BY: FLORENCE FOLAMI, RN, and J. SUZIE COUCH, RN
Ms. Folami is a prenatal educator specialist and lactation consultant at St. Mary's Hospital, and an instructor of nursing at Millikin University, both in Decatur, Ill., and Ms. Couch is a nurse educator at St. Mary' s Hospital.
An extended trip to a foreign country provides a holistic and integrated understanding of an individual's view of the world.
Sixteen nurses from China Medical University (CMU) in Taiwan recently underwent such an experience in July 2007. The group traveled to Decatur, Ill., for three weeks of education and cultural exchange at St. Mary's Hospital (www.stmarys-hospital.com).
The Taiwanese nurses compared cultural dimensions of the United States to China. They gained a heightened sensitivity to diverse points of view within a global society. They learned how health is viewed in America as part of fundamental basic need, and how St. Mary's Hospital believes that everyone is entitled to affordable basic health services. The nurses were surprised with the standard of care at the hospital and the idea of the Prenatal Clinic, which is available to provide access to basic prenatal care for everyone, especially at-risk populations. They watched the American nurses working together to create healthy working environments.
The global health nursing care experience for the Taiwanese nurses was focused on encounters that differ from previous ones. They visited another part of the world and learned about its history and people, studied the educational system, became aware of the economic issues, and studied patterns of health and illness. The nurses explored nursing care within a different context and learned how to cook and eat America food. They also explored historical sites in Springfield, Ill., including the Abraham Lincoln Museum and the Old Capitol Building.
At the hospital, preceptors and nurses worked together as they compared cultural and social structures in the United States and Taiwan. The Taiwanese nurses worked collaboratively with their preceptors at St. Mary's and they saw themselves as an integral part of a more global networked. They worked together to perform accurate and thorough physical assessments on their patients, and evaluated client outcomes and revised the plan of care as appropriate. The nurses also identified the components of an American diet and its effects on health. They also described some of the major issues in Taiwanese nutrition (like cultural aspects of eating, food security and food safety) and the Taiwan perception of foods for healing, which is the prescription of certain foods for healing based on their energy essences or energy signatures, and not for nutritional value.
This is the first time the CMU School of Nursing developed the cooperative relationship with other countries. The nurses made meaningful personal and professional connections through classroom, community and clinical learning experiences. They reflect meaningfully on relationship-building skills and success in working with people and environments that are different from their own. The nurses were able to gain substantive understanding of how the diversity of the world affects their everyday lives in the United States. One of the nurses from Taiwan stated that "in the United States, the medical ethics focuses on advanced technology while in Taiwan it is about no options, about lack of access to just the basics." The nurses identified the importance of nursing communities working together internationally. They believed this will have a tremendous impact on human health and create a healthier environment for everyone.
Their preceptors taught compassion and sensitivity with which care is given for patients on a one-to-one basis. The Taiwanese nurses witnessed how preceptors communicate with peers, physicians and interdisciplinary team members to collect patient information, report progress and promote patient care in a professional manner. Also, they witnessed demonstration of care through nurses' investment of self by showing sensitivity to the needs of individuals, families and colleagues. The nurses were enriched with this experience and are planning to incorporate it in their practice.
Residual effects from the initial visit by the nurses are apparent in the daily practice of the St. Mary's Hospital nursing staff. Suggestions and alternative nursing interventions (such as Qigong: an energy practice, generally encompassing simple movements and postures, and Acupressure: the use of specific hand techniques to help Qi flow smoothly) introduced by the Taiwan nurses have slowly but steadfastly infiltrated the current nursing practice of this Midwestern hospital. Our patients benefit from our experience with the Taiwanese nurses.
This year, the nursing staff from St. Mary's Hospital and Millikin University is tentatively scheduled to travel to Taiwan and return to the United States with the CMU students. Our hope is that the next trip will be just as enriching as this initial experience.