My experience in Nepal has been made truly unique and meaningful because of the poeple. It is incredibly touching to see the dedication and hard work that the Nepali people put into their businesses, families and religion. Though Nepal is still a developing country in many ways, and does not have many of the luxuries that we have access to in Canada, the people have a sense of comraderie and community that is something I feel very privileged to have lived in for the last 5 weeks.
       While studying at the hospital, there was hardly a single patient who did not have multiple members of their family present.  They played in major role in giving personal care to their loved ones and were loving and non-judgemental towards them.  They gave their money, time, energy and whatever else it took to help get their parents, their children and their brothers and sisters well. There is one man that had had a hemmorhagic stroke and he had been in the hospital for 4 weeks already.  He was trying to pull out his tubes and catheter and he could not recognize his family. Every day his sons were there, reassuring him, feeding him and caring for him. Working at the hospital showed me just how strong and important families are in Nepal. The Nepali people have many amazing qualities. I have learned so much here and I hope to return someday.
Melissa Nuttall       

I started my practicum at Tribhuvan University Teaching Hospital in the far back room of the male medical ward. I walked in to find the windows wide open, curtains blowing and three patients in four of the beds. I was introduced to my partner Nepali nursing student, and together we went to introduce ourselves to our patients. As we were entering the room the student turned to me, stating that "these are the free beds. There is no charge for patients in these beds". As I continued to work in the back room, I was informed by several different nurses and doctors that these beds were the free beds. Despite my questions, I never really learned exactly how these beds were funded and whether or not medications were included.

As I continued my practicum at the hospital, I had the opportunity to carry on patient care in the "free beds". I was really moved at how supportive the patients and their families were of each other and the other families in the room. One patient, diagnosed with gastric cancer, had a two-year-old daughter who spent a lot of time with him at the hospital. The bed next to him had a 15-year-old boy with a metabolic disorder whose grandparents rarely left his side. I was amazed at how these grandparents would look after the other patient's daughter. Often when I entered the room, this family would be looking after her from the floor mats they slept on beside their grandson's bed. One day I even saw the boy's grandfather leave the hospital to buy the gastric patient his medication. This gesture really impacted me - these families were too poor for health care but were still involved in the most important healing of all: caring for each other.

Vanessa

I'm really not sure where to begin when describing the reality of nursing in Nepal. With all of the differences, big and small, of culture culture, religion, technology, procedures, language, and so forth, its difficult for to articulate to others just what it is like to be a student, a nurse, a Canadian here in Nepal. I figure the best way to illustrate my experience is to contrast the nursing styles of Nepal and Canada using a couple examples.

One of the most challenging aspects I found while working in the hospital was the way Nepali nurses have a team-oriented approach to their duties and patient care. That is, each and every nurse is responsible for each and every patient. I found this to be confusing because, in Canada, we are trained to be one-on-one and "in relation" as much as possible with each patient, usually within an assignment of only four patients. The Canadian nurse would be responsible for all things involving those particular patients. Easier to distinguish what has been done and needs to be done, and would seem to eliminate room for forgetfulness and errors. In addition, the model of care back home recognizes each patient as unique from others and his or her health care needs would vary significantly from person to person. Thus, the nurse would need provide the patient with one-to-one focal, individualized care. Looking at the patients on a ward as a whole seems to neglect this individuality and may affect the nurses' ability to "see" the patient for who they are. It also weakens the possibility of developing strong patient-nurse relationships that are so emphasized in Canadian nursing. Although this practice is an ideal and is not always followed back home, it still is the expectation of my school and its the way I have been shaped over the last two years to perceive my role as a nurse. This dichotomy of trying to work within two entirely different nursing paradigms has admittedly been frustrating, but an opportunity for good learning nevertheless. I have learned that there are always multi-faceted ways that nursing practice is carried out and there is never any exclusive, "superior" way of doing things and looking at the world, especially when you consider the influence of culture in health care.

The language barrier has also complicated the process of assessing patients, developing these relationships, and ultimately, doing my Canadian-style nursing. However, it has offered much learning about communication and the importance of what body language is conveyed to the patient, which is harder to focus on at home as nearly everyone speaks English. It has opened my mind to be more conscious of my presence and my being with the patient. Beyond language, the fact that the Nepalese use their own calendar and have different drug names certainly has made for even more of a challenge in doing simple nursing tasks like reading a patient's chart. I had to pretty much cast aside all my knowledge of medications and start over, and figure out the new calendar. Its February 11, 2067 right now (I think). And, lastly, on a completely unrelated note, I decided that I despise gravity IV's. I had no idea they were so ridiculously unreliable and troublesome!

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The most memorable experience thus far in Nepal was my decision to bungee
jump off the second highest bridge in the world. I signed the waiver form
and was told that I would bungee jump the following day. I woke up the
next morning in a panic going between thoughts of I just want to get this
over with, to what was I thinking when I signed up for this. After the
first group had jumped we walked over the bridge and the reality of my
decision hit me like a Nepali bus whistling down the road. I looked down
and saw how high up we were, and how far down the rapids were flowing with
sharp jagged rocks exposed everywhere! My number was called to jump and I
felt as though I had just been called to death row. All harnessed up, I
tip toed to the plank and thought there is no way I am doing this! The
longer I stood there, the worse my conscious mind became but I still took
the plunge. I felt as though I had lost all control and I felt weightless.
After all of that worrying and build up, I felt absolutely nothing, until
I recoiled and felt pure bliss that I was still alive. It was almost as if
my body had went into shock mode, until it had realized that it was
attached to a rope and everything was going to be okay. I've never felt so
many emotions as I did when I deiced to leave my fate in the fraying
strands of a bungee rope. I had to find the strength within to throw
myself off that bridge and I was so glad that I went through with it.
After all of that, I can truly say that it was worth it. I've officially
crossed bungee jumping off my bucket list, never having to put myself
through that again!

"Always expect the unexpected", Dianne told us back in Victoria. Now I
really understand what she was talking about. My greatest fear in the
hospital was to come in contact with poop and pee (I can barely pick up my
dog's poo when she does her business). Lucky for me I got the poo and pee
introduction before setting foot in the hospital. On the first day in the
Kathmandu one of the Monks lead us on a nice walk to Thamel. As we were
walking down a busy street with motorcycles, cars, bicycles and people
going in all directions, I felt a nice stream of, what I thought was
water, on my head and arm. I turned and looked up and there were two
little boys giggling while taking a pee on me as if I was their walking
target. We got quite the laugh out of it but it was nothing compared to
what happened next. After that occurrence we gathered ourselves and had
lunch at the Himalayan Café. It was quite good; we all ate Nepali dishes
such as Alu Roti, Dal Bhat, Vegetable Thukpa and especially MoMo's. We
were all exhausted after and had decided that we need to head back to the
Monastery and catch up on sleep and still adjust to the altitude. Once
again I had another surprise ahead of me. The taxi that we caught pulled
over to the side of the street of a small market area filled with locals.
We thanked the driver many times and I took my first step into knee deep
fecal matter. That was when I learned that Nepal has open sewage
everywhere. The cab pulled away and there I was standing in the middle of
the street with one leg fully covered in human feces. The noise in the air
switched from dogs barking and cars honking to full on laughter. I felt
really embarrassed at the time and could not believe what had just
happened. After that I have learned you can only take life one minute at a
time. I have changed in the way that I really can not predict what is in
store for me in the future.

 

On the North end of the island (by Holberg) there is a legendary sign that reads ‘be prepared for the unexpected’… those are the words of wisdom that have carried me through this practicum.

            Our first week here in Nepal, an unpredictable Maoist strike/ political demonstration disable the country for one week and forced us into lockdown within the beautiful benchan monastery where we reside.  With daily grace periods from 6-8 am/pm, we utilized those moments to explore our surrounding neighborhood and connect with the locals. Those valuable days allowed us to connect with our surroundings; soccer games with the children, meditation session with the monks, Nepalese cooking classes, public exercise classes at swayambhu, and of course valuable time spent getting to know the fellow student nurses and teachers accompanying me on this trip.

            When the strike finally ended we were allowed to return to the hospital for our clinical experience. On my second day a kind doctor invited me into his gallbladder removal surgery. Hours later, I found myself scrubbing in (to be a fly on the wall) for his surgery, only to find out that it was not gallbladder removal surgery, but open heart surgery for an atrial valve replacement; what a fascinating, awe inspiring moment to have for my first Nepalese operating room experience.

            Last but not least, I never expected to have such laughable moments with the animals of Kathmandu. When I heard monkeys roamed freely around the monastery, I never thought that meant being chased on a daily bases while protecting my food and personal belongings from their quick little dexterous hands. Nor did I expect the highway traffic to give way to free roaming cows that roam in search of grass (or garbage) to eat. I have also come to admire the sound of the cuckoo bird, and laughed hysterically when I first realized that the bird from the clock in my childhood kitchen truly did exist.    

            This international field school experiencing has been remarkable, and I consider myself blessed to have been selected.  

            ~ Suzanne. CCNS year 2.

Nepals' Tribhuvan University Teaching hospital is actually the perfect medium for a fledgling nursing student to enter with no hospital experience, and exit soon thereafter as a confident, experienced, and well-rounded student reading to take on the next nursing challenge.

  Overall, my experience here in Nepal has been fantastic!!  My personal boundaries have been challenged in a way that has promoted self-growth, self-confidence and self-exploration - all the while allowing for an amazing healthcare learning experience.  I had an opportunity to see my first open-heart surgery and it has inspired me to pursue a career as an operating room nurse. 

  Nepal is a beautiful country, with just the right blend of adventure and relaxation...I hope to return soon.

Nepals' Tribhuvan University Teaching hospital is actually the perfect medium for a fledgling nursing student to enter with no hospital experience, and exit soon thereafter as a confident, experienced, and well-rounded student reading to take on the next nursing challenge.

  Overall, my experience here in Nepal has been fantastic!!  My personal boundaries have been challenged in a way that has promoted self-growth, self-confidence and self-exploration - all the while allowing for an amazing healthcare learning experience.  I had an opportunity to see my first open-heart surgery and it has inspired me to pursue a career as an operating room nurse. 

  Nepal is a beautiful country, with just the right blend of adventure and relaxation...I hope to return soon.

People always ask me if I know what kind of nurse I want to become and I always end up saying that it is too early for me to tell – because it is. I am a first year student and though I have a few areas of interest, I haven’t yet had the chance to try everything out and really see what fits me and what I enjoy. Today I had the opportunity to be part of something that I thought I knew I wouldn’t enjoy, and I found instead, something that I really love.

I was on the maternity floor today with a few of my peers. I was really excited to have the opportunity to be there, as normally maternity rotations start in second year. I loved seeing the pregnant mothers and the newborn babies and getting the chance to work with them. I have considered maternity in the past as a possible area that I might want to work. But I always thought that becoming an actual labour and delivery nurse would be taking it too far. I figured that it would be too intense and too graphic for me to handle.  So needless to say, when we entered the labour and delivery room to see a birth (a random chance that just happened to come up), I was a little nervous. What I found, though, surprised me. It was intense, and it was graphic – but I loved every minute of it. It was such an incredible experience to see this new life – to see this baby take his first breath in the world. I feel honoured that I was able to be there to witness it.

Though I know that deliveries in Canada will be a much different experience than the one I saw here, I feel like I am leaving this experience with an open mind and with something else that I will seriously consider for the future.

- Megan

When your plane lands in a new country, there are always certain things you expect and certain things you could never expect.  For example, I guessed right when I thought that my experience at T. U. Teaching Hospital would be nothing less than extraordinary. I knew that I would be travelling with an amazing group of other nursing students and I understood that I would find myself in a country that would further my awareness and appreciation of everything around me. However, on the other hand, there are a few things that upon arrival in Nepal I could never have guessed.   For example, I would never have imagined that I could find a good healthy meal under fifty cents, that a significant number of my meals would consist solely of digestive cookies, and that one foot tall monkeys could terrify me to my very core, raise my blood pressure in a matter of seconds, and make me run back to my room screaming and hide until I could be sure the path was safe.

My biggest lesson thus far, however, did not revolve around myself in Nepal. Instead, it centered on the people of Nepal.  The people that I have met in Nepal are as a group, some of the kindest people I have ever met. Without money to provide for themselves, I often find them without hesitation offering to others. It is a sense of community that I have never known before.  This sense of compassion found within Kathmandu was reinforced when we were lucky enough to meet some local kids at their soccer field. I find it interesting that no matter where you go and how much is different, kids are always universal. They are always striving to have fun, and with or without material items, having fun is never hard for them to find. The simplicity of having fun is often lost with age and it is something I admire so much in kids everywhere.

-Kathryn