As our journey of learning continues in Bangalore, India, the College of New Caledonia's second-year nursing students have completed orientation, observation and actual hands on clinical time on a medical surgical floor in Narayana Health's Mazumdar-shaw multi-specialty hospital (MSH), as well as two days with Dream India foster children.
It has been a culturally stimulating first couple of weeks for this indefatigable group. It is not possible to put everything being experienced into words, but a few of the highlights may provide a bit of insight into what has been experienced overall.
Initially, I think it needs to be explained that this group of nurses in training have naturally assimilated into roles, based on their strengths and personalities, and have assumed certain responsibilities, it is also safe to say myself and Anita are getting to know the students quite well and are able to see their growth as individuals.
Just a little run down on the group: Jamie Hofsink-organizer/planner, Michaella Wiebe-guitar player/singer/grilled cheese maker, Rebecca Ellement aka muggins/chicken, official Canadian waver, Hayley Parminter and Ellen Kaufman are the ultimate stair climbers, Anna Thallman is the ultimate cool clothes finder, Kailey Thompson and Ericka Kirby are the hunters of chocolate, Alana Legeard is the movie maker, Vanessa White is the "selfie stick" queen (yes, she actually has one) and she also discovered how to stop eight lanes of traffic with a handbag, Shawn Berteig is in charge of directions when walking out and about, and Steve Ferguson is the big brother/photographer/back up singer and guitar player. All is under control here in India.
In all seriousness, they look out for one another and ensure head counts are done regularly.
Bangalore is after all a large city (approximately 13 million people), so believe it or not, losing a Canadian here could easily happen just crossing the 8-14 lanes of unregulated traffic (seriously true), but no worries the head counts are always accurate and we haven't lost any one yet, except once, when we almost lost Ellen, but it was a false alarm (more on that later).
Some of the NH staff provided us with an infection control presentation, which was well presented, and very similar to how we practice at home, having some familiarity helped to ease the nervousness of the students going into clinical in another country and a very different culture from their own. Additionally students were shown some of the equipment used, such as infusion pumps.
The orientation consisted of paperwork, waiting, picture taking, waiting, paper work, waiting, obtaining NH uniforms, paperwork, waiting, a trip to the government office, waiting... I think you may get the point. Many of the students have commented on the differences between Canada and India when it comes to the perception of time.
Actually, Ellen eloquently explained how things are done in India: "Here when you set a time to meet someone, it is more of a general time when you should show up."
We eventually got through orientation and on to healthcare.
The greatest challenge thus far (besides the 40+ degree weather we have experienced), was expressed by Alana: "one of the most difficult aspects of practicing in the hospital here is the language barrier both with the patients and the nurses."
The initial day on the unit wings of the medical/surgical floor was, as expressed by multiple students, was quite awkward. They were teamed up in pairs and assigned a wing, they entered the ward and of course felt all eyes on them by both nurses and patients. Some of the nurses spoke English quite well, they just weren't the ward nurses, but more the supervisors. Additionally many of the patients didn't speak English well either, or at all but that didn't stop our nurses in training, it took them a day or so to figure out how to meet this challenge.
Although difficulty communicating was a general theme in the first days of clinical (along with feeling like they had regressed back to first year; afraid to enter the patients room) the students quickly adjusted how they communicated and practiced various forms of verbal and non-verbal communication, while performing bed making and manual blood pressures (as they figured out that everything, including linen, is regulated and kept under lock and key.)
This seemed to break the ice and it wasn't long before discussions were taking place with patients and nurses.
Vocabulary was advancing for all, students were learning words in various languages, such as "pain," patients were learning some English, nurses were practicing English, additionally my own vocabulary was increasing thanks to this great bunch of students.
Each day became easier and students became more familiar as did the nurses and the patients. Soon patients were requesting the students to do things for them, such as vital signs and assessments, helping them along with "how to make beds" and generally enjoying the care being provided.
As instructors, with each day, we were able to visualize the increase in the confidence levels of the students as they just jumped in with both feet, they were beginning to build therapeutic relationships.
The tasks students were able to perform increased as trust was established between the ward nurses and the students.
Although, they were not yet practicing to the full scope as they would be at home (yet), multiple barriers were being overcome, both clinically and culturally. The students knew that practicing a clinical in India was not going to be easy, nor would it be the same as at home.
Everyone would be outside their comfort zone.
Anna exposed that "the clinical experience will pale in comparison to the cultural experience."
All of the students have expressed that one of the greatest days spent here so far has been with the children of Dream India foster care. These are children, who each have their own story. Some have had traumatic backgrounds, have been abandoned or come from extreme poverty and have come to live in homes (groups of eight girls in one home) supported through Catholic churches and donations, which pay for food, clothing and education. Without the education, these girls would have no hope of supporting themselves in the future, leaving them living on the streets and poverty stricken.
Rebecca's thoughts were mirrored by many of the students: "I thought I had no expectations about today, but I indeed did."
Many students were surprised at how well educated the girls were (most spoke four or five languages), how well dressed and how they were as outgoing as they themselves were. The girls taught our students how to count in their language (only made it to five), some Hindi songs and apparently found that Canadians had a difficult time with pronunciation, which brought out some giggles.
In exchange Ellen taught her buddy for the day how to swim.
Through donations collected from the group, the students were able to take the girls (mainly teenagers) to an amusement park, with a pool and roller coaster.
The day they had there was summed up by Steve: "being a part of something bigger than yourself is essential" and by Ericka: "being present in the moment" was such a privilege and reward for all, and will not be forgotten.
The students made up goodie bags for each of the 18 girls, all from donations, which included toothbrushes and toothpaste from dental offices in Prince George, Quesnel and Kamloops, and taking Polaroid photos at the end of the day, as a final gift to remember the day.
It was a sad parting, as we left on our separate busses, the girls to their homes with the Sisters and us back to Casa Piccola Cottage. It was an experience that will not be forgotten.
Crystal Lawrence is a nursing instructor at the College of New Caledonia. She is filing reports from the CNC Nursing Field School in India.
