Northeastern nursing student Ashley Cavignano’s third co-op featured two starkly contrasting healthcare settings: Massachusetts General Hospital in Boston and Himalayan villages in Nepal.

Cavignano, BHS’16, spent her previous two co-ops at Mass General: the first in the Emergency Department and the second in the Neurosciences Intensive Care Unit. This third co-op, which she developed herself, spanned from January to April of this year. She split time during the first two months between those same Mass General units, and then spent the next two months preparing for and providing care in Nepal with Himalayan HealthCare—a nonprofit that delivers care and education to poor villagers in the mountains of Nepal.

Looking back, Cavignano said the Nepal experience taught her the value of thinking outside the box. She explained that while Boston hospitals offer world-class equipment, those resources aren’t available in the middle of the mountains, so you must rely on your knowledge and experience and do the best you can with what you have. Case in point: Cavignano’s traveling medical care kit consisted of a stethoscope, a blood pressure cuff, and a flashlight.

“It was a really good experience for me to see the best care in the world and then be in a remote place where I relied on my own assessment skills,” Cavignano said.

Triaging patients and assisting with surgery
Cavignano spent nearly a month trekking around the Himalayas northeast of Nepal’s capital, Kathmandu, as part of a team of some 20 healthcare professionals consisting of emergency room physicians and specialists as well as a nurse and physician assistant. To reach and return from each site, the team trekked for several hours up mountains on rough terrain while in direct sunlight, on narrow dirt paths, and along the edge of cliffs.

They set up clinics and provided healthcare education in four remote Nepali villages, seeing a total of 758 patients. The clinics drew long lines of villagers, some of whom walked for a day or more to receive care. Patients’ common ailments, she said, were respiratory, orthopedic, and stomach problems caused by cooking in poorly ventilated homes, living and farming on the steep landscape, and drinking from the polluted water supply, respectively.

Cavignano’s primary focus in the clinics was triaging patients—which was one of her roles on co-op in Mass General’s Emergency Department. In fact, she asked similar questions to assess patients in Nepal that she had asked back in Boston; she inquired about allergies and what problems patients were experiencing as well as whether they had any pain or had received any previous care.

However, patient assessments in these clinics were a bit more complex. Cavignano communicated with villagers via two translators—from English to Nepali to Tamang—and often used drawings and hand gestures to help assess patients.

Sometimes her role on the team went beyond triage. In one situation, Cavignano assisted a surgeon with removing a mass from one of the villager’s ears. “The wooden bench where I would sit with patients for triaging became a surgical table,” she explained. “I’d never before participated in a surgery to that extent.”

When I graduate, I’ll have three years of experience in patient care and bedside care as well as exposure to Mass General Hospital medicine. I feel that I’m way ahead of a lot of people in the field, and I’m very thankful for that opportunity. – Ashley Cavignano, BHS’16

The power of co-op
Cavignano, a senior who expects to finish her coursework in December, said the co-op program drew her to Northeastern and has provided her with powerful learning experiences and role models. She received a Presidential Global Scholarship for her co-op in Nepal.

Though Cavignano initially enrolled at Northeastern as a behavioral neuroscience major, she switched to nursing because she craved more patient interaction.

“I just like taking care of people,” she said. “I think especially in the emergency room, people are there during some of the worst times of their lives, and to have somebody there who can talk to you, take care of you, and provide for you, even if only for a couple of hours, is very important. It can make a big difference in people’s lives, and I’ve seen it happen many times. It’s a nice feeling.”