Since I began my nursing course, I have always been itching to achieve a greater sense of responsibility; take charge of my practical skills and put them to a more productive use then a simulation lab, or a pass/fail grade. I am not one to shy away from adventure, so decided to work as hard as I could all summer in order to save enough money to travel, but also to help those in need with the skills I had acquired. With luck and the help of my close friends, I was able to find an adventure within my niche of practice.
In October, a close friend suggested that I quench my eagerness for adventure and nursing by travelling with her to Nepal for part of my summer break with Work the World. The sheer beauty of the country and unknown realities that I may face whilst practicing in a foreign place were convincing enough. I was signed up within a week, and could not be more excited!
Before I could blink my second year finals were done, and June had appeared. Keen, but nervous, I was packed and ready to embark on what turned into my greatest adventure thus far. Departing Toronto Friday at 1600, we had 34 hours of flights/delays and layovers and lost 11 hours sleep because the time difference meant our arrival time in Pokhara was actually 1600h on Sunday. Fighting the jet lag was an integral part of our first few days, however we had the support of 16 other students travelling and working in the same capacity. Nursing Students, MD candidates, PT’s and dentists from all over the world readily welcomed us, excited to collaborate and experience Nepal in all of its glory, just like us.
I began working in Nepal at the Paediatric Intensive Care Unit in a private teaching hospital. I was working with many other students, which helped to ease the cultural transition.
Being a Male Nursing Student has many stigma’s, and these barriers became even more prevalent in Nepal where they refer to nurses as “sisters” - this caused unexpected hurdles which I had to overcome along with other male nursing students. I’m sure it didn’t help that I stand at over 6 feet tall, towering almost a foot over most of the doctors and nurses native to Nepal!
I enjoyed the time I spent in paediatrics; working in such an intimate and remote setting with such small and fragile children was incredible. I was presented with opportunities and learning experiences that I will never forget, such as placing an IV in an 8 day old baby—notably, on my first try. The sterility, or lack there-of, and the Nepali approach to medicine was at times quite shocking and took me a while to understand. I realised it was not a lack of skill, but rather lack of supplies and lack of “proper” technique. I use “proper” loosely as North American practice standards are far different than those in Nepal. Some of the most distinguishably different techniques I witnessed were using 2L coke bottles as catheter draining bags and using 1 thermometer for the entire ward (they would transfer between patients by simply wiping it off on their scrubs). The nursing atmosphere was different than anything I had or ever will experience again.
My other placements in the first two weeks included visiting orphanages. We would go with the doctors to do check ups and were given the opportunity to run some of the appointments, and interact with the children. As all of the students were eager to take on this opportunity, we had an excess of volunteers, so when we were not running check ups we were able to play and interact with the children in a non-medical format.
I was fortunate enough to attend a “One Day Women’s Health Camp”. Although the keynote speakers were all in Nepali, we were able to identify some words and interpret that the speeches were about female health, and gynaecological assessment. We were then stationed with a BP cuff, taking manual blood pressure, and teaching some of the first year MD students from abroad how this was done. It was interesting to note that the health care documentation although written in Nepali, was formatted the same and we were able to identify when there were discrepancies with the women’s BP, referring them to the attending for further assessment. This experience was especially rewarding, as I was able to use my fundamental nursing knowledge to benefit a vulnerable population within the Nepali community.
I was then partnered with a nursing student from Scotland and an interpreter, and sent to remote Nepali Locations fror my Village Healthcare Experience. The second placement was 2 hours by bus, followed by a 3-hour hike. We stayed with a family within this isolated community. All of the locals in the village were so grateful to have us be a part of their community. The medical situations I encountered in the village were relatively simple, and only having a supply of 10 medications limited the scope of practice and the ability to treat more severe cases. I encountered snakebites, lacerations, and some minor burns. I was often offered help by the local medicine man in my endeavours and he showed me how to drain a wound with the injection of Lidocaine. I was prepared for their lack of supply, bringing Band-aids, Tegaderm and gloves from home—all of which seemed foreign and advanced to these isolate individuals.
The last night I was able to spend in the village was an incredible experience. We were invited to celebrate a local wedding, joining in the celebrations, and feeling as if we were an essential part of the community. They were happy to have us, wishing that we were one of their own. Leaving these people, and this town, knowing that we had made an impact on their health was a surreal and a humbling experience, as I was able to act selflessly, and see positive outcomes for those around me.
The last two weeks of my trip were spent in the emergency department for the public hospital. All the memories seem to blur together, from burns to dog bites to car accidents. I was able to witness first hand how they were able to deal with stressful health situations, which was very interesting. The most common injury was electrical burns, as most Nepali natives live in poverty and steal their electricity. Thankfully, with my nursing background and with all the knowledge I brought forth, I was able to help in all ways possible, exploring the different wings of the hospital, and offering my expertise where it was needed.
Being in a foreign country, my colleagues and I when took opportunities to explore the communities in which we worked when we had finished work. We would take photographs and talk with locals about their health and their experiences in Nepal.
Twice while I was out and about, I was able to use my nursing skills to successfully save the lives of two individuals.
The first was a girl who was unconscious, and returning to shore with her friends on a paddleboat. A med student and I came to help her friend, bringing her onto the dock and checking her vitals. She was unconscious, but thankfully still breathing. We carried her to the main road, where we were able to hail a cab for her and her friends, sending them to the hospital. The girl had swallowed large amounts of polluted water, and seemed to be under the influence of alcohol when she had started to drown.
The second moment of emergency response was on my last day. It was an incidence of chance - I happened to be in the right place at the right time. I was walking home when a small boy crashed his bike. I helped to untangle him from the handlebars, only to realize that the bike pedal had become impaled in his upper thigh. There was a lot of blood, and it had impaled itself so deeply that I could palpate his femoral artery. A crowd gathered as I pulled my gloves and gauze from my dressing kit. Using only my instincts and adrenaline, I packed the wound with as much gauze as I could, ensuring all the fatty tissue was back in the wound, creating a small tourniquet ensuring that the boy had minimal blood loss. As soon as I had finished tying the tourniquet my colleague had hailed down a cab to get the child to the hospital. Luckily his mother arrived so we were able to explain to her his dire need for medical attention. In these moments of stress I felt great pride, and I derived great pleasure knowing that it was here at the hospital in Nepal that I became so aptly prepared for these very situations.
This trip was not only rewarding in an academic and practical sense, it was emotionally rewarding. Having an opportunity this vast at such a young age broadened my nursing horizon, and helped me to realize that I would not want to be doing anything else with my life. Helping others is what I signed up for, but I didn’t realize that throughout this process I would help myself, and grow so much as an individual. Riding elephants, giving needles, white water rafting, experiencing Tibetan religion, visiting the birthplace of Buddha and saving lives are just some of the memories I made whilst abroad. I know that nursing is right for me, as my biggest adrenaline rush on the trip was not paragliding, or doing dangerous acts, but rather the adrenaline I felt while caring for people, and helping to the best of my abilities in emergency situations. I am so honoured and blessed to have experienced such a rich culture, and I know that I will take my nursing career to every corner of the world in order to help those most in need.