Productive day for clinical team

Today the clinical team, Jeanette, Patti, Arif and I had a very productive day. We each had the opportunity to spend the morning with a nurse in the clinic. Jeanette experienced the TB/HIV/family planning area. Patti saw the child immunization area. Arif explored the primary care area as well as spending time with the administrative assistants and nursing assistant. I was with Danny in the chronic disease management area. The clinic was very crowded and we estimate about 200 patients are seen per day. We saw 30-40 patients in each area between 9:00 and 12:30. The clinic opens around 8:00 and the patients begin lining up outside to be seen around 6:30 am. There is no physician present on Wednesdays and the professional nurses (4 years training) function very similarly to nurse practitioners. They take a focused history, do a focused exam, diagnose, and dispense medications according to national guidelines. We were very impressed by their knowledge, dedication, and abilities. There is clearly a lack of space and resources . They have little time to spend with each patient, but do a great job with the time they have. We identified some areas for improvement, for example in efficient use of administrative staff and nursing assistants, infection control, and health promotion/patient education. We are excited about the relationships we formed today and look forward to learning from the nurses we met today, as well as hopefully making some useful suggestions.