1. Dunn, Debra MSN, MBA, RN, CNOR

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I'd been collecting supplies for charitable organizations for 15 years. I hoped that one day I'd get to take this effort one step further and volunteer as an OR nurse in another country.


I spoke with a few adventurous souls who'd already participated in surgical missions before applying as a volunteer with Healing the Children, New Jersey (HTCNJ). I was offered an opportunity to participate on a 1-week mission to the Dominican Republic where the team would perform pediatric urologic surgery.


My team had 18 people: an attending pediatric urology surgeon, two pediatric urology residents, two anesthesiologists, a CRNA, an anesthesiology resident, two circulating RNs, two scrub nurses, two postanesthesia care unit nurses, a physician performing preoperative and postoperative assessments, two HTCNJ administrators, and two assistants to perform numerous tasks such as finding needed supplies and preparing instruments for the next cases.


The crew met at the Newark airport at 0500 HTCN gave us 15 bags containing: supplies, instruments, medications, and equipment.


Once in the Dominican Republic, we drove to the host hospital, Centro Medico in La Romana. I was responsible for weighing and measuring height for all surgical candidates. We screened 52 children; performed 44 physical exams, and selected 19 children as surgical candidates.


Our host hospital provided two OR suites, use of ancillary rooms near the ORs, an area to recover two patients at a time, and beds for children postoperatively admitted to the hospital.


Each OR had antiquated, manual OR tables and overhead lights, although the anesthesia machines and monitors were relatively new, but in Spanish!


We unpacked our electrocautery machines, portable suction canister sets, disposable supplies, and the surgeon's instruments. An autoclave was available for our use in emergencies. We used glutaraldehyde to process instruments.


Our urologic team performed first-step hypospadias repair procedures or second-step procedures on patients who had the first-step procedure the previous year. We also performed circumcisions, a urethral fistula repair, a urethral strictureplasty, and one laparotomy for a bladder mass in a 2-year old. The surgeries lasted from 1.5 to 4 hours, on children from 7 months to 17 years.


We worked from 0715 until midafternoon, except for one day when we worked until about 1900. I was told this light schedule was a rarity.


There were some moments of panic. One day, we searched for a type A+ blood donor for a woman who delivered a baby at home and experienced postpartum hemorrhage secondary to retained placenta.


Another adrenaline-provoking moment occurred when the hospital lost electricity during a planned outage when we were scheduled to be done for the day. We lived through 5 long seconds without electricity until the backup generator kicked in.


After our mission some boys can now urinate normally. Others with tight, restricting foreskins underwent circumcisions. One 17-year-old, who'd had a traumatic injury to his genitals, will no longer have urinary tract problems.


I've participated in 2 one-week HTCNJ trips for the past 2 years in Dominican Republic and Ecuador. When I retire, I'll take a child from a developing country into my home for surgery in the United States.