Dr. Osiris Berriel Ortiz Report
Members of the Latin American and Caribbean Transplant Society (STALYC);
As part of the fulfilment requested in the application to the Improvement Scholarship, I am now sending you the reporting the results of my internship in the Unit Pancreatic and Kidney Transplant Unit in the Faculty of Medicine of the University of Sao Paulo, das Clinicas Hospital.
I began my internship on the 25th of June 2012, I was introduced to Dr. Elias David Neto, Medical Chief of the Pancreas and Kidney Transplant unit, to all its personnel and part of his multidisciplinary staff, by nurse Maiza Lazinno, Chief of the Kidney Transplant ward.
On my first day I got to know the structure of the clinics, formed as a hospital complex, with university characteristics, conformed by various hospitals which count with a: Oncology, Psychiatric, Diagnose, Nuclear Hospitals, Heart Institute, a Conventions and Scientific Centre and a Central Institute were I developed my internship for most part of my stay.
This Institute counts with 10 floors, each floor has different specialities, each floor counts with its own Intensive Care Unit, pharmacy, meeting lounge and offices that to my personal view is very beneficial for the quality in the attention of patients as for the preparation of doctors and nurses in training, this allows integration, quality and prompt attention to the patients showing solid knowledge of their speciality.
The Pancreas and Kidney Transplant Service consists of a ward, the Investigations and Protocol Department, the ambulatory service for Pre and Post Transplant and the Coordination Transplant Department.
The Transplant ward is situated on the 7th floor, were you can also find Hemodialysis, Urology, Intensive Care Unit of Nephrology and Transplant, nephrology ward, Department of Transplant Investigation and Pharmacy.
Together with nurse Maiza I met, all the routine, protocols and the nurse's specific actions in the different stages of transplant.
I accompanied the nurses on a daily basis (Edineidi, Maria Jose, Maria Vicenta, Mara) in the care of patients with kidney transplants, pancreatic, kidney, and transplant of live donors, I could in the same way exchanged techniques with nursing (Dora, Patricia, Thaisa, Eliane, Lorraine, Marcia, Susana) and other people whom supported me and made me feel part of their staff, apart from all of this they showed me material resources and equipment used in this centre that I had never seen before, for all of this I must say this is an experience to take into value for the future development of the centre in my country.
I participated in discussions of cases, and passed visits with all the medical staff which entitled us a gain of knowledge taking in consideration the scientific preparation and professionalism of each and everyone of the members of this staff, whom with great skill discussed and made accurate decisions on the treatments to be received by each patient.
We fulfilled rotation visits in the ambulatory capture and follow up of transplants, were biopsies were carried out, such as withdrawal of uretral catheters (JJ), follow up of patients on the waiting list as well as transplanted patients. The experience lived in this department, in the personal level, was new and beneficial to me because we do not count with such organization in the caption and follow up of patients in Cuba as what I have seen here. In the rotation I was accompanied by Nurse Vivian as the rest of the staff helped me and explained each and every function and activity that nurses carry out in this department, functions that guarantee an adequate and appropriate previous study to direct the patients to their transplant. Patients from different regions of Brazil come to these offices.
We rotated through the Investigations and Kidney Transplant Protocol Departments, where Nurse Fabiana works; she leads a staff formed by technicians, biostatistics, secretary and medical professionals that carry out investigations, the nurses are the facilitators, they carry out blood tests, supports doctors in the realization of biopsies, they tend to the documents and fulfilment in the protocols of investigations developed in this department, something I liked very much was the preparation of this group in this activity , their human quality that characterizes them ,without mentioning the existing organization of their data base of their waiting list and strict control in the laws enforced for transplant activity.
Shared experiences with the professionals of Hemodialysis, accompanied by Nurse Juliana, whom together with the medical staff pay daily visits through all the Intensive Care Units evaluating which patient is in need of treatment ,the way they follow up and give treatment to patients by speciality is very good because they know in detail the characteristics of the patients of Intensive Care, previously knowing the type of treatment to be given ,taking in consideration the speciality that they are in, they count on adequate documents to integrally evaluate the patients evolution until their recuperation and their hospital discharge. This experience caught my attention and I liked very much.
In general I consider my internship through this centre satisfied my immediate expectations, I gained knowledge, experience, exchanges with professionals of the same speciality. On the other hand with the common activities carried day by day is something I will pass on in my centre in order to obtain better results.
I cannot express my gratitude for the welcoming attention given by all the members of the Transplant staff, as well as the Hospital, throughout this internship they made me feel part of the staff.
I specially thank Maiza, Thaisa, and Patricia whom were always waiting on me and took me in as family during my stay.
To Veneranda and Neiri, the secretaries that helped me with all the documents needed for the exchange that would enable me to fulfil my internship. And of course Dr. Elias David Neto, who took me in from the first day in his centre.
Thank you to all the people that I did not mention, but undoubtedly supported me.. I thank you all kindly.
I felt honoured and privileged to receive the Scholarship from such a prestigious Institution as is STALYC, for the pleasant experience and honour to meet so many professional people with such humanism, like the workers of the central Institute and the Transplant ward of the Hospital Clinicas, professionals in all the activities assigned. This was a unique experience and necessary for the development of Transplant in Latin-America. It would be very beneficial for our community if hopefully many nurses dedicated to transplant could count with the same opportunity that I had.
In conclusion to my rotation, I completed my internship in Do Rim Hospital, directed by Dr. Medina and graduate Valeria, in this centre I was accompanied by Nurse Amanda, who showed me the structure of the Hospital's facilities and structure and presented me to the working staff. This is a nine story building, each floor is divided into 2 wards, each having its own Intensive Care Unit and Intermediate Care Service, the difference between the clinics is that they only carry out the activity of transplants, this centre carries out 80 to 90 transplants, I stayed here only for a few days, but the rotations were of much use, because I got to know the structure and dynamics of a specialized and experienced centre in this area of work. It's valid to mention the simplicity and dedication of the workers of this Hospital, as the professionalism with wish they developed their work. I would like to specially thank Amanda, Valeria and the supervisor that sadly who's name I have forgotten, who was by my side exchanging gained experiences and which he shared without distrust, I hope that someday I could complete a longer rotation, that without doubt will enhance my formation to another level.
Thank you STALYC, thank you to all who made this training possible.I returned with so many new and renovating ideas that will serve in the development of Transplant in Cuba, from a nurse's perspective.
Graduate .Osiris Berriel Ortiz