Serving in Santa Cruz

Serving in Santa Cruz
Kimmy Tungl
May 12, 2022

Being a part of the Medical Missions Outreach team to Santa Cruz, Bolivia has been one of the greatest experiences in my life.

As a new healthcare professional with only one year of nursing experience, I was pretty nervous to be heading out of the country in an attempt to use the little skills I felt that I had.

At one point on Tuesday Clinic, a female patient was brought to my table to be seen. She explained to me that for the last few months she had intermittently been experiencing a left-sided chest pain that radiated to her left upper shoulder and left arm. As an ER nurse, I would typically be getting labs, a chest X-ray, and ECG on this patient and with none of those resources available I was unsure what to do. I asked several more questions and took the time to listen to her heart and lungs. With all this information, I was still unsure how to officially diagnose this patient. Luckily, Dr. Jen Ney was available and I asked her to see the patient. Within only a few minutes Jen had found that this patient had a rotated rib to her left anterior chest. My only response to that was that I would never in a million years have come up with that diagnosis on my own!!

Jen explained to me how she was able to palpate on the patients chest and reproduce the pain which means that it is musculoskeletal and not electrical. As you palpate the area, you can also feel the rounded edge of the rotated rib that is supposed to be more flat. Jen explained further that most people will have issues with a rotated rib multiple times throughout their life and certain positions can cause the rib to rotate and hurt. We were able to provide the patient with the needed education and medication to help. I thought, “oh, well.. what a cool thing to know and maybe utilize while working an ER shift in the future”.


Little did I know that on Thursday clinic, I would have a male patient brought back to my table with very similar symptoms. This patient explained to me that he has been having left sided chest pain for about one year that is intermittent. I quickly decided to use the skills that Jen had taught me earlier in the week and palpated over the area where the patient was hurting. His pain was reproducible and I was able to feel where one rib was rounded instead of flat. In my mind, I thought “this HAS to be a rotated rib”.. but I also didn’t want to tell this patient something that was not accurate. I decided to double check with Jen who validated my diagnosis and I was then able to give this patient education and medication for his new diagnosis. How cool that God would orchestrate these circumstances and allow me to practice using a skill I had just learned earlier that week. That second patient could have gone to any of the other 8 providers, but God placed him perfectly at my table. The four days of clinic definitely stretched my mind and pushed me slightly outside my comfort zone and this is only one example.


I am forever grateful for the many other ways God allowed me to grow on this trip!