Contributed by the Duke School of Nursing Office of Global and Community Health Initiatives
Imagine, you are completing your clinical requirements and putting your nursing skills to the test. While on your way to the hospital or clinic you turn and catch a glimpse of the vast Blue Mountains of Jamaica, or pass the foothills of Mount Kilimanjaro in Tanzania. Perhaps you are dwelling among the locals in a remote, rural village in Honduras, visiting the sick and elderly in rural communities in Barbados and Nicaragua, or attending to the sick in villages in South Africa.
This year, 66 Duke University School of Nursing (DUSON) ABSN and MSN students will complete clinical requirements and residency hours through cultural immersion-service learning experiences abroad in developing countries. These experiences were made available through DUSON, Office of Global and Community Health Initiatives (OGACHI). More than 80 percent of the ABSN class will travel in groups of seven or eight to Barbados, Honduras, Jamaica, Nicaragua, and Tanzania to meet clinical requirements for N231, Community Health Nursing. In addition, the ABSN students headed for a six week experience in Tanzania will also satisfy maternity nursing clinical requirements at Marangu and Kilema hospitals located in a rural community about 45 minutes from Moshi, the site of Kilimanjaro Christian Medical Center (KCMC). Staff at the Duke HIV-AIDS Research Center at KCMC helped arrange all of the student placements in Tanzania.
MSN students are capping off their residency experiences at a number of international sites. Three Nursing Education (NE) majors spent a month as practice-teachers in schools of nursing at KCMC in Tanzania and the University of the West Indies-Mona, in Jamaica. One NE major returning from a recent experience in Moshi stated that, “we learned that it is not always possible to conduct a learning needs assessment prior to teaching a class and that one needs to be flexible in adapting to the culture of the present environment.” Meanwhile, two DUSON Family Nurse Practitioner (FNP) students were working collaboratively with local health teams at Pasua and Majengo Health Clinics in Moshi, Tanzania. Working with an Assistant Medical Officer as a preceptor, they provided advanced nursing care to community residents. There is no APRN role in Tanzania, so the students introduced a new level of nursing practice to the health care system. The FNP students saw conditions rarely seen in the US, such as Malaria and Typhoid, and cared for many children and adult patients on a daily basis. The Majengo Health Clinic normally sees about 70 patients per day, has about 50 deliveries per month and as many as 10-15 babies born on a given day.
Each student’s experience is different and offers and opportunity to build cultural sensitivity and an awareness of health disparities affecting developing countries. Students who participate in an experience abroad will bring back an in-depth understanding of the customs of diverse populations. As the US has become more populated with immigrants from across the globe, these experiences afford the nursing students the ability to identify with their patients’ backgrounds.
One NE major returning from a recent experience in Moshi stated that, “we learned that it is not always possible to conduct a learning needs assessment prior to teaching a class and that one needs to be flexible in adapting to the culture of the present environment.”