Thursday, November 19, 2015

Compassion, Dedication, and Trust: The Heart of Community Nursing

Prior to arriving in Thailand, I wasn’t sure what to expect during our two-week clinical experience. I anticipated feeling a bit of initial culture shock and assumed that the language barrier would potentially interfere with my ability to connect with patients as well as our Thai nursing student colleagues. 

However, I was pleasantly proven wrong. Since day one, the Thai nursing students (our “Thai sisters”) and the SUT faculty have welcomed us and integrated us as part of their team. Our first clinical day we rode bikes into the community with our Thai sisters to perform a windshield survey and begin the process of assessing the community’s health problems and needs. Our Thai sisters were kind enough to share their bikes with us, even letting some of us ride on the back of their bikes to get to patient’s homes. While a few of us felt a bit shaky about our bike-riding skills, we felt reassured that we were in safe hands when out in the community with our sisters as they frequently looked back to check on our status or warn us of the presence of a potentially unfriendly dog. 

  Biking to home visits in the community with our Thai sisters

When making home visits, our Thai sisters assist us in introducing ourselves to the community members and help translate our health questions. They help us learn basic Thai words and phrases so that we can better connect with the patients we see in both the clinic and the home. During home visits, they gather extensive data regarding individual health risk factors and community health concerns. 


Over the following days, we got to know the patients in the community better and begin to build more trusting relationships. They seemed to appreciate our attempts at learning their complex language and our eagerness to learn about their life and health status. And when we had difficulty communicating with words, a smile and touch seemed to go a long way in making a positive connection. 


As a healthcare provider, it really is a privilege to have the opportunity to see patients in their space, and the members of the community have been very gracious to allow us to enter their homes to learn from them. We gain a glimpse into their environment as we can see how they live, manage their daily healthcare needs, and explore what barriers and health risks are present. We can perform a thorough health assessment and medication review in the home, and when concerns are identified we can recommend that the patient come to the community clinic for further evaluation. During our days in the clinic, it has been encouraging to see these familiar patients from the community follow through and come to the clinic for further care.
I have greatly appreciated that the community clinic staff has welcomed us into their setting as well. In the community clinic, we work closely with the nurse practitioners and nursing staff, as well as the SUT faculty and nursing students who assist us with translation. They have an organized system for directing patient flow, even when well over 100 patients arrive at one time for chronic disease management day. The clinic staff, community members, and SUT students and faculty work collaboratively with us to develop individualized care plans and strategies to promote each patient and family’s unique health needs. 

SUT faculty, community clinic nurse practitioner, and Jason evaluating a complex patient in the community

As our time here in Thailand comes to an end, I continue to be extremely impressed by the hard work and dedication displayed by our Thai nursing student sisters. They stay up working late into the night, sometimes past 2AM, to ensure that they have complete data and a thorough assessment of the community’s main health risks and concerns. They frequently seek our feedback and suggestions on ways they can improve and prepare for community forums and grand rounds presentations on complex patients in their communities. Our Thai sisters will spend four more weeks living in these village communities after we return to Michigan, and I look forward to hearing about their progress as they strive to succeed in making a positive impact on the health of their communities.


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