‘We are service-driven people’: DNP students treat patients in rural Peru

Four University of Tennessee at Chattanooga Doctor of Nursing Practice students and faculty members smile in front of Machu Picchu in Peru, holding blue and white Chattanooga Mocs hats. Dramatic clouds hang over the iconic mountain and Incan ruins in the background as the group poses during their global health trip.

Karent Gresbrink (left), Kelly Jourdan, Chyna Germany and Dr. Kate McKinney pose at Machu Picchu. Photo courtesy of Dr. Kate McKinney.

In June, a woman in rural Peru walked five hours to receive a pap smear at a health clinic.

Those treating the woman—and others like her—included University of Tennessee at Chattanooga Doctor of Nursing Practice students Karent Gresbrink, Chyna Germany and Kelly Jourdan, alongside faculty member Dr. Kate McKinney, the Kay K. Chitty assistant professor in UTC’s College of Nursing.

“Through my undergraduate nursing school, I went and worked with an organization in Peru, Cervi Cusco, providing women’s health services in rural areas and it’s still around,” McKinney said. “I reached out and asked them, ‘Now that I’m in an instructor role, could I bring students?’

“They were very excited to have us come and help out.”

The three students, all members of UTC’s Family Nurse Practitioner Class of 2027, spent over a week providing primary and preventive care in Cusco, Peru. At their hotel, the students lived in close quarters, sharing a dormitory-style room.

Early each morning, they boarded buses for a two-hour drive to their clinic sites, where they set up in makeshift tents or auditoriums.

“In the family nurse practitioner program, we really emphasize the importance of cultural competency and understanding your patient’s background,” McKinney said. “Knowing where they come from and how that plays into their health because it really plays a significant role in how they make their health decisions.”

Gresbrink, Germany and Jourdan, who all work in Tennessee hospitals, agreed that healthcare looks different in Peru.

“In the United States, there’s immediate access to care at all times,” said Jourdan, a registered nurse at CommonSpirit Memorial Hospital Chattanooga. “You get your results back the same day or within hours.

“It’s not like that here.”

Two University of Tennessee at Chattanooga Doctor of Nursing Practice students provide care to a patient during a medical clinic in Peru. One student, wearing blue scrubs and a stethoscope, checks the patient's blood glucose with a finger-stick test while another student in burgundy scrubs gives a thumbs-up and speaks with the patient. All three wear protective gloves, and the student and patient wear face masks.

Chyna Germany (left) and Kelly Jourdan work with a patient.

Germany, a labor and delivery nurse who received her Bachelor of Science in Nursing degree from UTC in 2021, described the experience as “rural health on steroids.”

“We have problems like that, too, in our rural areas around here,” Germany said, “but seeing it to that magnitude, it was just very eye-opening and made me feel even more excited to be there and to do women’s health outreach in a different country where they don’t have as much as we have here.”

All three students said they noticed the health differences between the rural Peruvian patients and those they typically treat in Tennessee hospitals.

“The prevalence of diabetes and hypertension wasn’t as common there as it is in the U.S.,” Germany said.

Jourdan believes lifestyle plays a role.

“They’re much more active—very, very active,” she said. “They don’t eat fast food or highly processed food. They’re making things from scratch. They’re eating at home.”

Those observations aligned with Gresbrink’s experience treating patients throughout the week.

“When we do health fairs here in America, almost everybody comes with chronic diseases and tons of medication, and there we found people that have no medications at all,” Gresbrink said.

Gresbrink, who moved from her home country of Panama to the United States in 2020, began working as a registered nurse at Erlanger Baroness Hospital during the COVID-19 pandemic while taking prerequisite courses at UTC.

Fluent in Spanish, she helped with translation between patients and providers throughout the trip while also working alongside a local medical interpreter.

Gresbrink said even without a shared language, communication often came naturally.

“There is a lot that can be communicated through body language,” she said. “Everyone had a good chance to have clinical experiences, and the people were very kind to us, too.

“I hope more students can have this opportunity because you’re helping people at the same time you’re learning. It’s a very nicecombination of experience.”

Germany said the trip strengthened her passion for women’s health and preventive care.

“Seeing the difference between our healthcare system and theirs made me have a little bit more appreciation for what we have because it was very different,” Germany said.

The group also made time to explore.

“We got to go to the Sacred Valley and Machu Picchu,” Jourdan said. “It was neat learning about the cultural side of things to help connect everything.

“We all got along so well. Dr. McKinney was wonderful. She had everything so organized … Everybody just had something to contribute, and it made the trip really enjoyable.”

As the week came to a close, McKinney watched the students leave with stronger bonds and a renewed sense of why they chose nursing.

“We all talk about why we’re in nursing, and it’s that we are service-driven people,” McKinney said. “I think this trip reflectsthat. Healthcare resources and services are limited in many of the communities we visited, and this experience gave us the opportunity to contribute to patient care while also learning from the people we served.

“I think the students found it really rewarding.”