with her mom. “It was a way to help her, she was a stay-at-home mom with no skills” she said. She lead a double life during her teen years, but not the same rebellious double life as some of her peers. She was a normal high school student by day, and a CNA student by night. By the age of 18, she had completed both her LVN and her CNA degrees. She went on to attend Los Angeles Valley College, where she completed her 2-year RN degree. After graduating the program in 1979, she promptly got her first job in a telemetry unit at UCLA. She wasn’t even 21 years old.

While at UCLA, she met her husband, who was working there as a respiratory therapist. They married and moved down to San Diego in 1981, where she got a job at Sharp. She stayed there for 21 years, and just so happened to work in the ICU with our very own Dr. Kathy Marsh! “At the time, Sharp did an RN-BSN program that was affiliated with USD,” she said. When she graduated from USD in 1987, she said “it gave me the drive to move forward.” She went back to California State Dominguez Hills in 1994 and got her MSN-FNP. She didn’t stop there, in 2010 she graduated from Case Western Reserve’s DNP program. Her focus was Educational Leadership, and she did cardiac research and nursing at Scripps Mercy while finishing her degree.

Once she completed her DNP program, she and her husband moved to Hawaii for 2 ½ years. While there, she was the chair of the nursing department at Hawaii Pacific University. She’s also been a part of the faculty at Nova Southeastern University and National University.

Did I mention that throughout this whole journey she also had two children? Her story is incredibly inspiring. There is nobody better suited to teach USD MEPN students the ins and outs of medical surgical nursing and pharmacology.

I asked Dr. Puhek to describe a patient experience that has stayed with her throughout the years. She shared a powerful story from her days in the ICU at Sharp.

“I had been caring for a patient who had been in the ICU for about nine months. I would say he was probably in his late 50’s, early 60’s, and he was a failure to get off of the ventilator. His whole room was decorated with photos of his family, so I felt like I really got to know him. His name was Dave. I would always say “Hi Dave, It’s Lyn. It’s such and such day, the sun’s out. I’m going to be your nurse tonight. Hope you had a good day.” I would just talk to him, I wouldn’t talk over him. I would talk to him like he was actually here.

One of the main drawbacks to working in the ICU is that people do get better, and they transfer out and you never know what happened to them. I was working one day, about six months later, and a gentleman came walking in. He was looking around the unit and introducing himself to people, “Hi, I’m Dave”.  We’re used to caring for people when they’re horizontal, in a hospital gown, with tubes everywhere. They look so different when they’re vertical with clothes on. So, this guy came walking by and said “Hi, I’m Dave.” I said, “Hi, I’m Lyn,” and he said “Oh Lyn! I’m Dave! You took care of me!” I just started sobbing, because it never happens. That’s nursing. He sought me out to say thank you. He said “you would not shut up! You told me about the day and what we were doing every shift! I heard every word.” I always think of a patient as being somebody’s loved one. I think it’s important to do that. How would you want your loved one to be treated and cared for?”

Lyn Puhek-at graduation

Dr Puhek at her ADN graduation in 1979

 

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MEPNs give back to veterans at USO dinner

This post is written by guest writer, Maressa Malabanan, 1st year MEPN

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Tuesday night, March 13th, MEPNs gave back to at least 250+ service members and their families.  Along with nursing students from other local nursing programs, MEPNs worked together for this Sigma Theta Tau hosted event.  We all had the opportunity to give the military service members and their families an evening break from making a meal, doing the dishes, and entertaining the kids.  We arrived at 4 pm to set up the dining hall, help with pre-dinner activities such as face painting the kids, prepared drinks and set up the Panda Express food line. With dinner starting at 6 pm, we all had our USO aprons and food-serving gloves on and our entrees ready to serve the masses.  


It was a fun event where we got to socialize with our peers, other nursing students, faculty, and the military community while also giving back to those who serve!  As they thanked us for our acts, I only felt more thankful for them and their sacrifices.  It was an awesome event that allowed us MEPNs to get together to give back to the community!

Special thanks to Dr Lyn Puhek and Dr Susie Hutchins for overseeing this event.

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Posted in Class of 2018, Class of 2019, Class of 2020, community involvement, Guest Writer, Uncategorized | Tagged , , | 1 Comment

MEPNs Return to Campus for Alumni Panel

This post is written by guest writer, Jean HartleyIMG_6141 (1)

This past Wednesday, MEPN alumni from both 2016 and 2017 cohorts were invited to campus to speak to current second-year students about their ah-ha moments in their first year as a nurse

The alumni panel consisted of thirteen MEPN graduates who currently work in a variety of health systems and units, ranging from surgical intensive care to the pediatric emergency department. The forum was an opportunity for current students to gain insight into the world of nursing beyond the MEPN program. Topics ranged from NCLEX study tips and advice about creating a stand-out portfolio to handling difficult circumstances as a new grad and maintaining healthy and professional work relationships.

As a current second-year student with graduation, NCLEX, and job applications on the horizon, I found this forum to be a time of reassurance and reflection. We were able to speak candidly with the group about our hopes for the future, current concerns, and lessons learned both in and after the MEPN program. Many students in our class have started to feel the weight of balancing a heavy course load with fully committing to the job search, and this forum allowed us to catch our breath and remember the meaning behind the work we get to do. I think we all left feeling like our weights were a little bit lighter and our spirits a little bit higher. We look forward to joining the alumni family in just a few short months as we too get to add MSN behind our names.

In the meantime, we will rest in the knowledge that we are a part of something incredibly special by being part of the MEPN family.

A special thank you to the MEPN graduates who were willing to share their experiences and insight during this great event – it is so appreciated by current MEPN students.

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Rooftop Report

Ricky Padilla and Evan Gum

Nursing is full of endless opportunities from providing safe and efficacious care on the ground as well as in the air.  Professor Padilla and 2nd year MEPN Evan Gum take a photo-op after receiving a critically ill stroke patient who was transferred from an outside facility to UCSD Hillcrest.

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MEPNs Ready for New Grad Interviews

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In addition to juggling a busy last semester, second year MEPN students recently participated in Mock Interviews. All students arrived to the lab dressed in business attire. One-by-one students were interviewed by a panel of faculty posing as nurse managers from local hospitals. While the student was being interviewed, fellow classmates were watching the interview on a monitor in another room and provided constructive feedback when the interviewing student returned to the classroom.

When asked to comment about the interview process, Judith Ramirez stated,” I was a little nervous having my classmates watch me get interviewed, but I am thankful for the process. I think I will be a lot less nervous when I have my real new grad interview.”

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Leadership Team selects “MEPN Class of 2020”

MEPN team Feb 2018

(MEPN Team –  Dr. Susie Hutchins, Dr. Jackie Close, Prof. Peggy Mata, Amanda Hernandez, and Dr. Lyn Puhek)

 

The MEPN Team had a busy week finalizing the admission decisions for the incoming MEPN class.

Personal interviews took place last week, on campus, where 150 qualified applicants came to campus to meet current students and participate in a 1:1 interview with faculty. Many thanks to current students and faculty who participated in the interview process.

At USD, we use a holistic review of all applications. This means that after candidates meet the admission requirements, we widen the lens through which we view applicants, recognizing and valuing different dimensions that shape each individual. Careful consideration is given to experiences, attributes, and academic merit. It’s not just a numbers game.

From what I have seen and heard, the MEPN Class of 2020 will be a wonderful addition to the Hahn School of Nursing. Keep an eye out for our new group of students, who will be on campus, beginning in August.

 

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Hello from beautiful and amazing Guatemala

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We wanted to share a few of the highlights from our medical mission.

We arrived late Saturday, January 6th and early on Sunday morning, we met with the International Medical Relief (IMR) Organization team to review logistics and organize supplies.  We were soon put to work providing service to those who serve us, the local hotel staff. Considering the lack of access and resources for healthcare available in Guatemala, the hotel employees, their family and friends were encouraged to consult with our team free of charge. Over the course of two hours, we assessed approximately 20 patients ranging in age from 1 to 91 years old and suffering from chronic pain, heart conditions, depression, gastritis, and fungal infections. The services we provided included ear lavage to an unhappy child, blood glucose levels, developmental well-child assessments, education, and referrals. The clinic ended with a house call to a friend of the family running the hotel. Six team members including students Lauren and Sophia were led by passionate Dr. Dario and went to the aid of a 91 year-old woman who had been treated for a double hip fracture and was now experiencing symptoms of debilitating sciatica. Dr. Dario held her face close to his, reassured her, then provided much needed pain management. This experience truly demonstrated the importance of community and care of elders in the Guatemalan culture.

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Our first day in the field began as our team of 65 embarked on two diesel-smelling bumpy busses to a medically underserved region where hundreds of patients and new friends lined the streets before we even arrived. Everyone showered us with love, hugs, and kisses. It was both overwhelming and extremely humbling to see an impoverished community embrace us with so much love. It is an experience none of us will ever forget and will forever impact our future practice.

After a heartwarming welcome and introduction from the community, volunteers, and the mayor of the town, our mobile medical clinic was set up into various stations: Triage, Community Health, Dentistry, Emergency, Family/General, OB/GYN, Pediatrics, Laboratory, Pharmacy, and Hydration. We got straight to work with our new friends/teammates at the IMR and worked diligently to treat over 400 patients in just 7 hours.

Most of the patients we spoke to had never seen healthcare providers before, challenging us to establish trust, while tackling language and cultural barriers. Thus, breaking through with each patient was increasingly special and rewarding. A broad spectrum of issues presented including: cancer, gastritis, diabetes, hypertension, scabies, and wound infections.

It was a humbling, moving, and incredibly educational day. We came to find that honest conversations, education, and advocacy can often be more powerful than using resources as a band-aid to a larger problem. We are grateful to have empowered even a few to achieve better health outcomes.

On Tuesday we traveled back to the same site San Jose, Guatemala. Hundreds of patients again lined up awaiting our arrival. Our students again were assigned to a physician or triage station as the long day began.

USD MEPN students (Taylor, Kelsey, Diane, Coco, and Lauren) were assigned to work with the OB/GYN team at the clinic staffed by two amazing OB/GYN providers volunteering on this medical trip. Women ranging between the ages of 12 to 90 were seen in the OB/GYN clinic. The nursing students worked right alongside the doctors and completed assessments, scribed provider notes, and used doppler ultrasound to hear fetal heart tones. Together the OB/GYN team was able to provide examinations and order lab work to help treat these women in need. Some patients were urgently referred out to other areas of Guatemala for further diagnostic testing due to indications of breast cancer and palpable abdominal/pelvic masses.

All 500 patients received thorough education and pharmacological treatment for their conditions, plus education on preventive self-care. Given the opportunity to aid this Guatemalan population of under the direction of the bilingual providers was utterly eye opening.

As healthcare providers we will inevitably face barriers of language, health literacy, access, culture, and compliance when caring and planning for our patients. In San Jose, some of those barriers were broken down. The ultimate satisfaction comes from feeling, hearing, and seeing that during their visit these patients felt cared for and understood, often for the first time in their life. A quote by Maya Angelou comes to mind, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” It is experiences like these that we will never forget regardless of barriers.

Wednesday was our day to explore the numerous shops or take an unforgettable excursion hiking a nearby erupting volcano.   Guatemala has 5 active volcanoes, and we hiked along the side of Pacaya which was last active in 2014.  Close to the top, we took a group photo and roasted marshmallows on sticks over a small hot spot in the side of the volcano.

Getting close to this massive and powerful force of nature was humbling.   Those that stayed in Antiqua walked along the narrow cobblestone streets lined with weathered doors and windows, many of which open to lush courtyards, restaurants or shops.  Entering these establishments can transport a traveler to a world of authentic cuisine or local goods, all influenced by the Mayan culture of millennia past.

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Xin chào, Hello from Da Nang, Vietnam

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After finishing a rough but worthwhile stay of three clinical days in the mountains, the International Medical Relief (IMR) Vietnam team set off for a five-hour drive back down to Da Nang city to prepare for their next adventure! Accustomed to hearing the rooster crowing at 4 am, most of the IMR team had no problem getting ready to board the vans, bright and early at 6 am. We traveled across bridges and rice fields to the next clinic, located ninety minutes southwest from Da Nang. Town residents waited patiently, under tents with plastic rain coats in the muggy rain, for our arrival.

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                   **Dr. Puhek wearing a rice hat she borrowed from a patient she triaged**

 

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This facility offered by the community was quite different compared to our first clinic. The availability of  private rooms and beds enhanced the providers’ ability to assess and provide comfort for their patients. The population at this rural clinic was predominantly older compared to the first clinic, and many had complaints of joint and back pain. The team even walked with every patient and placed cardboard over the wet tile steps leading up to the clinic to prevent any falls. The USD nursing students stayed busy the past two days; streamlining the collection of vitals signs, assessing patients in triage and well-care, providing basic wound care, distributing reading glasses, counting and distributing medications in pharmacy, conducting simple lab tests, and assisting the medical providers. Throughout our many encounters, there were a few patients who have touched the hearts of many on the team.

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One special patient was a gentleman who was injured during the nine years he served in the Vietnam War. By “injured”, this man has been disabled for over 40 years after losing his left leg due to a bomb and enduring a chronic deformity to his right leg. This patient warmed our hearts because despite of his situation, he kept smiling and thanking everyone for providing care to the townspeople. There was a much discussion about finding a whelchair for this patient and luckily we were able to do so.  On the second day, the patient and his nephew came back to the clinic to pick up the new wheelchair with double tread wheels. The patient stated that he was “very happy” that he can now travel around more than ever before!

We noticed many patients we met in the clinic were very hardworking. While working in triage area, USD nursing student,  Anne, noticed an elderly woman carrying a man on her back. Along with a nurse, she  automatically jumped up as the woman continued to walk to the end of the line for registration and vital signs, which was quite a long queue! The  medical team and the Vietnamese translators were instructed to move this woman to provider seats right away. When Anne questioned why they came to the clinic, the woman responded in Vietnamese saying, “My son has been like this all of his life, and I was hoping you can find a cure for him.” The two individuals were heartbroken, and we knew that the request was impossible.

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One of the IMR volunteers took it upon  herself to pay for this young man’s double tread, off-roading wheelchair, complete with security straps. It’s the small things in life that makes a difference in someone’s world, and we are glad to have been a part of it.

Another patient who arrived at the clinic was a 95-year-old woman who hitchhiked a ride to our clinic. When she met with her providers, she told them how she currently lives alone and in poverty because she sends all of her money to her daughter-in-law who is currently being treated for cancer. The providers were so touched by the patient’s story that one of the volunteers donated some money and encouraged others to donate as well. She impressively raised a little over 2 million dong, which is almost $100! The patient was so grateful that she was rendered speechless, responding with nothing but a big smile, hugs, and a few kisses!

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As the day came to an end, Professor McAmis offered more than just healthcare to the patients. She talked to the Vietnamese community liaison Hoa about donating her own personal boots to someone in need. Hoa suggested it would be a great idea to give it to one of the rice farmers who are constantly outside working in the knee-deep water of the rice fields. The two ladies searched and spotted an older gentleman who was toiling in the fields, wearing worn down boots held up with mere rubber bands. He was in dire need of a new pair of boots to continue provide for his family. Equipped with a smile and a pair of nice boots from his “American daughter”, the elderly man ready to work another day!

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**Professor McAmis with her “Vietnamese father” whom she donated her boots.**

After the clinics were over, we had the opportunity to visit Da Nang’s hospital. The hospital serves patients ages 16 and up with a total of 2,428 beds. We definitely noticed a cultural difference as we stepped onto the unit floor. The first thing we were told to do was take off our shoes and put on hospital slippers! We also learned that ICU nurses have a 1:6 nurse to patient ratio with only a social worker as an assistant. In addition, there is typically a 20 hour wait in the Emergency Department! Though some modern treatments are available, the hospital staff clearly work very hard and are incredibly resourceful in using everything they have available to them. They are quite innovative when it comes to wheelchairs!

 

All in all, after spending five days at two rural community clinics within Vietnam, we served almost 1,400 patients, donated over 900 bags of food, provided 800 individuals with reading glasses, and gave some patients 200,000 VND (~ $10 USD) as an additional incentive, specifically to those in the community with little access to food and healthcare. None of this would have been possible without every member of our amazing Vietnam medical team!

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It only takes one person to make a difference in this world, and in Vietnam, we saw first-hand how one individual could move the team, and despite various limitations, the IMR Vietnam team went above and beyond and made a difference.

As we USD students go our separate ways and return home, we come exhausted but inspired, with our eyes and hearts opened after our many experiences in the clinics. Though we may leave only a small footprint in Vietnam, we step forward with a newfound confidence and passion to become that nursing leader who can move a team, initiate change, and make a difference in the world.

 

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Greetings from the Vietnam Mission Trip

This post is written by MEPN students and guest writers, Katie Lam, Anne Uyen Tran-Ho & Dana Yu on the USD trip to Vietnam.

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**Locals rush through rush hour trying to get home from work to pick up their children**

After a day of facing constant waves of oncoming motorbikes and cars we learned how to properly cross the busy intersections of Saigon with the assistance of kind locals. USD nursing students Katie Lam, Anne Uyen Tran-Ho, Dana Yu, and faculty Professor Molly McAmis and Dr. Lyn Puhek set off for Da Nang with the International Medical Relief (IMR) organization.

In Saigon, we held a team meeting and prepared to set up the clinic for our destination, a rural community located to the northeast, five hours away with a population of 26,000 people.  The team loaded up onto six vans, and we set off on our long trek. Rain fell throughout our drive up the mountains, and modern civilization slowly faded away into canopies of banana trees but also muddy roads.

 

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**Local body of water that some families used as a resource, when they cannot afford bottled water**

 

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** Our clinical site located within the mountains**

Stationed in a rural setting with few facilities and a large, overworked population of farmers, our health care services, education, and food donations provided a valuable service to the community. Over several days, we set up a clinic in the neighborhood auditorium. The windows, with a scenic view overlooking the foggy mountains were lined with spider webs and bees. We worked with an amazing, well-rounded team including nurses, nurse practitioners, physician assistants, doctors, EMTs, dentists, and Vietnamese translators. With such a variety of strengths, we worked collaboratively to triage, assess, and provide care to 700 patients who walked or traversed long distances on motorbikes, up the windy mountain paths in the rain, arriving at 2 am for the opportunity to receive care and a bag of food for their family.

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** Professor Molly McAmis, Katie, Dana, Anne & Dr. Lyn Puhek getting ready to start their second shift at well baby checks**

The role of the USD nursing student  included intake of vital signs, triaging patients, doing well-baby checks, running labs, and providing health related community education. However, we could not have done any of this without our amazing team of Vietnamese translators.

At the clinic, we assessed a variety of patients, ages ranging from a few months to 100 years old. We saw many interesting patients including a case of scabies, infected g-tube, and the saddest case we saw was a 9 year old male with an abdominal tumor. With a limited supply of equipment and mere desks and chairs in the clinic, we were forced to create solutions with what we had available, not only in our assessments but also in our plan of care.

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**Anne, Dana, and Katie working with translators when triaging the patients to define their chief complaint**

A family, all with rashes, was not an uncommon sight during our work. When a family of three came in with a rash, the initial assumption was measles. However, upon further assessment, the family practitioner determined the family was  infested with scabies. The pediatric patient had scabies for 4 months, and his sister had similar findings for 8 years. The rash covered the entire body of the infant, but he didn’t seem to be in pain. The family was given some medications and recommendations for hygiene.

There was a gentleman who arrived to the clinic with an infected G-tube. After being prescribed a course of antibiotics, the patient was sent to the nursing team to clean up the infected area. Due to the limited and cramped setting, it was difficult to find a private treatment area. We were eventually able to find a private room with a table used as a makeshift bed. As we were cleaning the area, we noticed that the patient hooked the end of his G-tube to his necklace to keep it in place, which demonstrated the resourcefulness and creativity of the patient. After the cleaning, he was sent back to the provider area for electrolytes and a referral to palliative care.

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** The local community hosted a New Year’s Eve party for the IMR Team**

Overall, this has been an eye opening and humbling experience. There is so much that we take for granted, all the while our hearts are warmed when the patients expressed their appreciation. Many of them left the clinic with a smile, their food donations in hand and waved as we passed by them. The community even threw us a New Year’s Party.

This was a fulfilling trip for everyone involved. It has been so rewarding to help the underserved, and the experience has truly showed us what global nursing really is all about.

**One of the little girls who was excited to receive food donations from the Vietnamese community.**

 

Posted in Class of 2017, Class of 2018, community involvement, Guest Writer, Hahn School of Nursing, International Program, Uncategorized | Tagged , , , , | 1 Comment

Nursing Students travel to Tijuana for Health Fair at Casa de Las Memorias

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This post is written by guest writer, 2nd year MEPN, Amena Adams

On Saturday 12/2/2017, eighteen nursing students dedicated their time and effort to a Health Fair conducted at Casa de Las Memorias, in Tijuana, Mexico. The group was led by faculty leader Dr. Hutchins and student leaders Brittani De Riemer and Amena Adams. First and second year MEPN students, a DNP student, and a recent MEPN alum spent weeks prior to the Health Fair planning their teaching stations.

The Health Fair took place at Casa de Las Memorias, a facility that provides care and houses men, women, and children living with HIV/ AIDS and TB. Many of the patients there are longtime residents and contribute to the daily operations of the facility. Teaching stations were both culturally appropriate and specific to the needs of the residents: basic hand hygiene, nutrition, diabetes screening, TB, HIV, Hep A and Hep C, compressions only CPR, blood pressure readings and hypertension screening, and a children’s dental hygiene station.

“Health Passports” were distributed to facilitate the teaching sessions at each station. Upon completion of the “Health Passport,” residents received a gift bag of basic medical supplies. Local San Diego business and organizations such as Volunteers in Medicine, San Diego County Dental Society, and Carmel Valley Pediatrics donated supplies to fill these gift bags.

For something as seemingly simple as providing health education, our presence at Casa de Las Memorias had a profound impact on the residents and will leave a lasting impression on the nursing students who participated.

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Posted in Class of 2018, Class of 2019, community involvement, International Program, Pipeline program, What is a MEPN program? | Tagged , , , | 1 Comment