PROVI DI NG EARTH-BASED CARE TO UNDERSERVED COMMUNI TI ES
Lorna Mauney-Brodek, Herbal i st a www. HERBALI STA. org 2013
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Version 01.31.14 $ ***WELCOME to The HERB BUS***
Earth-based care for underserved communities.
The Herbal i sta Free Cl i ni c, travelling by Herb Bus, provides free clinical care, a spot of tea, and herbal education to underserved communities. Currently hubbed in the Atlanta area, this mobile herb clinic offers both basic first aid treatment and long-term tonic therapy, based on a constitutional and energetic approach. We treat the patient, not the disease. The driver, Herbalista Lorna Mauney-Brodek, was raised Americana and practices a blend of Western Herbalism, Chinese 5 Phase, Ayurveda, southern folk and kitchen medicine in a clinical setting.
The Bus Servi ce Manual is a glimpse into how this clinic is currently organized and serves as the training curriculum for volunteers. Establishing some basic protocols provides us with a sense of stability and calm, vital touchstones when serving in the delicate and often unpredictable sphere of health care. The following pages contain information regarding how we set-up and service a station, how we stock and maintain the apothecary, examples of forms we use to track patient care and inventory, and much more. It is lovingly a work in progress, and as the Herb Bus meets more people and plants, serving communities across this country, we evolve our practices and will update this manual accordingly.
This project is the result of community effort and vision. Thanks to everyone who supported us herbally, inspirationally, creatively, organizationally, economically, mechanically, and all the rest! And with a special thanks to my Herb Bus Crew: Todd Cain, Corinne Lee, and Amanda Robinson. VIVA LA HERB BUS! Herbalista Lorna
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***TABLE OF CONTENTS***
Welcome to the Herb Bus 3 Bus Crew 5 Bus Schedule 6 Station Set-up 7 Safety & Sanitation 8 Flow 9 Apotheke 10 Intake Process 11 Forms 12 Log-In Form 12 Initial Intake Form 13 Follow Up Form 15 Dispensary List 17 Supplies Checklist 18 Tincture Chests and Run Kit 19 General Bins 21 Dry Herb Chest 22 Pills & Potions Case 23 Wound Care Kit 24 Resource Library 25 Support the Herb Bus 26 Herb Bus Wish List 27
Version 01.31.14 & *** BUS CREW***
Stati on Host / TeaMaster Herbal i sta(s)/HerbMedi c(s) Apotheker
Stati on Host / TeaMaster Holds it down. The station host helps to build the bridge between clinic and station. It is helpful if the station host lives or works at the station. They must have an intimate understanding of the ecology of the station and the community to be served there. They are responsible for securing physical amenities such as power hookup and restroom access, as well as assuring the comfort of both patients and Herb Bus Crew. The station host serves as reception, spreading the health with tea and peace, and keeps track of patient appointments. Station hosts must be prepared to handle difficulties as they arise in an efficient and compassionate way.
Herbal i sta(s) / HerbMedi c(s) The Herbalista conducts intakes and makes health recommendations. They must have an intimate knowledge of the herbs and other medicaments stocked in the Herb Bus. They formulate remedies, respectful of the individual needs of the patients.
Apotheker(s) The Apotheker is in charge of the dispensary which is located inside the bus. They set up and break down the apotheke with each clinic. They are responsible for filling the scripts, labeling and dispensing herbal remedies to patients, providing them with proper instruction on the hows and whens of taking their remedies. The Apotheker also handles refills. Record keeping is of utmost importance, following good labeling practices and inventory maintenance. We usually have two apothekers working during clinic. The Lead Apotheker sits at the tincture / oil / powder station. The Apotheker in training writes labels, tracks items dispensed and mixes tea blend formulas.
Version 01.31.14 ' ***TYPI CAL BUS SCHEDULE***
12:00 DOCKING 12:00-12:30 STATION SET-UP & BREW DAILY TEA 12:30 4:30 CLINICAL SERVICES 4:30 5:00 CLINIC BREAK DOWN
There are different set-ups and timings involved depending on the type of clinic being offered. The schedule above reflects a standard stop at a regularly serviced station. Station set-up takes a bit longer in inclement weather, but it averages around 20 minutes or so.
We have found that in the span of 4 hours we usually see between 6 to 10 patients, depending on the number of new patients (45 min each) versus follow-up visits (30 min each).
Version 01.31.14 ( ***STATI ON SET-UP***
DOCKI NG THE BUS Sufficient Space for our set-up Weather considerations (do we need extra tarpage) Power (extension chords, power strips) Restroom access
CLI NI C MAI N (si de tent on bus) Table (1) and Chairs (2-4) Herb Bus Clinic Binder Reference Materials Pulse Pillow Forms--New Patient & Follow-up Pens Script Pad Gloves / Sanitizer / Masks Tissues Trash Can
APOTHEKE (i n Van) Arranged by Apotheker See attached supplies lists
WAI TI NG ROOM (10x10 tent - i ncl ement weather) Seats Blankets (winter) TEA STATI ON Sign with Daily Tea Percolator Seasonal tea blend Cups Tray
WASH STATI ON (as requi red) Hand Sanitizer / Povidine Iodine Scrub Foot Siphon Pump Hand Wash Station Ethanol Spritz Paper Towels / Hand Towel Dish towel Rack Trash bag
Version 01.31.14 ) ***SAFETY & SANI TATI ON***
ALWAYS CONSI DER BOTH THE PATI ENT AND PRACTI ONER
STANDARD GLOVE PRACTI CE (as requi red) Change gloves between every patient. Do not touch clean supplies with dirty gloves. Either change gloves before handling supplies or touching common surfaces, ask someone with clean hands to assist, or remove gloves and wash hands. Wash hands after glove removal.
SAFE REMOVAL OF CONTAMI NATED GLOVE Pinch one glove with your fingers from the outside. Pull the glove off, turning the inside of the glove outwards. To avoid contamination of your environment, hold the removed glove in your still gloved hand. Slide your finger from your glove free hand under the remaining glove. Pull the glove outwards and towards your finger tips. As you do this, the first glove will be encased in the second glove. The inside of the second glove will also be turned outwards. Grab the gloves firmly, by the uncontaminated surface (the inside of the glove that was originally touching your hand). Dispose of the gloves properly.
MASK / EYE PROTECTI ON (GOGGLES) Wear as needed to protect lungs and eyes. Wipe goggles thoroughly with alcohol swabs after use.
HAND WASH STATI ON Thoroughly cleanse hands between patients or additionally as needed. Wash for at least 20 seconds (Happy Birthday song 2xs).
WASTE Properly label and dispose of all waste. Dispose of blades in sharps container.
Version 01.31.14 * ***CHOOSI NG A STATI ON***
While this might seem a minor point, it is the lynchpin for running a successful clinic, especially when working on the peripheries. The station becomes the rock upon which we can run a clinic, providing a sense of security both the crew and patients.
The advantage of a mobile clinic is that you can go to where the patients are. Select a station that is already a lynchpin for the community you wish to servea community center, a homeless shelter, a cooperative housing compound, etc.
Considerations: Are there restroom facilities for practitioners and patients? Is there a power outlet to plug in the bus? Is there a large parking lot or open space to accommodate our set-up? Is there a person who can serve as station host?
Station Respect: Respect the systems already in place at each community station. The community determines the patient list. The community will have specific guidelines for access to restroom facilities that must be respected. The station host serves as the bridge between crew and station and has the responsibility of bringing the crew up to speed on that particular communities needs.
GENERATI NG THE PATI ENT LI ST We have found it easiest to allow the station/community handle generating their own patient list. We agree on a schedule (say 2pm-6pm) and then let them know how many folks we can handle in that length of time. Ti mi ngs for Ful l Work-up-- Consti tuti onal / Toni c Therapy Consul ts Initial 45 minutes Follow-up 20-30 minutes Refills 10 minutes (Apotheker handles these) Ti mi ngs for Basi c Fi rst Ai d Walk in / Variable
Version 01.31.14 !+ ***APOTHEKE***
Apotheke [German] Pharmacy Apotheker [German] One who stores, compounds, and dispenses medicaments.
Why do we use these words throughout the Herb Bus Service Manual? 1. Apotheke is simply a lovely word. 2. The VW Herb Bus and her driver Lorna are both of German heritage. Volkswagen means car of the people in German. Herbalista Lorna is the great- granddaughter of Willi Victor Wiesenthal, a German apotheker from Stargart in Pommern. Back in those days, they worked with herbs too! Its nice to carry on a family tradition. 3. The word apothecary is regulated by the state of Georgia and has been coopted by the pharmaceutical industry.
The apotheke is maintained inside a 1990 VW Westfalia Camper van. The electricity, tables, counters, and kitchen allows us to prepare and compound remedies as required for our patients. We make almost all of our remedies with the utmost care and respect, utilizing organic or ethically wildcrafted herbs and other ingredients.
The Apotheker compounds, packages, and thoroughly labels all remedies according to the script written by the HerbMedic. This script is stapled to the patient form and kept in the file for future reference.
All herbs and remedies dispensed are entered on the Di spensary Form (see page 17) to track inventory, to help us understand cost, and as reference to make sure we always come as well stocked as possible when visiting different communities.
REFI LLS The first time a patient returns for a follow-up, they must meet with the HerbMedic for a review before a refill is dispensed. After that, if no follow-up is requested, the refill request is logged in on the refill list, dispensed by Apotheker (with HerbMedic review as necessary) Version 01.31.14 !! *** FULL I NTAKE PROCESS***
NAME / I NFORMED CONSENT / SI GNATURE
SPECI AL CONSI DERATI ONS Pregnant / Breast Feeding Can they take remedies made in ALC? Allergies (food, herbs, drugs, pets, seasonal, etc) Prev. Diagnosis
CURRENT MEDS/HERBS Product and Dose CONTRAS Common Side Effects Vit/Min Depletions
MAI N COMPLAI NT Why have they come to see us today? Do your final recommendations address their request for assistance?
REVI EW OF SYSTEMS / BODY BALANCE Relevant Medical History Diet / Digestion Sleep Elimination Exercise Systems Review
STRESS / RELAXATI ON How does stress effect them (whats the weak link?) How do they relax?
PULSE & TONGUE EXAMI NATI ON
ASSESSMENT Make an overall assessment before jumping to herbs.
PLAN Create a plan that is effective and practical. Can they do what you are asking?
FORMULATE & DI SPENSE Write formula (including parts and dosage) on script pad for Apotheker Clearly label all herbs dispensed Staple script to intake form for files.
PATI ENT EDUCATI ON Explain all remedies and recommendations. Provide handouts as necessary. Version 01.31.14 !# ***FORMS***
FI RST AI D LOG SHEET (BASI C I NTAKE & CONSENT) This is intake stripped down to its most basic necessities and also provides a place to indicate issue and remedy dispensed. We use this form when providing basic first aid at a walk-in clinical setting. N A M E I n i t i a l
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F U P R E G
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B F A G E M E D S S I G N
X A l c :
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N N A M E I n i t i a l
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B F A G E M E D S S I G
X A l c :
Y
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N N A M E I n i t i a l
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B F A G E M E D S S I G
X A l c :
Y
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N N A M E I n i t i a l
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F U P R E G
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B F A G E M E D S S I G
X A l c :
Y
/
N N A M E I n i t i a l
/
F U P R E G
/
B F A G E M E D S S I G
X A l c :
Y
/
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h e a l t h . A L L E R G I E S I S S U E R E M E D Y A L L E R G I E S I S S U E R E M E D Y A L L E R G I E S I S S U E R E M E D Y Version 01.31.14 !$ FULL CONSULT (I NI TI AL I NTAKE & CONSENT) This is the form used for an initial consultation at the Herb Bus. (2 pages) *** HERBALI STA FREE CLI NI C I NTAKE *** NAME Contact Clinician(s) Station By signing below, I understand the staff of this center are not licensed medical doctors and do not diagnose or prescribe. I understand that the herbs and other recommendations I receive are traditionally considered safe. I assume all responsibility for decisions I make regarding my health.
Sig X DATE DOB AGE Weight Height Pregnant / BF Initial / FollowUp ALC Yes/No Immuno Compromised Main Complaint
Allergies
Prev. Diag
Meds / Herbs (Product, Dose, CONTRAS, Common Side Effects, HERBS TO AVOID)
Doctor HEALTH HISTORY (Birth/BF/Surg/Hosp/Trauma/Family)
Version 01.31.14 !% UTERI NE Cycle length Bleed length Birth Control QUALI TY Hysterectomy STDs Vag dry/night sweats/cysts/H2O retention/headaches/clots/fibroids/ tumors/ InterCyst/PID/ EMOTI ONS DI SCHARGE CRAMPS Other
MEN Prostate/Libido/Etc.
SYSTEMS (skel /j oi nts/gums/teeth/ENT/eyes/ski n/uri nary/respi ratory/thyroi d/etc)
PULSE SPEED: Fast/Slow LOCATI ON: Surface/Deep FORCE: Strong/Weak COLD (tight and slow, side-to-side) WI ND (floating-ext /changing-int) DAMP (slippery, cotton, moist skin) HEAT & FI RE (surging, urgent, rapid) SUMMER HEAT (floating, rapid, slip) HARDNESS = Yin deficiency (Wirey) R DI GESTI VE(aquired/vitality--diet & ex) L ENDO (const./essence--needs rest) D Lung D Heart M Stomach M Liver P Bladder P Kidney BONES Thin/Broad TI SSUE Watery / Fleshy / Sinewy / Boney HANDS warm/cool/moist/dry NAI LS: VOI CE Timid / Loud / Chatty COMPLEXI ON EYES Puffy / Yellow / Red / Dark Circles TONGUE: body color: coat: shape: moisture: underneath: movement: OTHER
ASSESSMENT
PLAN
Version 01.31.14 !& FULL CONSULT (FOLLOW-UP I NTAKE & CONSENT) This is the form used for follow-up consultations at the Herb Bus. (2 pages) Herbalista Free Clinic Follow Up 1 HERBALISTA FREE CLINIC FOLLOW UP
NAME Contact Clinician(s) Station By signing below, I understand the staff of this center are not licensed medical doctors and do not diagnose or prescribe. I understand that the herbs and other recommendations I receive are traditionally considered safe. I assume all responsibility for decisions I make regarding my health.
Sig X Date
Version 01.31.14 !'
Herbalista Free Clinic Follow Up 2 VIT/QI BL/YIN
PULSE SPEED: Fast/Slow LOCATI ON: Surface/Deep FORCE: Strong/Weak COLD (tight and slow, side-to-side) WI ND (floating-ext /changing-int) DAMP (slippery, cotton, moist skin) HEAT & FI RE (surging, urgent, rapid) SUMMER HEAT (floating, rapid, slip) HARDNESS = Yin deficiency (Wirey) R DI GESTI VE(aquired/vitality--diet & ex) L ENDO (const./essence--needs rest) D Lung D Heart M Stomach M Liver P Bladder P Kidney BONES Thin/Broad TI SSUE Watery / Fleshy / Sinewy / Boney HANDS warm/cool/moist/dry NAI LS: VOI CE Timid / Loud / Chatty COMPLEXI ON EYES Puffy / Yellow / Red / Dark Circles TONGUE: body color: coat: shape: moisture: underneath: movement: OTHER
TRACKI NG CRI TERI A
ASSESSMENT
PLAN
Version 01.31.14 !( DI SPENSARY FORM This is the form used by our apothekers to keep track of the remedies dispensed at a particular clinic. This is extremely helpful in determining the cost of a clinic, and is consulted when organizing the kits for a return visit, to make sure we have packed all remedies needed for that particular community. The Wish List is where we jot notes for items we wish we had on the bus, so we can bring them with us the next time.
www. HERBALI STA. org HERBALISTA FREE CLINIC DISPENSARY LIST STATION_________________________DATE______________
CAP, RAW TINCT, GLY POW ETC PRODUCT AMOUNT(S) TOTAL
WISH LIST TOTALS
Product Uni ts Uni t $ Total
Tinctures
Raw
Pills
Other CONTAINERS 4oz 1oz 2oz 1/2oz Sniffers Pill Jar Other
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***SUPPLI ES CHECKLI ST***
HERB BUS STATION SUPPLY LIST Supply checklists for Clinic Supplies and Bins. Providing earth-based care to underserved communites. This list is lovingly a work in progress. LORNA MAUNEY-BRODEK www.HERBALISTA.org 2013 FREE CLINIC HERBALI STA Version 01.31.14 !* ***TI NCTURE KI TS***
These diagrams show the basic contents of our tincture kits. The run bag (pictured at left) holds one ounce bottles and serves mostly in first aid situations, as it is well padded and fits in my backpack.
The two chests hold the remedies we typically work from on the bus. One chest (on right) holds 64-2 oz simples and the other (in middle) holds 20-4 oz simples and 5-2 oz. combinations. It is important to keep track of the amounts dispensed of each remedy so you can no which you need to have in a 4 ounce bottle and which you may only need 2 ounces of.
*Most remedies are prepared in alcohol. If a remedy is non-alcoholic, we shade the box light green*
HERBALISTA FREE CLINIC WOUND CARE KIT Ace Bandages Activated Charcoal Alcohol Swabs Fabric Bandaids Finger / Knuckle Assorted Sizes Benzoin Spray Cotton Balls Dosage Cups Ear Bulb Essential Oils: Tea Tree Lavendar Eye Cup Gauze Pads: sterile and non 4x4/3x3/2x2 Gloves (S,M,L) Hand Sanitizer Honey Ice Pak Irrigation Syringe Linament - Arnica Masks Neti Pot Povidone Scrub Saline Salve Goldenseal/Calendula Muscle Rub/Tiger Sam Splint Second Skin Sharpie Soap Styptic Powder SurgiTube (fingers/toes) Q-Tips Tampons/Pads Tape: Medipore Durapore Tinctures: Calendula Goldenseal Turmeric Traumeel Triangular Bandage Tools Clippers / Nippers Curette / Files Scalpel / Blades Scissors Tweezers Vet Wrap (Assorted) Xeroform Yunnan Baiyao Powder Zinc Oxide Cream Version 01.31.14 #& ***RESOURCE LI BRARY BI N***
Pati ent Fi l es (Each stati on has i ts own fol der) A-Z Gui de to Drug-Herb-Vi tami n I nteracti ons Adaptogens: Herbs for Strength Stami na and Stress Rel i ef by David Winston Chi nese Medi cal Herbol ogy & Pharmacol ogy by John Chen The Herb Bus Servi ce Manual Herb Drug I nteracti ons by Francis Brinker Merk Manual of Medi cal I nformati on (Home Edition) Hel pi ng Oursel ves: A Gui de to Tradi ti onal Chi nese Food Energeti cs by Daverick Leggett SWSBM I ndi cati ons / Materi a Medi ca Manual s by Michael Moore TCM Di agnosi s Study Gui de by Qiao Yi The Yoga of Herbs: An Ayurvedi c Gui de to Herbal Medi ci ne by Lad and Frawley Vari ous Cri b Sheets Pregnancy Contras Breast Feeding Contras Pre-Op/Post-Op Concerns Interations / Depletions / Contraindications Pathology Cribs
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Earth-Based Care for Underserved Communities www. HERBBUS. org SUPPORT THE HERB BUS Please consider making a tax-deductible donation to support this greatly needed health resource. It is only through your support that we can continue to provide these services. Contributions of every amount will be deeply appreciated and carefully used. Donations can be made via check or PayPal.
Checks: Payable to Baraka Foundation (Please write Herb Bus on the memo line) c/o Lorna Mauney-Brodek PO Box 17967 Atlanta, GA 30316 Version 01.31.14 #( www.HERBALISTA.org HERBALI STA FREE CLI NI C APOTHECARY WISH LIST
Thank you for considering donating herbal supplies to our clinic. We are a traveling botanical clinic and classroom, providing earth-based care to the homeless and other underserved populations in Atlanta and around the country. We compound and dispense free herbal remedies for our patients. Your support will help sustain our efforts and hopefully to expand our offerings.
Below is a list of items we are either currently low on or dispense at a high rate. We care deeply about the health of our patients, so please, only send well-cared for medicaments as specified below, paying special attention to proper labeling. If you have any questions and for shipping information, please contact Lorna at Lorna@Herbalista.org. Viva la Herb Bus!
TI NCTURES Al l ti ncture l abel s MUST i ncl ude the fol l owi ng: Botanical name / Date / Part Used / Fresh or Dry / Lot # / Contact info Menstruum description - % and type of alcohol/glycerin/ACV used (i.e. 60% organic cane alcohol) American Ginseng Panax quinquefolius Astragalus Astragalus membranaceus Black Cohosh Actea racemosa Damiana Turnera diffusa Dong Quai Angelica sinensis Echinacea E. angustifolia, E. purpurea, etc Ginger Zingiber officinale Hawthorn Berry Crataegus spp. Lemon Balm Melissa officinalis Kava Kava Piper methysticum Milky Oats Avena sativa** Mimosa Flower & Bark Albizzia julibrissins Motherwort Leonurus cardiac Pedicularis Pedicularis spp. Reishi Ganoderma lucidum Rose Rosa spp Skullcap Scutellaria incana, S. lateriflora, etc Tulsi Ocimum tenuiflorum Valerian Valeriana officinalis DRY HERBS Pl ease l abel wi th the fol l owi ng i nformati on: Botanical Name / Plant Part / Date harvested / Source (organic / ethically wildcrafted, place of origin)
APOTHECARY SUPPLI ES !, 1, 2, & 4 oz amber bottles Quart & ! gallon ziplock Vegetable Glycerine CAPSULES CranStat Extra by Vitanica Milk Thistle Capsules by Eclectic Institute Cough Drops Super Quercitin by Bluebonnet Vitamin C OI LS Lavender Essential Oil Tea Tree Essentail Oil Olbas Oil Blend St. Johns Wort Infused Oil Arnica Infused Oil
Native American Herbal Apothecary: Learn From Native American Herbal Remedies How to Treat any Illness and Stock your Herbal Pantry (2022 Guide for Beginners)