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Nursing in Thailand: Jumping into the experience

December 19, 2013
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It didn’t take long for the nursing students from the University of Michigan to get a global health experience. They were flying to Thailand to do a two-week program when a female passenger became unresponsive with a slowing heartbeat and excessive sweating. The students got to work, despite a language barrier and limited resources. With help from the passenger’s  family and flight attendants, they stabilized the woman.

Ally Stencel and Shannon Darket tend to a patient with a finger wound

Ally Stencel  (center) and Shannon Darket (right) tend to a patient with a finger wound

“From the beginning, the students wholeheartedly jumped into the experience, which made it an amazing adventure,” said Michelle Pardee, a clinical assistant professor at U-M’s School of Nursing who was a co-leader of the group’s October trip.

Once in Thailand, the students  – part of U-M’s primary care nurse practitioner program – were based at the Suranaree University of Technology in the northeastern city of Nakhon Ratchasima.

The university has a special connection with U-M because the head of its community health nursing program, Naruemol Singha-Dong, earned her master’s and doctoral degrees in nursing at U-M and is a clinical adjunct faculty member. She assisted the U-M group with arranging everything from clinicals to excursions.

“Dr. Singha-Dong facilitated experiences we never anticipated or could have provided domestically. Her guidance and expertise were a critical element in the success of this pilot program,”  said April Bigelow,  a clinical assistant professor at U-M and co-leader of the student group.

Students must climb ladders to get into some of the homes

Students climbed ladders to get into some homes.

For two weeks, the U-M and Thai students worked together every morning at a local clinic to provide primary and acute care to villagers. In the afternoon, they went into the village for community assessments, home visits and educational programs.

“It was remarkable to watch the teams develop and progress throughout their time together,” Bigelow said. “By the end of the experience, we had developed into trusted colleagues and new friends.”

Pardee added, “The collaboration with SUT was an incredible experience that highlights the best in all of us as human beings, working together to improve lives and ultimately not only of the patients but of us as well.”

The students say they faced challenges such as language barriers, lack of resources at the clinics and during the home visits, and difficulties related to the environment. At times, flooding was a challenge, closing roads and forcing them to alter their routes. It also created learning opportunities when the students treated illnesses caused by contaminated water that are rare in the U.S.

The flooding caused one of the most distressing experiences of the trip – the disappearance of a child playing in the water, U-M student Ally Stencel said.  “A group of villagers saw the tragic event happen, and joined together, linked arms to form a line and starting walking through the rapids to find the missing child,” Stencel wrote in her blog about the trip.

The villagers found the child, and he was rushed to the facility where the U-M students were. “Working as a team with members of the clinic, we were able to transport the child through the jungle to meet the ambulance and transfer him to the local tertiary care hospital. We were happy to be informed the next day that the patient made it safely to the hospital and received appropriate care,” she said.

The UMSN team at Haoa Yai National Park

The U-M students at Haoa Yai National Park

Student Betsy Hetrick noted many cultural and clinical differences, such as less patient privacy. She was impressed by the “consistent stoic response to pain and discomfort” from her patients and the openness of the villagers who welcomed the students into their homes and generously allowed them to perform physical assessments, which included opening their refrigerators to inspect food choices.

“We realize the essence of our health-care mission is the same in Thailand as it is at home,” Hetrick said. “We are all working toward the common goal of improving the health of our patients, using a compassionate and holistic approach. It has been amazing to immerse ourselves in a different health care culture and to understand the differences, but more importantly, the similarities of our systems.”

This story was originally published here by the School of Nursing. The faculty and students will share their experiences and insights on Jan. 16 at a brown bag presentation.  

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