Nurse's Rounds

Twice a month, two nurses will go to a cluster of villages where they have been assigned. They will visit the village the week before the doctors go in their Mobile van, and then will follow up the week after the Mobile MD clinic. Most of these visits occur in people's homes. And the majority of these home visits are for prenatal and antenatal care. There are also some visits with high risk OB patients and chronically ill patients who have diabetes and hypertension. Nurses will do standard prenatal visits where they will measure fundal height, check fetal heart tones, and check the woman's blood pressure. They will also do blood pressure checks for the hypertensive patients and deliver appropriate medicines to those who need it. The structure of the visits is effective because they can decide whether a patient needs an appointment with the mobile MD clinic, or if something is serious enough to warrant a visit to the main hospital in Vellore.

The nurses each have a full registry of all pregnant women in the area. Every woman is registered within 3 months of becoming pregnant (if she realizes she is pregnant) and will then receive the appropriate prenatal care. Impressive! Each nurse is responsible for about 7,000 patients.

The day was very interesting. It was exciting to see people in their home environments, going about their routines, participating in village life. Generally, everyone takes off their shoes before entering the home. I appreciate this because I was raised in a "shoes off" house. Although, I had to laugh because sometimes there is more dust and dirt inside the house than outside. The intention is admirable.

One woman we visited needed to have her stitches removed from a tubal ligation. I think I have already mentioned how the government provides financial incentive for sterilization. Population control is definitely in effect here! I had the opportunity to help with some prenatal exams and listen to fetal heart tones. Here, we used a stethoscope to listen to fetal heart tones. I was surprised I could hear them. We get so used to using the doppler in clinic, it is easy to forget the subtleties and graces of the simple approach to physical exams!

As an aside, today was Pongol, the harvest celebration in Tamil Nadu. In celebration of the holiday, many of the families we visited offered sweets and food. I have become wary of tasting local food after a few too many days with a GI problem. So, I kindly accepted my edible treat, and "saved it" for later. One household showered us with flowers in our hair. They are deliciously fragrant white flowers, tied together on a string. It is nice to get a whiff of the flowers after a long, sweaty day in the village!