Sharing life, making a difference; weaving my experiences as a woman, a mother, and nurse.

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Nursing Challenges – Global Awareness


There are so many aspects of our trip to the Philippines that I love, it is impossible to pick a favorite.  Each focus area of our trip is rich with unique opportunities for sharing and learning. Sharing what we know about nursing; our routines, skill-sets, education, expectations for practice, passions. Our sharing combined with what we learn at the Mary Johnston School of Nursing, clearly illustrates a global approach to nursing practice.  Global nursing practice that draws on the uniqueness of culture, economics, politics, nursing knowledge, resources, and passion that leads to quality outcomes for the many individuals and families that receive nursing care around the world.

Meeting with Mr. Lester Naval, Director of Nursing at Mary Johnston Hospital, I learned about the most significant challenges he faces as he works each day to ensure that patients receive the care they need and nurses can work in an environment that supports their practice.  A nursing shortage is very real in the Philippines.  Many go to nursing school here, but many also leave to work overseas or leave nursing to work at other jobs.  For example, we rode with a Grab (Uber) driver one day who worked as an RN in an Emergency Department for 7 years.  He had to leave and find a way to make more money to support his growing family with a second child on the way.  Driving for Grab provided a larger paycheck than a job as an RN with a BSN degree.

So, Mr. Naval searches for ways to retain his nurses on staff.  He has started a new program of using nursing assistants who help the nurses during their shifts to accomplish all of the patient care that is required.  He is advocating to raise nursing salaries. The hospital is a private hospital with a mission focus, reaching a very impoverished community.  Combining this reality with the already very low nursing wages makes this a very challenging uphill battle.

Another challenge he faces is resources.  Gloves, soap, hand sanitizer, catheters, IV supplies; syringes; these are all things that nurses use daily in large quantities and supplies are not free.  How do you keep enough gloves on hand?  It’s pretty tough!  Equipment that we often consider disposable is cleaned, autoclaved and reused as this is the only way to keep stock in supply. Assessment equipment, such as BP cuffs, stethoscopes are in short supply throughout different areas of the hospital.

Exposure to this reality is a moment of awakening for U.S. nursing students.  Knowledge of the seemingly endless supply of gloves, syringes, needles, catheters, soap, BP cuffs, and stethoscopes, in our hospitals and nursing schools at home has new meaning and value. How do we respond to this new awareness?  Reflecting on this question is a task of each student on this trip.  My own personal awareness and reflection has led me to answer with education. Educating those who live and work in a more privileged environment to be aware and contribute to a global nursing practice. Educating those who live and work in a less privileged environment to use resources efficiently and incorporate our nursing science effectively with available resources to provide quality patient care.

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From selfies to selfless

Selfies are a phenomenon of our modern, global society.  Regardless of your location on this big orbiting globe, you will find someone taking a selfie. Selfies are not limited to the younger generation, this phenomenon spans generations, cultures, and nations.  It is simply a fixture of our humanness.

What is the attraction with taking selfies?  I have read comments that suggest that selfies represent a society that is self-absorbed, maybe somewhat selfish or thinking only about one’s self.  I don’t agree with that thought process.  I see this action of capturing one’s image and sharing it confidently on social media, as an act of being open to others, inviting friendship, sharing one’s inner self through one’s outer image. IMG_5400 copy

As I watch my team of nursing students take selfies on this first day in the Philippines, I am actually struck by their selflessness. These 12 young women chose to take this journey to a place where they are not familiar and to boldly share of themselves with people they do not know and likely will not ever see again.  We left just a few days after a very busy semester.  They are physically and mentally tired, yet they chose to travel to an unfamiliar land, where they will be physically, mentally, and emotionally challenged daily.

The combination of their individual selves melds to make a unique identity as a team.  I expect to see evolution of this team through our time here, but the image of this unique team and the selflessness they bring is captured forever in this “selfie”.


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Carunoan West

Yesterday we held a Medical Mission in this little village in La Union province, located on a hillside outside of Agoo where we are staying. We worked with our partner teams from International Baptist Church Manila and Living New Ministries to provide medical care. The students were assigned different stations – Intake, Vital Signs, Pharmacy, and the Dental clinic. There were volunteers from the local church that helped translate for them. Besides keeping up with the students I enjoyed practicing a little nursing myself. I filled in where needed and taught oral hygiene with two groups of children. 

The clinic was held outside in the middle of their community with either the cover of trees or bamboo and canvas makeshift tent. Luckily no rain today, after heavy rains yesterday. 

Community nursing at its finest! 

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A nurse’s hands…

We completed our week at Mary Johnston Hospital and the students had an incredible time. There is much to share about their experiences, and I will, but first I just have to brag a little. These students are awesome! I would say 99% of all nursing students begin their first clinical experience just a little anxious about what will happen. How will it be to interact with the patient? Will they know I am just starting? Will I know what to do? It’s normal; it’s expected. But that’s in an environment that is familiar. Slightly different story here and they embraced it. There is a nice list of skills they now have done in a setting that is not like home. 

These tasks they learned require the nurse to express her knowledge and compassion through the use of her hands – the art of nursing! There is dexterity needed for carrying out procedures and tasks and equally important the discernment to know that all that is needed from the hands of a nurse is a kind touch.  These students illustrated that so well this past week and I cannot wait to see their hands reach out this week in a new place and a new nursing adventure. 

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The first anything is always an experience to remember. As a Mom, my children’s first words, first steps, first day of school, first jobs are all firmly embedded in my mind and bring a smile every time I remember.

As a Dean/Professor, I appreciate “firsts” of nursing students as well. The first time a stethoscope finds the ears of a student. The first time a BP is taken, the first IV, the first injection, even putting on the first set of scrubs is exciting!

All of these firsts, from saying Momma to starting a patient’s IV are monumental accomplishments and deserve just a little shout-out! I am happy to share some of these moments here in the Philippines. 

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And again…


Off we go again…the “we” always changing. Every year, I leave the USA on a “May-venture” with nursing students from ETBU. This is part of our school’s Global Study and Serve program. More specifically for my nursing students it is living-out their call to nursing and exploring the idea of missions all through cultural immersion.

It is fun; it is exciting, but it is not easy. The climate is different, the time change is significant, traffic is nothing like we see at home. Though the English language is prevalent, there is an unfamiliar language that surrounds us – Tagalog. Even within our team some of us are not well-acquainted and we experience the uncertainty of knowing no one well. In the hospital and the nursing school the equipment, procedures, and treatments vary somewhat from what we see in the USA.

For me, this is the beauty of the trip, in all things different, challenging, and maybe even frightening, we find a commonality within all the differences. Finding that commonality brings balance to all things unusual and unsettling. Though the daily habits may be different, the Filipino people strive each day to get to their jobs, provide for their families and enjoy life. In our small group we evolve and establish our unique identity as a team. Here at Mary Johnston, the call to serve God through nursing is identical to our call and so much like us, is unwavering.

It is a beautifully diverse world God gave us. Delightfully different, yet a thread of sameness and connection interwoven among us.