By Carla Hazarian
LAU Tribune staff
As he walks up to the patient’s bed, Samuel Joseph Maljian greets her with a smiling hello. The patient, who is an older woman, reciprocates with a smile; she has recently been diagnosed with hypertension.
With a pamphlet of papers in his hand he stands at her side and asks her a series of questions to ensure all is well. He appears sensitive to her needs, and makes sure she is as comfortable as possible.
Maljian is a student at LAU’s Alice Ramez Chagoury School of Nursing, and this is just one of the many tasks nursing students have to take on during their time of study.
“She is currently suffering from hypertension,” he explained. “I start off by asking her what she already knows about the subject. After she tells me what she knows, I make sure to add in anything she missed. I also ensure she knows she has to make a few lifestyle changes; for example, she will no longer be able to smoke cigarettes.”
On designated days of the week, nursing students come to the university’s medical center -Rizk Hospital (UMC-RH) in Ashrafieh, where, mentored by nursing faculty, they have the chance to get hands on experience. They make rounds with the other nurses and work with physicians.
The LAU school of nursing was originally approved by the LAU Board of Trustees in 2007; preparation for the school began in 2008, when a group of six leading nurses in the country were commissioned by LAU to write a curriculum plan and a feasibility study for the school. In 2009 Nancy Hoffart, PhD, RN, was hired as founding dean and professor to oversee the development of the school.
At the Rizk Hospital, nursing students are assigned patients to their care. They must observe them, monitor their heart rates, and make note of the symptoms their patients experience. If a patient had surgery or is wounded, students must also take note of the wound’s condition.
Being pre-assigned to patients allows students to prep overnight. “We have to assess the patients pre op and post op, we must take note of their progress, and the psychological aspect of the patient,” Marie Elise Haddad, a nursing student currently working at the hospital, said. “We are the link between the patient and the physician. There is also a level of empathy that we have to give.”
At the end of their shift, students meet up with their supervisor and mentor Grace Khatcherian, MS, RN. They sit around her in a circle with their notes and files and share the problems they faced with patients.
Khatcherian does not provide them with guidelines. Instead, she asks them questions until they find their own answers.
“What we focus on is the physical assessment,” Khatcherian explained. “A long time ago, nurses didn’t do physical assessments, it used to be considered the doctor’s job, but now it’s not like that. It’s our responsibility as nurses to asses everything, and even initiate autonomous decisions, we are teaching our students to voice their opinion and not just take orders.”
Across town and far cry from the UMC-Rizk Hospital, another group of LAU’s nursing students are helping patients in quite a different setting. Every Thursday and Friday, a selected few give their time and care to the cause of the St. Antoine dispensary through a program arranged by LAU.
St. Antoine is a little health clinic and medical dispensary located on the border of Jdeideh. Its mission is to offer the best primary healthcare service to the large marginalized population of the region.
The clinic, which relies mostly on donations, is run by Sister Hanan Youssef of The Good Shepherd Sisters Congregation. It has been in her care since 2005.
Nursing students in such setting have to work with a lot of people who lack basic education and knowledge.
Students start their day with a group meeting before opening the clinics doors. The inside of the building is bigger than it appears to be from the outside, with long but narrow rooms.
In an office decorated with informational posters, students sit with a counselor and social worker, who briefs them on different problems and situations that may arise. She reminds them that patience in such a particular setting is important.
Students are mentored and guided by Dr. Myrna Doumit, assistant dean and associate professor at the LAU school of nursing. “Students are always supervised by a nursing faculty on clinical areas; we never leave students alone,” Dr. Doumit explained.
At St. Antoine, Lebanese, Egyptians, Sudanese, Iraqis, and Syrians access the clinics services along with other foreign workers living in the area. In 2010 alone, the number of patients topped 15,000 –an average of 70 to a 100 patients daily.
By noon, the hallways are literally full of women, children and elderly patients, waiting for their turn. Pregnant women come for check-ups. Many come for screenings and vaccinations.
St. Antoine also runs a program of home visits to impoverished families in the region, where nursing students experience firsthand the poor health, and conditions many of Lebanon’s refugees and unemployed face today.
“It is shocking how much poverty there is,” Yvonne Jleilaty, a nursing student working at the St. Antoine clinic, said. “There was a lot I didn’t know until I saw it for myself.”
In such an environment, nurses are at the forefront of healthcare; they are the ones who have to screen patients in order to refer them to the appropriate physician.
“Nurses are the heartbeat of every hospital, and every setting,” Dr. Myrna Doumit explained. “With the advanced preparation nurses now get, they can function without physicians, but physicians cannot function without nurses.”
“Unlike physicians, nurses stay at the hospital round the clock; you cannot have a hospital without nurses,” she added.