Feature: NURSES WEEK TRIBUTE: Global Insights
Heather Bracken is an RN at Christiana Care Health System in Newark, Del.
The author has disclosed that she has no financial relationships related to this article.
DOING SOMETHING OUTSIDE of your comfort zone can make you see the world differently. My experience volunteering in a clinic in Haiti impacted me both as a person and as a nurse, changing my worldview. I always liked being a nurse, but I fell in love with nursing while volunteering in Haiti.
In June 2011, a group called the Haiti Family Initiative was looking for volunteers.1 I signed up. Three weeks later, I was white-knuckled on a ramshackle bus careening around the mountains between Port-Au-Prince and Jacmel, Haiti.
This was my first time in Haiti and I was completely shell-shocked by what I saw during the 3-hour bus ride. A year and a half after the 7.0-magnitude earthquake that devastated Haiti, the country was still in desperate need of help. I saw demolished buildings, trash and sewage piled high, tent cities on highway medians, and people everywhere. Young children were wandering in the streets, seemingly alone. Dogs were running around loose and goats and donkeys were being walked on leashes. It was unlike anything I'd ever seen.
At the Salvation Army School in Jacmel, at least 50 patients waited in the schoolyard while we set up the clinic and camp. I was sweating profusely, more from nerves than from the hot and humid weather. I'd never been in a situation like this. Here I was in a foreign land, providing nursing care for people I couldn't even engage in conversation. I'd never even worked in a clinic or setting other than an American hospital. Without the luxury of resources I relied on at home, I worried that I wouldn't be nearly good enough.
I set up a nursing triage table with Alix, a young man from Jacmel who offered to translate everything I said into Creole or French, the two official languages of Haiti. Assessments took longer than usual because of the time needed for interpretation, but things went smoothly. Not able to speak the language, I found myself relying on nonverbal communication to convey caring, empathy, and concern. A smile and a light touch on the arm or shoulder seemed to go a long way.
Change in perspective
Being deposited into another culture, unable to speak the language, made me think about my patients at home who are from a different culture and unable to communicate effectively. I could now understand the frustration one must feel when dealing with a language barrier in addition to the stress of hospitalization.
When I came home from Haiti I had a different perspective on cultural competency. I certainly gained an appreciation for my hospital and all it has to offer. I began to fully utilize our cultural resources for patients with limited English proficiency. For example, I make sure those patients have a translator telephone in their room, access our patient education database in their native language, and use the translation tool on the interactive bedside TV network for conversational needs. Making an effort to communicate effectively shows the patient I care.
My experience in Haiti affects me every day. The images of poverty are etched in my mind, but the spirit of the people is etched in my heart. When we were conducting our clinics, it amazed me to see the translators and the patients laughing, smiling, and joking with each other, even though they were strangers. They were so warm with each other. Some patients were barely able to stand, yet they'd walk miles to get to our clinic. I've never had so many patients hug and kiss me, just for giving them acetaminophen.
I now know what it feels like to be immersed in a culture different from my own. I value the Haitian interpreters who reached out us, and I want to make sure my coworkers and I are reaching out to our patients in the same way. I want us to understand, interact, and effectively communicate with patients across different cultures. I found that my organization has a wealth of resources to help provide culturally competent care, but many coworkers aren't aware of them.
Providing optimal care
I'm currently planning a cultural diversity awareness project, educating staff about various cultures and common healthcare beliefs within those communities. I'm also helping increase awareness of the vast cultural resources available to us. Through these endeavors, I hope to provide optimal culturally competent care to our multiethnic patient population.
I returned to Jacmel in 2013 and plan to return every year. Forever in my heart, Haiti has changed my nursing practice for the better.