At bustling Bugando Hospital in Mwanza, Tanzania, nurses need nerves of steel.
They handle problems like spear wounds, a man who drank battery acid in a suicide attempt, flesh scorched by burning garbage and a lad whose throat was slit by a machete.
Now, these talented and salty healthcare pros from East Africa are getting a chance to modernize their intensive care training and know-how, thanks to a program offered 10,000 miles away at Providence St. Vincent Medical Center.
The city of Mwanza and surrounding villages are home to about 800,000 people. Teams from Providence St. Vincent have been going there for several years to provide services and train Tanzanian staff. In 2005, Oregon nurses Deby Reilly and Pat Perry trekked to Mwanza to teach at Bugando Hospital’s new intensive care unit.
After serving in Mwanza a month, it became clear to Reilly and Perry that the African nurses were every bit as talented as any US colleague. But in Tanzania, nurses were not given authority to do as much as they could. There was no sense of a team approach, with nurses and doctors working together. Reilly found a drawer full of dusty stethoscopes and asked why they weren’t being used; the prevailing notion was that only doctors could employ such tools.
At the same time, the Tanzanian nurses had received no training in reading the multiple monitors in the ICU.
They carried a huge work load, with as many as a dozen intensive care patients being tended by two nurses or a single nurse watching 40 less-serious patients.
On the long plane ride from Africa, Reilly and Perry thought aloud. They knew their nursing skill and perspectives had been strengthened by entering another culture and decided it might well work in reverse, too. Reilly got advice and support from St. Vincent’s and wrote up a proposal for a regular nursing exchange between St. Vincent’s and Bugando.
The first two African nurses arrived in 2006 and began the custom of staying in the homes of local nurses to experience US life first hand for three months. They entered an already-extant training program for intensive care staff. They shadowed Providence St. Vincent nurses and attended team meetings.
Outside the ICU, the African women ate dishes like chili and gingerly tried bites of elephant ears, after making sure the pastries weren’t really made of elephant. For the first time, they went shopping with no need to negotiate, made snowballs and used dishwashers, washing machines, refrigerators and stoves. They were wowed by discount stores.
Once the first two African nurses returned to Bugando, they started teaching co-workers in electrocardiograms, care of ventilated patients and life-saving techniques like CPR.
In 2007, two more St. Vincent nurses traveled to Bugando and found that many of the skills that were taught by Reilly and Perry were still in effect. All the nurses use stethoscopes now.
One of the new nurses with the current exchange, 30-year-old Rachel Ng’wandu, says she noticed a change in the first two Tanzanian exchange nurses after they returned home to Bugando. They have a different relationship with patients and are somehow more responsible for their care.
Ng’wandu, who took her first plane ride to get to Oregon, notices her own thinking changing already. She is looking forward to helping her co-workers brush up on reading an EKG better.
Married for only eight months, Ng’wandu says that before she arrived in Oregon, she was afraid that Americans would be rude and arrogant. It did not take long, she explains, to dispel the stereotype and learn that people are very much alike the world around.
Rebecca Kulinganila, 37, has been a nurse for about a year and a half. She likes Oregon and is taken by nursing here, with its team approach and empowerment.
The nurse exchange program will continue next year.
In 2005, when she was asked to go to Tanzania, Reilly said, “Who? Me? Africa?”
She decided not to live from fear and to be an example of courage for her daughter.
Now, her thinking has changed. She realizes that the many tools provided in U.S. healthcare are a tremendous gift and that being an American is a real blessing.
“I complain a whole lot less,” she says. “I am grateful for everything.”
A letter to Providence St. Vincent from officials at Bugando Hospital expressed thanks for the exchange program. It appears to be one of few training opportunities for ICU nurses in East Africa and the exchange has made the learning more effective.
“This program has put us on a more equal basis and in a true relationship,” the Tanzanian officials said.source
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