When she came to UK to work, she was on a rollercoaster of emotions– scared, excited, confident, insecure, homesick…
Scared of what she will be encountering—culture shock, different nursing style, language barrier (multiple accents), state-of-the-art equipment (touch screen monitors, arterial lines, swan ganz catheters, intra-aortic balloon pumps, ecmo- a lung bypass machine, nitric oxide, continuous veno-venous hemofiltration-a dialysis machine, cpap machine-continuous positive airway pressure)…..so scared that she was having doubts whether she would be able to prove my nursing competence… So scared that she did not want to go on duty… so scared that she wanted to go home.
Excited to be independent and detached from the safe and secure bosom of her family… Excited to be free to do what she want as long as she is aware of her limitations… excited to learn new things…. excited to be working on a specialized unit.
Confident that she will be able to prove that she will be a well-motivated and competent nurse…..confident to be recognized as an effective and efficient nurse….this so-called inspiration may be attributed to the presence of Filipinos in the cardiac unit who are doing very well. There was a tiny spark of hope that she will also make it.
Insecure because she came from a third world country with limited medical and technological experiences when it comes to equipment. And not to mention that she come from a private hospital in the province. This will indicate that she will have limited experiences when it comes to cardiac patients. As we all know, there are limited medical cardiac procedures done in the province…even almost nonexistent.
Homesick for her family’s support and presence, encouraging words, sense of security, in spite of these bizarre emotions, she is proud to say that she can level with the British nurses. It took a lot of hard work on her part to achieve the status of where she is today. And she owes it partly for her schooling in Saint Paul College of Iloilo and for 1/2-year training in the medical ICU at Saint Paul’s Hospital.
She started as a C grade nurse while waiting for her pin or nursing license. It was a big blow to her pride and ego to start again at the bottom. The UK standard of nursing does not recognize the training they’d had in the Philippines. They have to undergo a 3-month training in order to qualify. In these 3 months, there will be orientation and supervision phases.
In the orientation phase, she will be working with a senior nurse. Her nursing responsibilities were reduced to:
1) vital signs taking as reflected by the cardiac monitor
2) bed baths and other forms of hygiene
3) oral drug administration. She could not administer any IV medications.
In the supervision phase, she got to work alone but shadowed by a senior nurse. I was now allowed to administer IV medications and make decisions as long as it had been checked with the senior nurse.
After 3 months of hard work, she was promoted to D grade. she got to handle patients on her own. In her unit, they have a 1:1 ratio of nurse-patient. Day by day, she learned new procedures, enhanced my knowledge and skills.
After a year and a half of proving her competence in knowledge and skills through the official nursing competency booklet as prescribed by the UK nursing midwifery council, she was promoted to E grade. Her responsibilities became wider in scope– she got to look after new nurses, train new nurses and handle student nurses…. what had gotten her through were the
initiative and motivation to face new challenges and responsibilities.
After a year of being an E grade, she was promoted to a pod leader (a pod leader has a group of 4-5 nurses and patients. She will act as a liaison between the junior nurses and the senior nurses plus the medical team). SHe is now being trained to be one of the nurses-in-charge of the cardiac high dependency unit (a step-down from the cardiac intensive care unit.
She is proud of what she have achieved so far. She have gone through a lot– shed a few tears, bruised pride and egos, plummeting self-esteem. These experiences made her a better nurse and a better person.
It is difficult to work in another country because of the cultural differences. It cannot be denied that some of her colleagues (doctors and nurses) have racial discriminations towards Asians.
No matter where Asians will go, there is the question of superiority and inferiority. Her Filipino colleagues and she have been treated as an inferior. For example, during ward rounds, doctors would rather address their orders to senior nurses instead of her. She find it insulting and quite degrading. She would stand there and look stupid. It was her patient their discussing but they were not including my sis in their plan of care for the day. This can be a major stress factor. Some would even refuse to help Asians.
Filipino nurses are very hard working. They often get the most critical patients. Ironically, they are one of the lowest in rank when it comes to the nursing hierarchy but they get to be allocated to critically ill patients. And when they do, it is on a 1:1 ratio. But when the British nurses handle the same kind of critically ill patients, the ratio is 2 nurses to 1 patient.
Nevertheless, they, Filipino nurses manage to withstand the trials and tribulations they encounter. They manage to work for years no matter how difficult for the sake of professional development, career advancement and security.