my second practicum placement

originally i planned to work on masaka regional referral hospital's many wards as a social work student completing tasks such as arranging transport for individuals who have been discharged, locating attendants for individuals left at the hospital without anyone to care for them, and getting birth certificates for orphaned children. however due to a change in interest i have decided to narrow my focus at the hospital to one ward in specific. due to my increased interest in hiv work and my drastic increase in comfort around individuals who have hiv, i've set out to complete my second praciticum practicum at the m.c.h. ward. i will work here wednesdays and thursdays for the remaining duration of my practicum in uganda.

m.c.h. which stands for the 'maternal and child health' clinic offers many services including hiv/aids and health education, antenatal care, child immunizations, routine testing and counselling (r.t.c.) for pregnant women and their husbands, postnatal care, and gynecological services. this ward is funded through an initiative working to reduce parent to child transmission of hiv.

working at m.c.h. i have the opportunity to experience a variety of situations. for example i spend time with women awaiting hiv testing, offer a listening ear and a hand to hold while women/children are being tested, and partake in post-test counselling as individuals receive their tests results. last week i managed to spend an entire morning in the laboratory as individuals were test for hiv. this was a huge accomplishment for me since i am known to have a fear of needles and ill stomach at the sight of blood. i was very nervous entering the laboratory but managed to stay strong and confident for the individuals being tested; i did not want my fear of needles or blood to project onto the clients and increase their already heightened anxiety. i told myself 'rachel, if these individuals can have the courage to test their hiv status then you can handle the sight of needles and blood'. miraculously after about three clients i was able to comfortably watch the entire testing process.

being present for hiv test result delivery was my next fear to overcome. since i am present for testing i know an individual's status before they do. i feel an uncomfortable sense of power over the clients in this situation, but am working to understand that service providers are automatically placed in this power position over clients. i am trying to gain a better understanding of how to competently work within this power imbalance without coming across as agreeable to it.

nurses have the responsibility of delivering the test results where my role is to assist in post-test counselling with individuals who understand and are comfortable with speaking english. post-test counselling consists of emotionally supporting the client, making sure they understand what is the next step in their situation (positive = hiv treatment, negative = how to protect themselves from this point forward). i speak with the client about their fears or concerns prior to result delivery, what they know about keeping themselves healthy, and help to empower them to take control of their situation once they know their status. i am very nervous in post-test counselling sessions but have wonderful support from my supervisor. i am confident that my comfort level with this will eventually increase as i become more familiar with the process and gain more experience.

well, that's it for now. thanks for reading :)

-rachel-