International Nurses Not So Different

October 7th, 2011

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By , BSN, RN

Working as a nurse internationally is sometimes cause for concern. Will I be culturally competent? Translation, need to try not to offend anyone. Working in someone else's hospital is also a cause for concern. I need to maintain the standards of practice I'm trained to in the United States but don't want to appear condescending or stupid to my hosts. Working with Perfecta Balbuena Jazmin, Licensiada (that is equivalent to RN), in the Dominican Republic this past week, was a great chance to allay my fears and learn that really nurses are all alike (conscientious, caring, bossy) and in an exchange of information, everyone benefits.

What are the educational requirements for becoming a nurse in the Dominican Republic?

"Here, after your graduation from high school it is 4 ½ years of college to qualify to take your federal licensing exam. I went to the Autonomous University of Santo Domingo, the first university in the Americas. I was provided an excellent education and have been a Federally License nurse for 22 years."

As a sidebar, all licensed nurses in the Dominican Republic still wear white and usually caps that indicate what school they attended. The only RNs who don't wear white are pediatric nurses who wear pink or blue.

In the United States we are suffering under a nursing shortage, do you have the same problem here in the Dominican Republic?

"The opposite is true here. Lots of people here are studying to be nurses, lots are finishing their licensing and lots are applying but there are no jobs. The biggest issue is there are lots of pensioners not getting their government pension so they just keep working. They have worked as nurses for 35 years and aren’t quitting."

If it's so hard to get employment why do so many pursue a nursing career?

"Salary—it is one of the best in the jobs women can get in this country. And, it does offer good employment opportunities."

How many nurses are there in this hospital?

"We have 74 staff nurses, only three are men. "

What are the biggest challenges you face as a nurse here in Samana?

"Bureaucracy. When you want to do one thing as a nurse you have to ask 20 people and spend two hours doing it.

Can you give me an example?

"You are doing rounds with a doctor and he asks for blood work on a patient. As the nurse I have to walk down to the lab and get a lab tech, if he is there. If not I have to come back, in person, several times to get someone to come with me to draw the labs. That brings in the other challenge; communication. There are no telephones between areas of the hospital, no computers either. "

What kind of impact do the mission teams have when they come to your hospital?

"It can be disruptive but it is positive for the community.

No, what I meant to ask is what does the nursing staff think of the mission trip teams coming, so many of us dropping in, working and disappearing in a week?

She smiles and laughs. "It used to be more disruptive but we have worked with it. We change our staffing load. And, lots of systems have been put in place to keep the disruption down: tickets for specific numbers of patients to be seen, moving clinic spaces around to keep crowds under control, adding guards to keep people in order."

Nurse to nurse, what could we do as a group to help you all: a teaching program, equipment you need, or anything else you can think of?

"We are short on instruments for the delivery room, for normal deliveries. We never seem to have enough or exactly what we need." The nurses of the October Midwest Medical Mission have already agreed to help them out and when we return next October we will come bearing all we can think of for their labor and delivery rooms.

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