Monday was the first day with my students, Sara and Kelsey, at out clinical sites. We are at Los Ninos Hospital which is pediatrics. We take a guagua (an old van) to our sites every day. Traffic here is 20 times crazier than anywhere in the US. In a guagua, you pretty much cram as many people in it as possible and a cobrador (the person who collects your money) hangs out the side of the van through the open sliding door. I think we counted 24 people on our guagua yesterday!

It was really overwhelming the first day at the Hospital! My students have already been here for 2 weeks with their first instructor, so they were able to show me where we see patients and explain how their workflow typically goes. It is very different than where I am used to working!!! There are probably about 8 kids in each big room and I get the idea that a family member is required to be with them all the time (which I guess is good because the staff don't seem to be checking in on them regularly). There are a couple doctors I met, one is a physiatrist who is great and really helpful; the other is on the burn unit. There are also a lot of medical students and nurses that work there. Only one PT works at the hospital and is solely in the burn unit very part time (I have never met her). So PT just doesn't exist on the other main floors of the hospital.

On Monday, we first saw a couple kids on the burn unit (1 successful treatment and 1 kid who was in a lot of pain and crying so we couldn't do much with him). Then we saw a few kids on the orthopedic floor and neurological unit. There is no way that we can decipher much in the patient's chart because not only is it in Spanish, but their abbreviations are also very different. We pretty much just walk around the hospital looking at the kids lying in bed that look like they could use PT and then try to work with them. Monday was very difficult for me because I am used to having students in my familiar work environment, so trying to lead them around in a foreign country, with a language barrier (my Spanish is not so great), and different health care culture was hard! After Monday, it was so overwhelming, that I thought at times, "what am I doing here?"

In the afternoon on Monday, we had a free PT clinic at the ILAC center. An orthopedic team from Creighton comes here in January to perform a bunch of surgeries, and the PT follows up with them in April. Sounds great, but for a lot of them, it is really a late start (especially for patients with total joint replacements!) The students are supposed to lead the evaluations/treatments and I supervise and help them as they need it. It went alright, I just really wish I knew more Spanish!!