Name: Kirsty Reid
Course: BSc(Hons) Pre-registration Nursing (Child)
Nepali Placement Enlightens Student Nurse
I am a student paediatric nurse and I spent 8 weeks in Nepal, three of which at a government hospital, four in a private hospital and one at a village in Nalma.
The journey to the government hospital was thrilling. Travelling by micro bus, the smell is a mixture of dust and petrol and you can hear toots and beeping constantly as buses, cars, motorbikes and people zip and dodge one another. All you can feel is the jolt and banging as the bus rushes over holes and bumps and the sights are truly fantastic. People spilling in and around the traffic, markets, shops and houses, beautifully decorated and all stamped with the pretty Nepali scroll. You can see tailors on their sewing machines, fruit sellers punting their mangoes, its hustle bustle.
On my first day, after my orientation of the ward – five bays of six beds and a few separate rooms which you can pay for, plus one isolation room – a nurse bids me to sit at the nurses’ station. The nurses ask me my name and one or two questions but the exchange is limited, especially when I say I don’t speak nor understand Nepali. I end up making friends with the Nepali student nurses who soon take me under their wing and speak very good English. They ask lots of questions about me, the UK, hospitals in the UK and are very smiley and friendly. The nurses speak better English in the private hospital but the government one is very different from the UK so I felt like I got the ‘true’ experience of a Nepali hospital there. As the private hospital is also a teaching hospital, the ward rounds are in English and I’d say you learn more in terms of skills and knowledge here.
The village placement was absolutely amazing and a highlight of my trip. After a six hour trek, I arrived in the beautiful Nalma and gained an insight into the mountain village life, which most Nepali’s lead. People walk for whole days to reach the health clinic which only has a limited number of medicines and no doctor. The nurse who runs the clinic would translate the patients’ problems and the student doctors would help advise on treatment. Here, I mainly experienced wound dressings of infected mosquito/leech bites and taking pulse and temperature.
The hospitals themselves are quite grotty by UK standards as resources are stretched. The once white walls are now stained a tea colour with dried splatters of unknown liquids. Kids scramble about the floors and window ledges. In the neonatal unit there was just one pulse oximetry machine - a machine that in the UK most children are able to have of their own - which was shared back and forth between babies. Observations of the children very much relied on the nurse’s ability to look for signs of deterioration. Due to limited resources, gloves are reused and even cannulas – although thankfully not between patients – if it doesn’t reach a vein the first time and the infection control policy is very different to the UK. The conditions seen here are similar to the UK – bronchiolitis, pneumonia and gastroenteritis – but there are some which you might not often get the opportunity to see as often on paediatric wards in the UK such as hepatitis and HIV.
Parents and grandparents are around each bed and bored mothers lie on their side as their baby or toddler breast feeds. Families bring in pots and pans to cook at the bedside and one grandmother rolled out a mat on the floor and winding her arms under her neck and head, tried to nap. Mums mingle at each other’s beds and in different rooms and I’ve seen, more than once, a woman pick up another woman’s baby and sit it on her lap for a cuddle if the child is upset and their mum is elsewhere. Infection control implications aside, I find this really nice – a warm sense of community and shared responsibility that is perhaps lacking in the UK.
I left Nepal with mixed feelings as it was one of the best experiences of my life. Spending time in the hospitals was fascinating and enjoyable and I felt I learnt a lot; using different skills and observing different practices in a very different culture. It was a real test of my resourcefulness and initiative and hopefully it will have made me a better nurse on my return.