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PAGE 11 November 2020 PAGE 9 November 2020 Amber Hendrix is a nurse practitioner for Health Care Collaborative (HCC) of Rural Missouri and its Live Well Community Health Centers. She is dedicated to patient advocacy after having her own critical patient experience. Hendrix spent her childhood in Alabama but moved as a teenager to meet her birth mom living in Missouri, where she also met her husband. Despite dreams of being a hostage negotiator when she was younger, her husband was not as enthused, and she ventured into physical and occupational therapy. In 2010, Hendrix was involved in a nearly fatal car accident which left her in a critical mental health state as well as unsure if she would walk again. The experience of being a patient through an emergency room experience, lengthy recovery process, and reconstructive surgery led Hendrix to decide she wanted to be a nurturing role for others in a similar state. She returned to nursing school and eventually transitioned into intensive care unit and emergency room work – an ambitious decision as most nurses typically choose one or the other. "I've always been a people person," Hendrix said of her career riddled with customer service positions, restaurant jobs, and her history of advocating for patients. When patients are in critical situations, they rely on their health care providers, education, and communication about what's happening, as well as mutual trust. Hendrix stresses the importance of helping patients understand what's wrong, what's being done, what that means, and what the recovery process looks like. In a year of uncertainty even for health care professionals, Hendrix's dedication to advocacy and education was tested as the COVID-19 virus broke out. "It was a roller coaster in the beginning, it was not something we could have ever predicted," Hendrix recalls about the lack of knowledge surrounding the first few weeks of the pandemic. "I went in to see my first two patients and by the time I saw my next two patients, the guidelines had changed." Hendrix applauded HCC and Live Well's role to educate the community, provide free testing, and other health care support during this pandemic. After she contracted the virus, Hendrix noted the disease's inconsistencies. There were differences between her experience with COVID- 19, a horrible bout of illness and severe pain, and her husband's experience, which felt more like a strong cold. Because there is so many unknowns about the after-effects of COVID-19, Hendrix stresses the importance of continuing to test those who have been exposed as well as tracking changes in symptoms, physical health, and antibody counts -- even after recovering. "The more we test, the more we are able to learn about the evolution of the virus and learn about symptoms and treatment." Esteban Saenz is an RN who shares Hendrix's dedication to patient advocacy, specifically in regard to the intercultural and communication barriers present in rural health care. Saenz grew up in south Texas with migrant farm workers in the family, including his sister's husband who went on to join the U.S. Armed Forces. "He's the success story I want to see for everyone," Saenz said about his brother-in-law and his process of becoming a citizen, allowing him access to health care and other luxuries not all countries have. While pursuing liberal arts in his undergraduate years, he learned about the intercultural barriers that go beyond language. Even a perfectly translated joke, for example, may not be understood, as humor is influenced by cultural factors beyond the language itself. After a lack of available earth science courses led him to a human anatomy course, Saenz shifted his focus to health care. "I said, well I'm going to give this a shot, I either make it or I don't – and I loved it. I fell in love with it. I felt at home there." Saenz transitioned to nursing school at Oklahoma Wesleyan University, keeping in mind the prevalence of intercultural barriers within health care. When he moved to Missouri and especially when he joined the staff at HCC, he saw the opportunity to use his own migrant farm work and mission work experiences to help others. "Through HCC I found an avenue to really be a more contributing member to society." In his mission trips to Mexico, he learned the biggest barrier to helping those who need it is communication. In his experience, people have had to wait weeks or months to even be seen for health issues, in stark contrast to the health care they receive as citizens in the US. "They don't know how to ask for things, they don't know where to go," Saenz explains. Amid COVID-19, one of the biggest problems with these communication barriers is the fear factor, according to Saenz. He said people are afraid of the virus and even wondered what would happen if they went outside. To break down these barriers, Saenz strongly supports having bilingual or multilingual staff members. As a multilingual RN, Saenz offers translations and explanations of medical jargon to patients as well as doctor's recommendations to ensure the patient understands what they are experiencing and can confidently make decisions in their own best interest. He has seen patients speak many languages, not just English, and recognizes that having knowledge of multiple languages allows more opportunities to find commonality between staff and patients. Saenz also stresses supporting Teaching English as a Second Language (TSEL) programs for immigrants, especially for children, citing the overwhelming nature of being in grade school and suddenly being expected to speak another language with none of your native tongue involved. "There were a lot of wet pants that day," Saenz recalls of his own experience. "It sounds funny, but the kids didn't know where the bathrooms were." Exposure to other cultures is also a way to begin breaking down intercultural barriers. If you've ever traveled internationally, Saenz explains, you've experienced how jarring it is having to navigate a country where you don't speak the language and can't read signs. Imagine the difficulty people face when they come to America to work or live permanently and have to establish their families in schools and businesses and health care, with no real guide. Saenz hopes to continue as a guide for others as well as encourage more blended culture and communication throughout the community and country. Hendrix and Saenz are located at Live Well Community Health Center – Lexington. To schedule a visit, call 660.651.6440, or visit LiveWellCenters.org.