I cannot believe that I just left China! I am going to miss all of the friends I’ve made, the faculty at the HOPE Nursing School, all the staff at the community clinic, and the delicious jian bao… Last week was our last week collecting data from the patients in the clinic, and it was incredible to think how 2 months ago they had no idea who we were or what we were doing. Two months later, there we were communicating with them (a very little bit and as best as we could, but much more than we were at the beginning)! I have learned and experienced firsthand just how frustrating language barriers can be, and I think I can say that I am now a more patient person because of it.
Since we had been so busy with our project, we had not been able to visit many other hospitals to see the differences in the health care and the role of the nurses there. The last week we (and the staff) had time to see a few different hospitals, and a few different floors. The week before we had visited the ER and VIP units at Zhongnan Hospital. The VIP floor was beautiful and spotless. Each room was equipped with a bed and some modern equipment, a second room with chairs and couches, and a private bathroom. Despite my personal objections of hospitals having VIP floors, I thought it was a very welcoming environment, and any patients would be lucky to be there. Even though we were able to see that floor, there were no patients. We craved the chance to see nurses at work and the chance to see everyday citizens on various floors. We got a brief tour of the Women and Children’s Hospital and were able to see the Pediatrics Plastic Surgery floor. It was so strange (and might I say almost comforting?) to see the absence of the cage-beds we see in the pediatric units in the US. I know the purpose of the beds we put the children in at the hospital, but I always wonder how many babies and toddlers get traumatized when placed in one of them and how this detracts from their healing process. There were a few reasons I noticed as to why the peds floor did not have these beds: 1) They only have the large adult beds available to them and must make due with what they have and 2) The families are much more involved in patient care and life than in the United States. It would be unnecessary to have another kind of bed because the family was there to watch the child at all times. The nurses recognized, too, that infants sleep better in more familiar places, and we saw an infant patient sleeping its own stroller. Even though there is a potential problem with germs and bacteria being transferred through this stroller, there is still something beneficial to patients’ healing in being comfortable and feeling more at home – especially for children.
Tying in with the decreased consideration for germs, we noticed on the cardiac floor that nurses do not wash their hands between patients, when entering, or when exiting the rooms. They also did not wear gloves when inserting IVs (which were just needles they left inside the veins). I wish I had found out what the rate of infection was, but I did not ask at the time. China is still developing its theories and practices in Western medicine, and it seemed as though the hospital were just behind us in the times in terms of practice and equipment (they use gravity instead of automatic pumps for IVs). The interplay and occasional conflict of Traditional Chinese Medicine (TCM) was also apparent while on the cardiac floor. We listened in as a doctor was explaining treatment to a patient. After the patient said something, everyone in the room laughed, and the nurse said that the patient had said that Chinese medicine had cured his disease, but Western Medicine had saved his life. That one statement really got me thinking, and I think that it really shows how many people really put their faith in TCM. TCM helps them in their daily lives to overcome illness and to maintain a balance, but they still believe that if this balance shifts too much at one time that Western Medicine can save them. The patient did not think that Western Medicine had cured him but that it gave him more time on the earth in which to keep his balance of yin and yang in check. I hope that makes sense, but if not, feel free to ask me.
The day after we went to the cardiology floor, we went to a psychiatric and a mental health hospital. As for the mental health hospital, it was very nice (and expensive) with therapy rooms, patient rooms, and a variety of programs for patients to participate in. Overall, I was impressed with the facilities. That is all I will say about it because I want to focus on the psychiatric hospital we saw. We observed the nurses and nursing students on the adolescent floor, and it seemed to be out of an old movie where patients are in locked rooms and wander around in a daze. When we got there, all the patients were in one room either watching TV (a violent movie was on), playing ping pong, playing cards, looking at magazines, or wandering around aimlessly due to sedation. When we walked into the room, a horde of them gathered around us and talked with us in English. Many of them had smiles on their faces, and it made my day. Being there and seeing the young people in that room and imagining what it would be like to be in one room all day made my heart ache. I realized just how far a little bit of attention can go. The nurse told us that other than the students, the patients don’t really have anyone talk to them because doctors and nurses were always so busy. This sounded so familiar to my experience at St. Vincent’s where the patients were so appreciative to the interaction that the student nurses had with them. It does so much good for everyone to have someone pay attention to them, to talk, participate in an activity together, or just interact in some way. Even just a comment or a smile goes such a long way. When I say interaction, however, this does not mean sitting them in a chair and interviewing them about private things in front of a room full of people. We were able to sit in a few interviews of patients, which were educational to see, but I also had the feeling like I should not have been there. I just wanted to patients to feel comfortable and to know that someone cared about them, but anyone would be intimidated by a room full of people listening to everything they said and judging them. I also found myself getting angry with the parents of the patients because as adults in China age, their children take care of them – even when they develop mental illnesses. This is why, we found out, that there aren’t many elderly people in mental hospitals. How could people find the time and energy to take care of their parents but not their own children? As I become a nurse, I hope I never forget that patients are people who deserve privacy, attention, and care.
I hope this post does not make my experience in China sound bad. It is not meant to deter people from traveling abroad but to give you a piece of the picture that I saw there. I am so lucky to have seen as much as I did, and I loved traveling to the various hospitals and comparing them to the only ones that I knew. This experience was so amazing, and I would never have passed it up. I had the privilege of seeing so much, and it really made me appreciate everything we have in the United States not only in terms of health care but also in terms of everyday practices and hygiene. All that I have seen, experienced, and learned here in daily life, working at the clinic, and visiting other hospitals will all help me to be a better and more culturally competent (yes, I had to throw in that term) nurse.
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