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A Surgical Mission in Ecuador Becomes a Once-in-a-Lifetime Opportunity for Two CRNA students


When Columbia Nursing Certified Registered Nurse Anesthetist (CRNA) students Julian Piazzola ’18 and William Scott Wise ’18 first heard about an opportunity to assist a surgical mission in Ecuador, both knew it was something they couldn’t miss.


Accompanied by Michael Greco, DNP, director, Nurse Anesthesia Program, the students participated in a weeklong health mission with Blanca’s House, which works to bring quality medical care to countries and communities throughout Latin America. The experience involved setting up an operating room (OR) in Lojas, Ecuador, in preparation to provide anesthesia for total knee replacements as well as head and neck cases for local citizens in need.


Each year, CRNA students at Columbia Nursing participate in a clinical rotation, but for a select few, that rotation can happen abroad. In order to receive credit, students must be accompanied by a Columbia Nursing faculty member or clinical advisor.  


Though the clinical hours abroad do not count toward their case and hour requirements for official CRNA licensing, the students say it isn’t about that. They explain that this kind of opportunity to volunteer their services to those in need is the kind of human experience that is invaluable.


The students spoke with Columbia Nursing about the mission.


You both worked as Pediatric Intensive Care Unit (ICU) nurses prior to coming to Columbia Nursing. Why did you decide to join our CRNA track?


Julian X. Piazzola (JP): I am interested in the high level of practice and skill CRNAs displayed in my experiences as an ICU nurse. Columbia University was my dream school, and I had heard so many wonderful things about the program.


William Scott Wise (WSW): I chose to enter into a CRNA program because of my interest in medication and its physiological impact. I chose Columbia Nursing based on recommendations from students who had previously been in the program.


Why was a global mission important to your education?


JP: Providing care in a remote location was extremely rewarding. I felt the impact we made on this community, and I left with such a positive feeling about the patient experience, which is integral to nursing care. 


WSW: To me, what sets nurses apart from other health care professionals is our emphasis on culturally sensitive empathy and care. The global component enhances this aspect of our education.


What was your day-to-day role on this health mission?


JP: We participated in pre-operative assessment of patients. We then administered Neuraxial blocks prior to surgery, and monitored patients intraoperatively and postoperatively. We also provided general anesthetics/sedation anesthesia for patients undergoing surgery. We contributed to the surgery by providing anesthesia care and assisted in any way necessary to facilitate patient care.


WSW: When we arrived at the hospital in the morning, we would first check the OR to ensure we had all of our equipment ready and that it was functioning properly, after which, we would then perform a preoperative assessment on our patient and then transport him/her to the OR.


Once in the OR, we applied standard monitors and induced our patient ensuring physiologic stability under anesthesia prior to the surgical procedure. After the procedure was completed, we emerged our patient and once stabilized, brought the patient to the Post Anesthesia Care Unit for further observation.


How was working in Ecuador similar or different than what you were expecting?


JP: The experience was similar to my expectations, and we were well prepared for the environment and patient population. The major takeaway from the trip for me was how appreciative these residents were and what a positive impact we felt we made on their lives. 


WSW: One difference was the quality of the OR. The hospital that was hosting our surgical team had just renovated their operating room and had equipment on par-- if not better--than the equipment I have used in the United States. I was expecting less sophisticated working conditions.


What was the most impactful moment of the week for you?


JP: The appreciation from patients and their families was by far the most impactful moment. The hugs and tears on our rounds after surgery are something I will never forget. 


WSW: I cared for one patient who was constantly smiling and thanking me for the treatment our team was providing. The gratitude expressed by this patient made the whole experience extremely rewarding and put into perspective the impact we were making on these people’s lives.


Did your week in Ecuador change your career path?


JP: In the future I will be pursuing opportunities to volunteer abroad again. The experience was very rewarding and unique. I have never had such an experience and I look forward to giving back.


WSW: Prior to beginning this program, I knew I would one day donate my time to provide care to patients in underserved countries. My week in Ecuador has solidified this purpose and has provided me with a great foundation to continue health care work abroad.


What are your plans after you graduate this year?


JP: I would like to obtain a position as a CRNA and provide care to the best of my ability. I would also like to teach new students and of course contribute to Blanca’s House Foundation in the future.


WSW: After graduating from Columbia Nursing, I plan to join the Army as a CRNA.