The reward is in the journey.
The changes in the nurses in training that left Prince George a short few weeks ago to complete a clinical portion of their second year Nursing 220 course have truly started to materialize. Their understanding of culture has evolved into a daily reality engulfed in learning how others live each day and the many challenges faced.
The students learn about the determinants of health (DOH) in both first and second years of the nursing program, and discuss how these various aspects such as culture, gender, social/physical environment, healthy childhood development, personal health practices, education/literacy, health services and income and social status, in some way all indirectly or directly impact the health and well-being of all people.
These variables are not easily controlled, especially when considering a population the size of Bangalore, and when considering that approximately 80 per cent of the people here live day by day and participate in an all-rupee system (no bank, no credit), this impacts the tax system and thus, the services available to assist in the needs of the people. The students have seen the negative results and the impact of poverty, lack of resources such as access to healthcare, limited available resources within the healthcare settings, as well as the lack of clean drinking water, clean air quality and the struggle of maintaining/managing garbage disposal, has on the health and well being of a population.
The nurses in training are currently experiencing first hand, the differences between India and Canada and how many of the DOH are so vastly different than their own reality, yet have some similarities. Additionally, they have come to understand more about themselves as individuals (personal bias, assumptions and values), and as future nurses, how these experiences influence their view of their nursing practice.
They have gained insight and a greater appreciation for many areas of education, nursing practice and personal aspects they had previously taken for granted, or perhaps didn't really understand that there were such vast differences in some areas of their lives that were just "how it is in Canada."
For example, in the discipline of nursing depending on your geographical location. Available resources, owning one's practice, professional standards of practice, and governing regulatory bodies, are well represented and practiced in Canada, but are not part of the discipline of nursing in India.
The students have been reminded by many at various times, that you are in India now, not Canada. A great example is expressed by Shawn Berteig during time spend with the kids of Dream India, while putting his garbage in his bag to take back home, as there was not a garbage can in sight. The girls thought it was strange that he would do this, he tried to explain his actions (not littering the ground/concern for the environment), they simply told him, "you are in India now, not Canada."
Through experience comes transformation (deeper understanding and learning). This is happening for these students as you read this article, and it is, in part, what they will take home and keep with them as part of their foundational practice as nurses, and as individual people within a whole society.
They are not just fulfilling a nursing clinical experience in a county across the world from their home, but they have been immersed in the daily culture of India as well as the culture of nursing in India. Each day they are embarking on a journey.
Walking around Bangalore is an adventure all on its own, misaligned walking stones, copious amounts of traffic coming from all directions, so much to see (and watch that you do not walk into wires, poles, holes or people) and the constant honking from various types of vehicles never stops and is a language of its own. Just going to the bathroom here has been a learning experience (bring tissue and hand sanitizer), all of which the students have embraced.
During their short stay, what these nurses in training bring home from this cultural/clinical experience, and what they may leave here in India, for both the people encountered within the community and the nurses within Narayana Health, is yet to be fully discovered, as this journey continues.
