by Work the World

Nursing, Clinical Features, Where Are They Now?

Leanne travelled to Tanzania back in 2011 for her overseas adult nursing placement. 

Now working as a Tissue Viability Nurse Specialist, Leanne reflects on her time in Tanzania and explains how her experience overseas helped her to where she is today…

Leanne Jane Steel (STEEL2580)

What was it that made you want to study nursing in the first place?

It all just happened very organically. My mum was a carer and I studied Health and Social Care at college. Whilst studying I was also doing a community care role. 

I went to the University of Manchester and did the Adult Nursing Diploma. During the first year, I honestly thought I was going to quit. I’d never worked on a ward and there were lots that I hadn’t seen before. 

I was used to working with older people which was great and I’m definitely a people person. But, suddenly being on a ward and looking after people that were very sick was a shock. 

I remember one day that really threw me. A patient had had a seizure and they’d bitten through their tongue. I was a first-year student nurse and all I wanted to do was help, but I just didn’t know how to at the time. However, I spent some time reflecting on this particular day and it helped me to realise that nursing was still definitely what I wanted to do. 

And you studied at the University of Manchester – what was that like? 

I went straight from college to university, so as much as it was exciting, it was also very daunting. 

I was the first person in my family to go so it was a very surreal thing at the time. My grandmother was really proud of me because her Grandma was a nurse too, and she nursed in London during the war.

During my first year, I was in halls and when you're nursing it’s a very different university experience. I had two weeks of orientation, and then I went straight out onto placement. I had a regular Friday where I went into university but I also had to complete thirty hours of placement too. Plus, I had my assignments to complete on top of that. 

Regardless of this, I still wanted to have the proper university experience. It was important to balance it all. I got the hang of getting up for a 7am shift whilst also still having a bit of fun. That was pretty challenging. But I did it!

So where did your overseas elective fit in? Which year did you go to Tanzania?

I went during my third year. I remember a representative from Work the World came in to talk about overseas electives, and that was how the seed was planted. I looked into it and made the decision to just go for it. 

Leanne Jane Steel (STEEL2580)I couldn’t really afford it, so I fundraised. Which was an adventure in itself! A group of us hosted a race night where we managed to raise quite a bit. We hosted it at the sports club and we played pre-recorded races on the big screen. We invited all our friends, family, and friends of friends. It was a really fun night, and it raised a couple of hundred pounds – it was brilliant.

So, what was it that made you want to go overseas on an experience like this?

Coming from a small town and then moving to Manchester to study, my independence kind of just manifested. Nursing really helped to build my confidence and I felt like I could stand on my own two feet a bit more. 

I wanted an adventure. I’d never done anything like that before. I would have loved to have gone travelling but I wasn’t sure how I could fit that in. But my overseas placement was the perfect opportunity to go away for six weeks – it gave me a good taste of what it’s like to be away from home. 

We’re so fortunate to have the NHS, so it was important for me to see the differences.

I was also really intrigued about what healthcare would be like in Tanzania. We’re so fortunate to have the NHS, so it was important for me to see the differences.

Would you have considered arranging your overseas placement independently? 

No. I might consider doing that now, as I’m a lot older and wiser. But at the time, definitely not. 

When I booked my flights I actually managed to book my flight to Zanzibar which is a completely separate island to Dar es Salaam. But I didn’t realise. 

So when my flight landed in Zanzibar, of course, there was no one there from Work the World to greet me. And I just panicked. My mum got a panicked phone call from me. But of course she wasn’t able to do anything. 

The benefit of travelling with Work the World was that they were straight on the phone and we managed to sort everything out. I was soon on a flight to Dar es Salaam where I was greeted by the Work the World team. They were brilliant throughout it all.

Was there anything that worried you about going overseas for your placement?

Not that I can recall. I was more excited than anything else really. Because I knew I was going with a reputable organisation like Work the World I felt quite comfortable about it all. 

And then I had the mishap with my flight, but that was the worst that could happen and it ended up being completely fine too.

What made you choose Tanzania?

I’ve always loved Africa. I was that child that loved the Lion King too. In Tanzania, they speak Swahili and there are so many Swahili words in the Lion King. 

It’s also a beautiful place. And everything I read about it I just loved the sound of. 

I liked the idea of going back to basics. I wanted to be away from the world that I was used to and appreciate that it was going to be very different. I wanted to experience that. 

Leanne Jane Steel (STEEL2580)

There were also lots of opportunities outside of placement too. We were close to Zanzibar and there was a lot going on there. You could go out on the boats and spot dolphins and go snorkelling. You could explore Stone Town and go and see the turtles as well. There was just so much to do.

I also went to Kikumi National Park and did a weekend camping safari. That was incredible. I’d go back in an absolute heartbeat.

And how did you find the hospital placement? What was the day-to-day like?

We’d get up in the morning and have breakfast at the Work the World house. We’d then take a dala dala, the local transport, to the hospital. It was the cheapest way to travel and we wanted to experience the local culture. 

We didn’t really have a routine set in stone because you’d never know what was going to come in that day. We interacted with the local doctors a lot and we’d be guided by them as to what we could do to help, and we’d learn that way. 

There was also the language barrier, so we were lucky that the doctors all spoke good English. They were able to support and brief us on the different patients. 

What were the most interesting cases you saw during your placement? Are there any particular patients that spring to mind?

I remember one particular day, there was a seventeen-year-old boy who had travelled to the hospital in Dar es Salaam from a village. 

He was suffering from severe gangrene across both his legs. I remember thinking why would his parents not have brought him in sooner? Why had they let it get so bad?

It transpired that the family were from a village many miles away and the village had to club together to get the money in order to bring him into the hospital. But at that point, he was beyond saving. It was a real eye-opener. 

I often think of that particular patient when I’m working for the NHS and people are taking it for granted – people just don’t know how lucky they are. 

These experiences really do shape you. My mum always said when I came back from Tanzania I had changed. So much can happen in six weeks, that these experiences do become a part of you. 

What were the most striking differences between nursing in Tanzania and the UK?

The lack of any kind of ambulance service was definitely one. Patients had to find their own ways to get themselves to the hospital. 

There wasn’t really any help available until they got to the hospital. Here in the UK, we can just pick up the phone and get the help we need. They don’t have those options in Tanzania.

Let’s talk a little bit about where you are now and what the timeline was after you graduated. How do you think the experience changed your approach for the rest of your degree?

When I returned home from Tanzania I only had one final placement left which was our leadership placement. I think my experience in Tanzania definitely helped me to become a better leader. I was more confident to take the lead and take charge.

My overseas placement helped me to develop the skill of assessing and prioritising – I developed the ability to quickly assess where I needed to focus my attention first. 

Leanne Jane Steel (STEEL2580)

it especially set me up to go out into the world as a registered nurse

It gave me more confidence all round really. And it especially set me up to go out into the world as a registered nurse the following September. I felt a lot more prepared.

What did you get up to after you qualified? 

I tried to go into nursing straight away, but it was really hard to get a job in nursing at the time. 

So I worked in a pub for a bit whilst doing bank shifts. After a couple of months, I got a position in an Acute Stroke Unit and I was there for two years which I really enjoyed. 

I then moved to Milton Keynes where I got a role on a Gastro Unit and later went to work in the community which I ended up doing for six years. I started off as a Community Staff Nurse and then I was funded to complete a degree in District Nursing. 

Leanne Jane Steel (STEEL2580)

I’ve since taken up a role as a Tissue Viability Nurse Specialist. And that’s what I’m doing now. I love it. I got a lot of exposure to wound care in Tanzania, and again when I worked in the community.

Did you draw upon your experience in Tanzania when you were talking to employers?

I always do. I actually did an interview with a local newspaper when I returned home from Tanzania, which I’ve kept a copy of in my portfolio.

It’s always a really good topic of conversation in interviews and I think people can see how passionate I am when I start talking about Tanzania.

Do you think your Work the World experience contributed to where you are now then?

Yes, I think so. Especially in my last post, as it made me unique in a lot of ways. 

At the start of my career, it was very hard to get the interviews. I was a newly qualified nurse and there were so many of us around. 

I’ve been in my current role as a Tissue Viability Specialist for nine months now, and I think my experience overseas is what set me apart. In my interview, I spoke about the 17-year-old patient I mentioned earlier. I believe, especially as the role specialises in wound care, they remembered that – I think that helped me get the job. 

My experience in Tanzania definitely helped me get to where I am now.

What’s the day-to-day like for you as a Tissue Viability Specialist?

It’s changing at the moment. But normally, first thing in the morning I would go through patient notes to check if there are any to be concerned about. I would triage these and check in on them. 

As Tissue Viability Specialists, we get referrals from everywhere – there’s only two of us, and we cover the whole hospital. We cover surgery, acute, maternity and outpatients as well. So, we basically get everything. Which I don’t mind. I find it interesting.

I then go and see my patients. I review them, put a care plan in for them, liaise with different specialists, and make sure everything is in place for them. 

We’re also an advisory service and provide education as well. At the moment, because of the COVID-19 pandemic, the usual way we provide education has had to change. 

My colleague and I were very quick to address this and set up a digital 30-minute bitesize Tissue Viability Session on a Thursday. We’ve covered wound infection, negative pressure therapy, pressure ulcers, moisture lesions, and just about everything else. 

We started recording these sessions, and it’s just grown and grown since. It’s been really interesting to teach in this way as it’s not something I had done before. I’ve got experience with patient education and carer education but I’d never run sessions with nurses, doctors or consultants before. But I’ve enjoyed it!

Leanne Jane Steel (STEEL2580)

Do you have any words of encouragement for current students thinking about undertaking an overseas placement?

I’d say, just do it! If you’ve ever considered doing it, then you should just go for it. It’s so worth it. 

Of course, it will be hard and it will test you. It’s challenging at times but that’s a good thing really. Nursing does that anyway. So why not get as much exposure to that beforehand?

There’s the opportunity to do a little bit of travelling and have fun around the placement as well. Go and experience what it is like to nurse in a different culture. It’s important to go out and expand your horizons when you can.

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