Category Archives: Nursing students

Hayes’ helping hand

By Monica Grice

Overwhelmed. This is how Maria Hayes felt walking through the rain forest of Nicaragua.

It’s day three of the Texas State University nursing student’s trip, and they set out to complete census’ of a rural community located in the rain forest.

“Many of us went into this experience being very timid and unsure of what we have learned up to this point,” said nursing student Logan Smith. “However, once we got accustomed to conducting assessments and communicating with patients, the uncertainty melted away and confidence was built.”

Confidence is something Hayes exuberated without fault while abroad. Her adaptation to the Nicaraguan culture communicated her will to help people, and her love of nursing.

Next Stop Nicaragua

The Denison, Texas, native fell in love with healthcare when she was a student in high school.

Hayes spent 12 hours a day for a week shadowing doctors and nurses at her local hospital and experienced everything from surgeries to deliveries, which made her want to be a nurse midwife.

“The first delivery I saw, I cried; it was the most amazing thing I’ve ever seen,” said Hayes. “That’s the moment I knew I wanted to be a nurse.”

Hayes on day two in Nicaragua. Photo by Monica Grice.

Hayes went to Nicaragua with her nursing school colleagues in January hoping to see what it was like to practice global health as a travel nurse, and to brush up on her Spanish.

Hayes originally enrolled at Texas State University in San Marcos as an engineering major.

“I wasn’t really connected to that; I knew I would get a job and went with it for that reason,” said Hayes.

After talking with her father, she ended her engineering major and pursued a nursing career.

Clinic Days

While in Nicaragua, the College of Health Professions students split into three groups and spent four days in three communities.

On the first day in the community, the teams were guided through the villages to interview community members and take a health census. The census would give them a better understanding of what illnesses were in the community, and how to prepare for them when clinic days arrived.

Hayes saw patients at a clinic located deep in the rainforest of Ticuantepe, Nicaragua.

“She just jumped right into whatever challenge was set before her,” said fellow nursing student Jessica Yehl. “She communicated well, assessed her patients with all the skill of an actual nurse, and was so prepared to help the team in whatever way she could.”

Hayes during day two of clinics. Photo by Monica Grice.

Hayes remembered meeting a young woman in her 20’s on the day they collected census. The woman was emotional because she had a lump in her breast that she believed to be cancerous. Since the team didn’t have any medical supplies on them that day, Hayes urged the woman to come to the clinic. She came on the first day, but became nervous and left, leaving Hayes worried for her health.

Day five was frustrating for Hayes. The woman still hadn’t shown, and another patient’s blood pressure was dangerously high. Hayes and other healthcare students urged the woman to go to the hospital, but never found out if she did. It left Hayes feeling like she wanted to do more, but she couldn’t.

“I think her ability to be realistic sets her apart,” said Yehl. “A lot of nurses can be tempted to sugar coat hard situations, but she just gives it straight.”

On the third, and last day of clinics, Hayes felt rewarded.

“I feel really proud of the team and how much work we accomplished,” said Hayes.

The Woman From The Rainforest

After the last day of clinics, the Texas State group returned to one of the clinics for a day of giving back. Games, balloons, and a piñata were brought for the children and triage stations were set up outside of the church for any remaining community members who hadn’t been assessed.

Hayes’ clinic was chosen.

The woman from the rainforest was there. Hayes helped assess her and found out the lump was mastitis.

“I’ve been worried all week,” said Hayes.

Mastitis is an inflammation of the breast most common during the first six months of breastfeeding. Although painful, it’s not serious and can be remedied easily.

The emotion Hayes expressed was pure joy. She got the reassurance she had been waiting days for. Her worries were alleviated.

“That was really good, it was so relieving,” said Hayes. “I told her ‘I was ready to climb back up the mountain and find you,’ she thought that was really funny.”

She made a warm compress for the woman and explained how to continue treating the inflammation.

Hayes recalls this day as being the best part of the trip.

Returning Home

“I feel like I don’t need to be home,” said Hayes.

After the clinics, the team had a few recreational days and went to the nursing home in Masaya.

The nursing home was a unique experience for Hayes. As a career, she loves working with children. She seemed a bit hesitant, the whole team did. However, she molded quickly to the environment and left happy.

“She was able to adapt to the different culture and conditions of Nicaragua and perform confident and competent assessments on patients,” said Smith.

The day before the team’s departure, Hayes didn’t want to leave.

“It’s a bitter feeling to leave,” she said. “I wish we could have a few extra days.”

The soon-to-be midwife gained a deeper knowledge of the people and the country during the trip. Fellow nursing students, Smith and Yehl, admired how Hayes was able to jump into any situation and tackle it.

In the 11 days the Texas State team was in Nicaragua, Hayes explored what it’s like to be a travel nurse and practice global health: she thinks she can do it.

“I definitely loved it and I definitely think I could see myself doing it long term,” she said.

Hayes with a village girl. Photo by Monica Grice.

Journey to Nicaragua: Two veteran’s paths to joining the Texas State inter-disciplinary study abroad trip

Two weeks after returning from Afghanistan – his second of two Middle Eastern deployments –  Andrew Pagel, a Texas State University nursing student, was handed his walking papers from the United States Army.

“I was absolutely destroyed and betrayed,” he said.

In 2014 the Army cut 40,000 soldiers, according to a Wall Street Journal article, “How Obama Shrunk the Military.” Pagel was one of these soldiers.

At the time, Pagel, 32, had two children, a wife, a mortgage and livestock on a hobby farm near Florence, Texas. He was preparing to become a captain and had received high praise from his superior officers.

“I had a plan that completely crumbled because of that,” Pagel said. “I didn’t handle it well.”

Two years later he would be in Nicaragua charming elder village women and cheering sick babies.

Jennifer Pemp, 34, a clinical lab science student at Texas State University, was deployed to Afghanistan in 2008 where she tended to Afghanistan nationals detained by the United States military. These individuals were being held for questioning, and many of them had been injured in conflict.

They called her “PT Doc” and “Angel.” To them, she was someone who ensured they received proper medical care. For her, this experience kickstarted her desire to work in global health.

These two military veterans, with a combined four deployments and 13 cross-country moves, recently completed a mission of a different type as part of the 2017 Texas State interdisciplinary study abroad trip to Nicaragua.

A portrait of Pagel and Pemp

On Jan. 2, 2017 Pagel began the trip talking animatedly to whoever sat by him in the terminal and on the 6:42 a.m. flight out of Austin Bergstrom International AirportHe talked about the Lego tattoos on his left arm and how he plans to add more to make a sleeve.

From his physique, to the ruck-style way he carried his Army-issued backpack, to his near-daily workout of throwing sandbags, Pagel distinguished himself from the other 29 students early on. He was older, married, a father, but perhaps more noticeably, he was well traveled, knowledgeable, worldly.

Often he gave students tips about safety or travel. In crowded areas he hung back to watch over the group, successfully stopping a man he believed was trying to pickpocket one of his female colleagues.

During the team’s orientation session in Nicaragua, Pemp, too, set herself apart. She introduced herself as a veteran and that she had served in the United States Air Force in Afghanistan. A palpable sense of surprise rippled among many of the group members. For many, going to Afghanistan seemed impossible.

Pemp fit in easily with her colleagues and quickly made friends.

Pagel, too, was quick to talk with everyone. He told anecdotes from his life and even if he was talking to just one person, it felt as if he was inviting the group to join in.

“He will strike up a conversation with anyone who sits down next to him,” said Cassie Thompson, one of Pagel’s fellow nursing students who often sat next to him on the yellow school bus that took the team all over the country.

He was often content to sit on the bus alone listening to “Winds of War” by Herman Wouk on Audible, though he indulged anyone around him in conversation or showed them pictures of his children when asked.



Pagel joined the military a few years after he graduated high school. He moved five times for the military and deployed twice – once to Afghanistan and once to Iraq. He started in infantry then became an intelligence officer. When he separated from the active Army he was a captain. As part of his separation package, he transitioned into the Texas National Guard and is now a major.

For his first deployment, Pagel was sent to Iraq in 2009. One day his squad received information about a disturbance in a pomegranate grove on the edge of their territory.

The enemy had beat them there.

Every man in the village had been beheaded and every body had been left in a shallow grave dug among the rows of trees. The bodies had been arranged by family: grandfather, father, son. These macabre rows of family lineage had been left to rot, or maybe left so that men like Pagel and his Iraqi translator who both broke down sobbing, would see.

“I saw some things…Night, day, it doesn’t matter, I see them again,” Pagel said. “I smell them.”

Pagel, who talked lovingly about TVless Sunday mornings making pancakes with his children and who danced shamelessly with elders at the nursing home, looked far off when he spoke. There was almost a look of acceptance on his face.

“It is what is is,” he said. “What happened happened.”

Pagel returned to Alaska where he was stationed in 2010. Between his return and 2014 Pagel had his first child, moved to Arizona where he joined a search and rescue team and had his second child.

Then he deployed again.

This time Pagel was sent to Afghanistan as an intelligence officer. He mostly stayed on the base during his deployment. He returned to the states after three months.

Two weeks later Pagel’s superiors called him in to talk. He thought he was getting promoted. Instead, he was handed his walking papers.

“I didn’t know what I was going to do,” Pagel said. “I thought about being a vet for a few minutes.”

While Pagel served out his last few months as an activity duty Army officer, he took stock of his life. He has a degree in criminal justice, but after a number of high-profile police shootings he decided he did not want to be an officer.

He created a list of qualifications for his next job. He wanted to work in the service sector and create a tangible impact in society.

Pagel crossed paths with an army nurse and after the man told him about his travels and work, Pagel realized the career move was right for him and he enrolled in nursing school.

“The goal is flight nursing,” Pagel said. “I definitely need that adrenaline rush.”



Life wasn’t always easy for Pemp.

In 2004 she met and married a man in the army. That same year he was deployed to Iraqi as an Army Combat Engineer. He was shot in the leg a few months later and was sent home for a month—the bullet still lodged in his leg. He redeployed and Pemp deployed for the first time at the end of that month.

Though their deployments were only an hour away, they lived in different worlds.

Pemp was escorting local nationals on base and only left the wire fence once. Her husband was directly involved in combat and had his vehicle blown up by an improvised explosive device.

As her deployment ended, Pemp requested retraining to become a physical therapist. She packed up and left their apartment three weeks after she returned home. She was on her way to attend school to get her associate degree in Wichita Falls, Texas while her husband was still overseas. She was determined to get the training she needed to help him recover.

“When he came home all of the other guys had their spouses or families there and I couldn’t be there for him,” Pemp said. “It was very traumatizing to him.”

Her husband was sent to Tacoma, Washington to have his mental and physical health evaluated. They tried to reintegrate him into society but came to the conclusion that he suffered from post traumatic stress disorder.

Meanwhile, Pemp was working on her associates degree in physical medicine at a technical school in Wichita Falls, Texas. She was painfully aware of her husband’s condition. She tried to contact his superiors but was ignored. She had no choice; she put her nose in her books and focused on making it through school.

“I don’t even know how I graduated tech school,” Pemp said. “I was so stressed out.”

After she graduated, the Air Force wanted to send her to Maryland, but she applied for and received permission to go to Washington to help her husband.

She found her husband to be a changed man. He fluctuated from happy to angry to sad in minutes. He was “unhinged and erratic.”

“We were not supposed to become a statistic,” Pemp said.

They divorced in 2006, and Pemp threw herself into work.

“One of the things they teach you in the military is resilience,” Pemp said. “You have a choice: be resilient or let the world get the best of you.”

In 2008 she deployed to Afghanistan with a medical team where she worked as a physical therapy assistant in a detainee facility.

“One of the things we had to keep in mind was that we were not there to interrogate them or judge them,” Pemp said. “We were there to provide quality health care as if they were any other patients.”

The detainees were given very little – as little as just one blanket and one towel in their cell – and many of them needed medical attention. Physical therapy was hard to practice due to the limitations on their freedom to exercise.

With extra free time, Pemp began doing phlebotomy and giving immunizations. She found that the sickest patients were often not being seen first. The detainees told the religious leaders of their group who would tell guard if they were feeling sick. The guard would make a list of names for the medical center and the center would go down the list.

Pemp decided to create a program called Cell-Side Triage. She visited patients in their cells, assessed them and then helped the medical staff decide in which order the patients should be seen. This earned her the name of “PT doc” or “Angel.”

One day a detainee came in to have a medical procedure done. He did not respond to the medical staff. He just looked at Pemp and smiled. The translator explained to the man that the guard was going to have to escort him out if he was not cooperative. Still, the detainee just smiled. The guard began to pull the man out. The man stopped him and opened his hand. In it lay a small ring woven from threads carefully pulled from his blanket and towel. He asked the guard to give it to Pemp. The guard told the man that it was contraband and that he was going to confiscate it. The detainee threw himself on the floor and started yelling.  The entire floor began to riot.

Later, the guard gave Pemp the ring and said, “I hope you know this entire riot started over this ring.”

Pemp only cared that the detainees were human and that they needed help. This inspired a deep love from her. Throughout her time, they brought her many thread rings and rosaries which are now framed in her house.

“I realized I was very interested in public health then,” Pemp said. “That started my desire to want to go abroad and do this kind of stuff.”

She left the military in 2013.

“Sometimes I wish I would have stayed in, but I wanted to see more than I was seeing,” Pemp said. “After both my deployments I felt like I fulfilled the reason I joined and that why I got out.”

Ever since, she has worked as a physical therapist in Texas attending Texas State University to get a degree in clinical laboratory science.

“I’m going to be a successful veteran,” she said.

Gear from her time in the Air Force is currently being displayed in the “Memories from my Duffle bag” display at Alkek Library.

For Pemp, the trip to Nicaragua was a no-brainer.

“I don’t like ‘out of sight, out of mind,” she said. “I feel like (the health care conditions in Nicaragua) should be acknowledged. I think there is a lot of stuff we ignore because we are afraid to feel the emotions, but I’m not afraid.”

Nicaragua and beyond

For Pagel and Pemp, their stories make them who they are. For Pemp, her hardships caused her to experience life a little more. She laughs easily and smiles readily. She is happy to talk to anyone.

“I really do enjoy life,” Pemp said. “I mean, there is so much to enjoy and learn and take in. I don’t feel like we should spend our lives just going to work and coming home and sitting in front of the TV. I want to explore the world and meet new people and learn new things.”

Pemp’s fellow classmates notice her hard working spirit.

“She always wants to learn more,” said Ashley Wells, a clinical lab science student who worked with Pemp in Nicaragua. “She’s never content. She always wants to go further.”

Patients in Nicaragua

The most memorable patient for Pagel was a 90-year old woman who wandered in during one of the clinic days.

She peaked her head in the side door and asked to be seen. She explained she had walked quiet a distance. She was so thin that her bones showed and she was so elderly that snow white patches of hair grew out of her ears.

The woman in charge of the clinic agreed to let her be seen. Pagel offered to see her during lunch.

While everyone else ate—by that point the group was starving as lunch had arrived late—Pagel examined the woman. He listened to her medical history, which included possibly being cursed—and good naturedly looked at the fungus on her feet and in her ears every time she requested.

The woman, in turn, told him that his Spanish was bad. Despite her griping, the woman stared at Pagel like he had come to personally save her.

“This woman is built like a tank,” Pagel said, as he examined her back. “She’s as crazy as a bat though.”

The woman was given a meal and when she finished, she left the clinic.

“Everyone here has a good heart,” the woman told a translator while smiling at Pagel.

The next day Pagel looked out of the school bus window as it rolled down the dusty road out of the village. The woman was walking through a field.

“Hola abuela,” Pagel yelled through the window at her.

Later, Pagel said this was the most memorable part of the trip.

“I enjoyed working with him because he is very confident,” said Chelsea Fowler, a nursing major who has worked in clinical groups with him before. “His strong personality is going to make him a very good patient advocate.”

Desiree Davis: A personal journey providing healthcare services in Nicaragua

By: Allison Fluker

Desiree Davis was sitting in the window seat of the 28th row on the plane headed for Managua, Nicaragua, that would take off Jan. 2. Her pink neck pillow hugged her neck as she quietly waited for the plane to take off.

Davis is from San Antonio, Texas. She is senior at the St. David’s School of Nursing at Texas State University.

At first glance, she looked calm.

When the plane lifted off from Austin, Texas, she let out a small scream as the air pressure popped her ears.

A team of 24 students from the Texas State University College of Health Professions was on its way to collaborate with the International Service Learning organization in Nicaragua to set up free medical clinics in small villages outside of Masaya.

When Davis found out about the trip last year, she didn’t hesitate to apply.

“We’re so used to being in America, it’s forcing us to have to embrace a new culture we’re not used to,” said Davis after spending a day seeing patients in La Borgoña. “It is important to connect with people who are not like me.”

Davis’ determination to get outside her comfort zone caught the attention of her friends and colleagues.

“She’ll take the opportunity that’s most challenging,” said Madeline Longtin, a senior in the nursing program. “Even if she’s scared, she likes to push her boundaries to see where her limits are.”

Davis does not speak Spanish, but was called on to communicate with patients in their native language. Her nervousness was evident, but she overcame that obstacle and looked people in the eye and nodded her head in understanding.

A Life-Long Dream

Healthcare has always been important to Davis.

During her senior year of high school, she participated in a certified nursing internship at local hospitals and in nursing homes. Her dream job is to be a pediatrician.

“I love working at the bedside with patients,” Davis said. “I love to be there for people and to take care of them.”

Davis has a strong will for taking care of people. When she graduates college, she wants to work at Brackenridge, a level-one trauma center, in Austin, Texas. She ultimately wants to work in an intensive care unit.

“Level one is when you get the most critical patients, like from air support,” Davis explained.

Davis’ love and compassion for patient care have not gone unnoticed from her peers.

“She has so much joy,” said Longtin. “She cares so much, beyond words.”

Davis’ joyful attitude and pleasant demeanor makes her patients feel comfortable and at ease.

“She’ll help you out before she takes care of herself,” said Rebecca Duffy, a senior in the nursing program.

How the Clinics Worked

Davis and her colleague completing a census form during home visits in La Borgoña. Photo by Allison Fluker.

On Jan. 4, the health professions team was split into three groups and named themselves: Group Peanut, Group Butter and Group Jelly. Each group followed a community leader into the villages to visit residents in their homes and take a medical census. They used this opportunity to invite community members to the clinics, which were held in local churches.

Davis’ group – Jelly – went to La Borgoña, a community near Masaya that received three free clinic days.

“There was a reason why we were there,” said Davis. “We were there to show them love.”


The local residents attended the clinics to receive care for illnesses ranging from diabetes to allergies.

During the operation of the clinic, the health professions students split into groups of two and, with a translator next to them, conducted focused assessments on the patients who had lined up outside the church to be seen.

Davis completing a focused assessment form. Photo by Allison Fluker.

Davis exuded confidence expected from a seasoned professional. A curious fire raged in her eyes when she consulted with patients.

“You start to see the same illnesses and know the right questions,” said Davis. “It gives you a lot of confidence.”

By the third day of the medical clinics, the previously nervous students grew confident and eager. Their confidence was built, in part, by consulting with the Nicaraguan physicians who pushed the students to utilize the knowledge and skills they learned in nursing school.

“You’re able to sit down with the doctor, tell them what is going on with the patient and you’re able to give your own assessment,” said Davis.


Some students began to assess patients without one of their colleagues by the third day of clinics.

Davis filling a prescription after completing a consultation with a patient. Photo by Allison Fluker.

“I was by myself the rest of the day,” said Davis. “I began to ask questions like ‘Has anything changed in the last 6 months?’ A lot of education went into finding out what happened to some patients.”

One patient stood out to Davis. The woman they were performing an assessment on who already knew what was going on with her health.

“We had a 47-year-old woman that was diabetic who was diagnosed 13 years ago,” explained Davis. “When we took her blood sugar, it was 448. In that moment, she automatically knew it was high when we showed her. She started to tell us how stressed she was. Her son had just gone to jail. While my partner, Mady, was taking her blood pressure, we started hugging her and holding her. You could tell she was just so stressed out. We asked Harold, our translator and ISL assistant team leader, to take her to the hospital with one of the buses.”


Giving Back

After the three days of clinics ended, the health professions team returned to the village, Chocoyera, to give back to their community. Everyone in the team went to the store earlier in the week and bought things for the children to play with.

“There were tons of kids,” said Davis. “Everyone was so comfortable with each other. Some of us started blowing up balloons inside (the church) and others set up the health fair outside when we arrived.”

Some students played with children from the community while other health profession students set up a couple of tables outside the front of the church. These students would continue to take blood pressures for local residents and give smaller focused assessments.

“I played with a little girl named Carmen,” said Davis. “She was teaching me little words (in Spanish) the whole time. I asked her what she wanted to be when she gets older and she said ‘doctor.’ I had brought a doctor play set with me and I decided to give her the doctor set. The smile on her face was so breathtaking.”

Davis special moment with the little girl, Carmen, is a small reflection of the experiences many of the other students had that day.

Davis playing with a bowling set and a young girl during the community give back day in the village of Chocoyera. Photo by Allison Fluker.

The study abroad to Nicaragua was brief. The health professions team flew out of Austin, Texas, on Jan. 2 only to return on Jan 13. In that time, the students traveled to small villages outside Masaya, a nursing home and to a children’s home. Throughout their time abroad, they performed hundreds of focused assessments and impacted many lives.

“We’re walking into a place where people didn’t choose that lifestyle,” said Davis. “It’s important to count your blessings because you don’t know what that person is going through.”

Davis went on the trip not knowing what was going to happen but she returned home with a bigger understanding of the world, healthcare and the knowledge that she made an impact in so many people’s lives.

“It is impressive to see the locals have so much joy in them even though their situation might not be the best,” said Davis.

A Passion For People

By: Amanda Gibson

Dalton Fierst, the only male nurse who decided to study abroad, walked to row 27 of the airplane and took a seat as he waited for the plane headed to Managua, Nicaragua to take off on Jan. 4. He sat down quietly.

Upon first appearance, he is an athletically built guy with broad shoulders and a quiet demeanor. On this morning, he was casually dressed with a resemblance of the west coast he grew up on.

The St. David’s School of Nursing at Texas State University was heading to Nicaragua where they paired with International Service Learning to host free clinics in rural communities surrounding the city of Masaya.

Over the course of the next two weeks, the nursing students would split in two groups and provide healthcare to families in four communities who might not receive medical attention otherwise. This trip would serve as a class credit in community health for the 28 nursing students who were about to begin their last semester of nursing school.

The summer before he moved to Round Rock to begin nursing school, Fierst went on a solo adventure to the country of Uganda.

“I wanted to be spontaneous and go on an adventure,” Fierst said. “But I went there because I knew they were a poor country and I wanted to help the community.”

Fierst walks at the San Francisco community to gather a medical census of local residents. Photo by: Amanda Gibson

Fierst grew up in Malibu, California, before moving to Kerrville, Texas, at the age of 10. In Kerrville, Fierst found his niche in high school on the football and soccer field.

Upon graduation, Fierst and a group of his closest friends attended Blinn Community College in Bryan, Texas.

While at Blinn he obtained an associate degree in humanities and then decided to pursue his bachelor’s degree in nursing at Texas State University.

This same passion and heart to help the community and people around him is what has caused Fierst to find success in the nursing field, gain respect from his peers and experience the recent trip to Nicaragua.

“I chose nursing because I like to help people,” Fierst said. “I figured this was the best way to go about it.”

Fierst’s passion for the people around him caught the attention of his classmates.

“I think Dalton has one of the biggest hearts and he loves to make people feel good about themselves,” Fierst’s close friend and roommate, Caitlin Ortiz said. “Especially when they are feeling sad, he loves to make them feel better. I think as a nurse that will be good for him because nursing is all about caring.”

Ortiz said Fierst’s demeanor helps make patients immediately feel comfortable opening up to him.

Fierst gathers medical information for residents in the San Francisco community to better prepare for the free clinic that followed. Photo by: Amanda Gibson

“I think that’s a great strength for nursing because the patients have to trust you,” Ortiz said. “In awkward situations, like when you ask about their last bowel movement or what their pee smells like, if they are more comfortable with the nurse, patients are more likely to tell the truth and get the help that is needed.”

After the first few days in Nicaragua, Fierst knew this trip was where he was supposed to spend his winter break, despite being the only guy on a trip with nearly 40 girls.

“It takes a lot of courage to go against the grain,” Dr. Adriana Hernandez, a dentist and ISL team leader, said. “It’s hard to be different than what society expects.”

Many people may have let stereotypes of the industry and negative connotations toward male nurses slow them down, but Fierst has only allowed this to push him toward further success in the industry.

Community health was the course the nurses were enrolled in for the trip. It is a course that challenges them to go into an unknown community, evaluate the health conditions and then assess and diagnose patients who attended the weekly clinics.

The 28 nursing students split into two groups and each group went into designated communities. They visited families in their houses in order to gather a medical census of the surrounding area and invite them to the clinics.

Residents attended these clinics to acquire medicine for their different illnesses ranging from allergies all the way to a possible case of osteosarcoma-a type of cancer that starts in the bones.

Fierst was the nursing student who spotted this potential case.

He felt what he thought might be growths similar to osteosarcoma on the foot of a young girl. Fierst’s persistence to make sure the doctor made intentional notice of the growths he found led to a referral for the patient to see a specialist.

Regardless of the final diagnosis, Fierst remained humble and viewed this patient the same as all the others he had seen that day, but his care caught the attention of one of his peers.

Fierst takes the vitals of a patient who attended the free clinic. Photo by: Amanda Gibson

“I don’t know what textbook he was reading but it definitely wasn’t the one I was,” Sydney Stilwell said. “I would say he got the diagnosis right 99 percent of the time.”

When talking with other nurses in the same clinics as Fierst, all of his peers had a similar review: he was an intelligent nurse too humble to see his own strengths.

“We need less sass and more of Dalton in nursing,” Stilwell said.

Helping to Bring Life

“In labor and deliver

By: Elisha Colip

A mom, wife, student, friend, painter, nurse, and chairman for Paws for a Cause are just a few of the hats that Sarah Lohmeyer, 35, wears on a daily basis. Lohmeyer isn’t your typical nursing student at St. David’s School of Nursing at Texas State University.

Lohmeyer didn’t always know what she wanted to do, but after years of trying different things, being a corrections officer and a personal trainer, she finally decided that she wanted to help people through nursing.

In January, she got the opportunity to go to Nicaragua in participate in clinics at local communities. Lohmeyer originally was interested in oncology nursing due to her grandmother’s death from cantaloupe-sized brain tumor when she was 15.

“That pretty much rocked my world because I saw her suffer for a year and a half,” Lohmeyer said. “I felt like there had to be something more that could have been done with her. She was misdiagnosed with an ear infection. She complained of earaches for months and they just kept prescribing ear drops and we just kept thinking there has to be something else.”

Her grandmother was finally convinced to go to another doctor after months of pain. They found the large tumor in her brain, they operated, but the tumor to grew back. Her grandmother’s story really inspired Lohmeyer to become the kind of nurse she is.

“We are all human and we all make mistakes,” Lohmeyer said. “There is more you can do to not just assume, but to ask more questions, get more evidence and try to find out what is really going on instead of just letting them be a number. Just to focus on the person not the symptoms.”

After her grandmother’s death, Lohmeyer said she quit going to church. In her mid-20s she started going to a non-denominational church. This church is where she met her future husband, Steve. When they met, they were dating others but a few months later they had their first date.

“We went to a Greek restaurant in South Austin for a casual dinner and then we went and bought two forties,” Lohmeyer said. “We went down to the lake and sat and talked for while.”

They got married in September of 2007. Only four weeks after getting married, Steve was deployed to Iraq for 10 months.

“It was hard for me because I always told myself I never wanted to be married to someone who has to leave and be gone so it was really difficult,” Lohmeyer said.“It helped me become my own person as a wife and just be able to take care of a household.”

Lohmeyer takes a census of the San Francisco de Nindiri in Managua Nicaragua. Photo By: Elisha Colip

Before her husband left for Iraq they decided that at the same time, from across the world, they would pray Psalm 91 together. While everyone interprets things a little differently, Lohmeyer interprets it, as no matter what falls around you, even if everything does, you will live.

While on her trip to Nicaragua she was drawn to a painting in someone’s homes.

“I didn’t know what it said because it was in Spanish and then at the bottom it said Psalm 91,” Lohmeyer said. “I literally had goose bumps all over because it reminded me of the time he left and I’m away from him again and it was just a little sign or something. It was really neat.”

After a couple years of marriage, Lohmeyer became a mother to her first-born Grace Lois Lohmeyer, who is now four and a half, and later Allison Naomi Lohmeyer, who is 18 months. Grace Lois was named after Sarah’s grandmother, Grace, who passed away from the brain tumor and Steve’s grandmother Lois.

Lohmeyer has become more interested in labor and delivery nursing because of her good experience when giving birth to her daughters.

“She came to nursing school with the idea to be a Labor and delivery nurse,” Elizabeth Biggan, assistant clinical professor at St. David’s School of Nursing, said about Lohmeyer. “This is her goal, her dream, her everything all the way through and you can see it in labor and delivery. She will skip lunch, she will do whatever she needs to do to be there with that mom and help her with delivery. So yeah I think she is really driven to be a labor and delivery nurse.”

Lohmeyer asses a young patient at a clinic during her trip to Nicaragua. Photo By: Elisha Colip

Lohmeyer was chosen for Labor and Delivery at St. David’s Hospital in Georgetown for her capstone clinical rotation and where she delivered both of her children, St. David’s Hospital in Austin.

She said that when she first started nursing school the hardest challenges for her were letting go of things she can’t control and finding balance between her school and family lives.

Only a couple months after applying, she found out she was pregnant with her second daughter Allison.

“It is ok if I make a B because the difference for me is time with my family. I chose to spend more time with my family,” Lohmeyer said.

A friend of Lohmeyer from the nursing school, Anastasia Houze reflects on a time they were orienting for a job. A questioner asked them what they would do if they had extra money from a bonus.

“She said she would give it to people in need and I think that really sums up what she is all about,” Houze said. “She truly wants to help people and really wants to make a difference in people’s lives. That shows in her work, in her friendships, and in her relationships… We all go through rough times and she is always working to be a better person to serve others.”

Her time in Nicaragua doing clinics a very humbling experience for Lohmeyer and she hopes to medically help and educate people in Uganda in the future.

“You have known them for three days and you can’t communicate but when you have to say goodbye it is the hardest thing to do,” Lohmeyer said. “They come up to you and remember you and give you hugs.”


Lohmeyer helped to pain an orphanage wall in Nicaragua. When the paintbrushes couldn’t get in the tight spots she resorted to fingerprinting the wave. Photo by: Elisha Colip


A Call To Action: Perseverance

For the past five years the St. David’s School of Nursing at Texas State University has sent a team of senior students to volunteer holding clinics in communities in Nicaragua. One of the students this year, Emily Asa, was heavily impacted by her time in Nicaragua.



Asa is 25 years old and from the city of Granbury, Texas, where she grew up with her parents and older brother.

It was as a young child that she first knew she would work in the medical field. Her dad was diagnosed 50 years ago with type-1 diabetes. One huge influence on her life and career has been her father.

“He’s really shown me the definition of perseverance,” Asa said.

He was told that he wouldn’t live to see his twenties, thirties, and every decade since. When she was younger, her dad would often go into diabetic shock and she would be the only one to get through to him.

“There were many nights I would wake up and check on him and he would be having an episode and I’d help him come to. It was like God was telling me he needed me.”

After a troubled past in her teenage years, Asa was court-ordered to spend time in a positive after-school program of her choice. Asa took the opportunity to join a church. It was then that she became the woman her colleagues know. She learned about forgiveness and she said she hopes to be the positive light in other’s lives that she has found through God.

Asa has a passion for working with children, specifically babies.

When she began studying medicine she found an interest in critical care and decided she would like to work in in the Neonatal Intensive Care Unit (NICU). Asa spent much of her free time in Nicaragua playing with the children in the communities.


Asa completed her nursing prerequisites at Austin Community College and then applied to the nursing program at Texas State. She was placed on a wait list and due to the course sequence of the program, had to wait a calendar year to re-apply.

The next year, she was not only accepted into the program, but also awarded Texas State’s Terry Scholarship- a prestigious award given to assist Texas high school students who have excelled in the areas of academics, service and leadership.

Asa is considered one of the top students in the program. She currently holds the office position of secretary of her class.

“She is supportive and helpful without being intrusive. If her peers need help, they know she is there,” said Beth Biggan, clinical assistant professor at St. David’s Nursing School. Biggan has worked with Asa on projects such as Faith In Action outside of school, where they donated several boxes of medical equipment.

Asa attributes her success in school to her devotion to mental health.

After her first semester, she found herself facing anxiety and set a strict schedule that keeps her balanced. She has set aside time for mental relaxation, personal time, and even a curfew to counteract late-night studying.

“She is super organized and stays after class to study right after (learning) the material, which is what we always strive to do. None of us do it, but she does,” said Marina Hendrix, colleague who will intern with Asa this spring at St. David’s Women Center of Texas in the NICU. “I think she is very strong-willed and puts in all the work that’s required to become a good nurse. When we graduate, she will have earned her degree.”