Scholarships for nursing students
Greta Davis, Hanoi, December 2014
As a recipient of the Hoc Mai nursing scholarship, I spent 4 weeks working in the general Intensive Care Unit (ICU) at Bach Mai hospital. I was placed at this hospital along with a physiotherapy student and an exercise physiology student, both working in rehabilitation, and one medical student working in neurology. Although I spent most of my time in ICU I was given the opportunity to visit the departments of the other students which were all vastly different, each providing a unique picture of the Vietnamese health system, the role of health practitioners, and the patient experience. Throughout the four-week placement we experienced joy, frustration, appreciation, confusion and curiosity. Despite the inherent challenges of working in a foreign country (language, resources, ethical dilemmas… just to name a few) at the conclusion of the placement I walked away from Bach Mai hospital with an unforgettable experience, enriched clinical skills and new friendships from both Vietnam and Australia.
Working in ICU allowed me to see a variety of patients with different diseases and conditions, some of which we rarely see in Australia. This department received some of the most severe patients from across northern Vietnam with conditions ranging from acute myocardial infarction, cardiogenic shock, acute pancreatitis (most frequently due to alcohol abuse), Guillain Barre Syndrome, parasites in the spinal cord, pneumonia, severe chronic obstructive pulmonary disease, anaphylaxis and much more. Some of these patients recovered. I witnessed patients who were extremely unwell who I thought would pass away begin to slowly improve, be taken off the ventilator, sit out of bed and be transferred to the ward. These patients are an example of the effectiveness of the Vietnamese health system and the competence of the nurses and doctors who contributed to their recovery.
To contrast, almost daily I was also confronted with death and dying, an inevitable aspect of working in the ICU. Although challenging at times, these experiences gave me insight into the social and cultural practices surrounding death and dying in Vietnam. I observed many families take their sick family members to die at home because they could not afford the cost of treatment. Other families preferred that their family member died at home as dying within hospital was considered taboo or bad luck to these families. Some families also consulted fortune-tellers regarding the patient’s prognosis, and made decisions regarding continuing or stopping treatment based on the information they received.
Whilst working in ICU I was not always working with nurses who spoke English so I had to learn the routine, be flexible and find opportunities wherever they appeared. The day usually started with providing personal hygiene and oral care to the patients in ICU. Many patients also required wounds to be cleaned and new dressings applied. In ICU I was able to perform central venous catheter dressings, tracheostomy dressings, arterial line dressings and surgical wound site dressings. This was a fantastic opportunity to apply my knowledge and skills learnt and practiced in Australia in a new context with different resources.
Overall, I had an incredible experience. The Vietnamese people made us feel incredibly welcome and we were never short of an invitation to lunch or dinner. My first experience as global health nurse was invaluable and the resourcefulness and efficiency of the Vietnamese nursing staff is something I will take back to Australia.
Lenore Maitland, Hanoi, December 2014
The Hoc Mai Foundation provided me with the amazing opportunity to learn about nursing in Hanoi, Vietnam. I spent one week at Bach Mai Hospital in the Intensive Care Unit (ICU) and 3 weeks at the National Hospital of Paediatrics in the Neonatal Intensive Care Unit (NICU). As a nursing student, this placement was probably one of the most challenging, but also one of the best I have undertaken so far.
With around 160 babies in the NICU, there were plenty of opportunities for me to improve my skills. The doctors and nurses took the time to help me develop new skills in caring for the newborns and educated me on their conditions. I was amazed at the skill level of many of the nurses and the resources available to them. The high standard of care provided by the staff enabled a rich learning environment and improved my competency as a nurse.
The language barrier was a major challenge at times, but it helped me to improve my non-verbal communication skills, surprising myself at how much I could learn through careful observation and interacting with staff with few words. In return, I was also able to assist some of the doctors and nurses with their English medical terminology. They emphasised the importance of them learning English, as the NICU is a relatively new area of research in Vietnam.
I was blown away by the incredible generosity and hospitality of my Vietnamese colleagues. They not only made me feel welcome in the workplace, but they invited me into their homes and to see more of their country. It was such a unique experience, enabling me to form a strong network with my Vietnamese colleagues, and friendships that I will continue to cherish in years to come.
Overall, Hanoi provided an exciting and rich cultural experience. Although my placement at times proved to be emotionally challenging, I believe it has further prepared me for my future role as a Nurse in Australia and abroad.
Phoebe O’Carrigan, Da Nang, December 2014
Why did I choose to study Nursing at The University of Sydney? I had read about the Hoc Mai Scholarship program before I even applied, but had begun researching different nursing courses. Although there was no guarantee I would be a scholarship recipient, I am so grateful that I was, I would like to share with you two moments that left me with a lasting impression of what nursing is really all about.
Later in the afternoon on the first day, a pre-term infant was admitted with a congenital heart condition. Although I could not understand what the doctors and nurses were saying, I could interpret the seriousness of the situation through the rushing, and by how many staff were at the bedside of the infant interpreting the ultrasound of the heart. Another aspect of medicine and nursing that can be transferred across languages, the gravity of the situation, simply through body language. I was then able to sit in on the conversation in which the doctor informed the parents that that their baby had pulmonary atresia, with ventricular septal defect, a disease that is curable with the implantation of a stent, but with many risks, such as sudden death, death from the general anaesthetic in surgery, or poor organ perfusion. Observing the conversation with the parents, again, although in Vietnamese, I was very clearly able to see the exact point in which the parents realised they had a very sick child. The mother slumped back in her chair, her eyes began to glass over with tears, and she began asking fewer questions whilst the gravity of the situation sunk in. It is known that it takes 3 seconds for information to sink in. And I witnessed the change in the mother in those 3 seconds, even without being able to speak a word of Vietnamese. It was in these moments that I wished I could portray my empathy and compassion, because my heart also sunk when I realised that the prognosis for this child was very poor.
On a Friday, we followed Dr V on her ward rounds on the maternity wards. Seeing the wards was how expected the hospital to be. Overcrowded hallways due to the families staying, bedsharing, rooms which would accommodate one bed at home in Australia, housing 4-5 beds, and minimal hand sanitiser. However, on top of this, there were leaks in the ceilings, with buckets placed under to attempt to catch the water, sinks around the corridors were full due to blockages, a perfect breeding ground for bacteria. The hospital, although one of the newer of hospitals, is extremely run down, with minimal medical equipment and limited resources. On the ward rounds, we performed newborn examinations, which I was taught how to do on the spot, part in English, part in Vietnamese with demonstration. An important aspect of nursing is to always gain consent, and to converse with the mother whilst performing the examination. So, as you can imagine, this was very difficult. None of the newborns I assessed had English speaking mothers, so with the assistance of Dr V and Dani, I was able to perform a full assessment and thank the mother for allowing me to do so. Many of the families are often from rural areas, and come into the hospital to give birth, given that I am obviously a foreigner, I do tend to stand out. However, all of the mothers and families greet me with a huge smile in reflection of my own smile, and I feel very welcomed.
Having been accepted to a four week nursing scholarship in Vietnam, I was given the opportunity to be placed at Vietnam’s biggest hospital called Bach Mai Hospital. I was thrilled to be accepted and filled with anticipation, and after a long but swift flight to Vietnam I found myself a great place to stay and was more than ready to observe and learn about patient care in a country with a different language and different culture.
On a typical day most mornings were spent in the emergency department. None of the nurses were able to communicate in English and my mentor Dr Tue kindly made sure that my fellow students and I always had an opportunity to learn something new, ensuring that we could understand through his own English speaking ability. I was able to observe the nurses whilst they were working and I also had the privilege of gaining a better understanding of patient’s pathologies and prognosis. I cannot stress enough how kind all the doctors were to the students, they were exhilarated to have us there and were always going out of there way to make sure we had a tutor with us. Most patients who presented in the emergency department were cardiac related, cirrhosis or/and hepatitis B which are unfortunately quite a big problem in Vietnam.