Called to Promote Nursing Excellence as Facilitators of Service Learning

Saturday, 7 November 2015: 3:55 PM

Linda Rice, MS, RN, CWOCN
Wound Care, Banner Boswell Medical Center, Sun City, AZ, USA

Experienced American nurse educators discuss their experiences living in and learning about the Chinese culture. They were in residence in Hubei Province, China from February through July 2014, living in Wuhan, a city of 12 million people in the central region. This city is the Chinese center of high-speed railway transportation, automobile, computer and electronic manufacturing. Wuhan is located on the Yangtze River and has a rich cultural history.  The educators share their integration as visiting professors of nursing into Wuhan HOPE School of Nursing, their adaptation to the Chinese culture, and their personal learning.  This includes visiting historic sites such as the Yellow Crane Tower in Wuhan, the Terracotta Warriors of Xi’an and the Great Wall of China, near Beijing. The educators reflect on clinical teaching activities in and touring Chinese hospitals, clinics, health centers, and community centers.  They share the day-to-day experiences of observing health care, medical and nursing practices.  Living in a densely populated city results in learning to overcome the challenges of using transportation systems, shopping for personal items, and obtaining required resources.  Other issues that are shared include the effects of pollutants, in the air and water, and how this is integrated into the daily living routine and work setting.  The educators were teaching in a nursing program that was presented in English, but lived in a community where the Han oral and written Chinese dialect is used. This is a challenge when using transportation and business services. 
Cultural learning focuses on the role of Chinese nurses in diverse health care settings and the community perspective of the nursing professional. Chinese nurses are limited in their opportunities to practice what they learn in the classroom.  In most health care environments, the focus of the Chinese nurse is on medication administration with patients and families accepting only teaching by the Chinese physician. Patients and families have limited understanding of the nursing role and their expectations are that nurses are there to work under the direction of the physicians. Nurses are not viewed by the Chinese as individuals in leadership roles, as providers of client education, or in a direct hands-on role for routine day to day care. Patients and families expect nurses to administer medication according to their preferences, rather than following established guidelines. New graduates are expected to be competent at performing nursing skills by passing national and hospital based exams as part of their nursing registration.  New graduates seeking employment must meet hospital hiring requirements of height and personal appearance, and have lengthy orientation periods before being assigned to a specific unit in a permanent full-time position. The expectation is that the nurse will work the assigned hours, and accept the directives of nursing administration. There are opportunities for assuming additional responsibilities with graduate education and time in the position.  There has been increasing incidents of violence against doctors and nurses perpetrated by dissatisfied patients.  Much of this violence results from patients’ lack of understanding of Chinese health care financing and insurance, the increasing distrust of pharmaceutical and health care industries as more incidents of product contamination and profiteering emerge, and the increasing government burden in providing health care to the world’s largest population.  The American nurse educators discuss their perspectives on the diversity of nursing practice observed in hospitals, hygiene and sanitation standards, equipment being used, organizational practices, standards of care, the use of computer and other electronic resources, and the limited availability of community health services. 
The American nurse educators discuss the nature of their experience from the service learning perspective. The educators supported nursing students who were providing health promotion activities at the only geriatric residential care facility in Wuhan. The educators obtained a Sigma Theta Tau, Gamma Pi At-Large service grant to assist the Chinese students to purchase supplies and equipment to offer health education classes, exercise programs, and other activities at this geriatric center. The educators worked with a videography company in writing and developing a video about the nursing students’ service learning project which was used for a major grant application by the Chinese nursing faculty at Wuhan HOPE School of Nursing.  This grant would support community nursing practicum activities resulting from the opening of the new rehabilitation center at Wuhan HOPE School of Nursing.  The American educators worked with Chinese nursing faculty in writing, filming and narrating a video which will be used for a future grant application for another community service project.  A third video the American educators assisted with was a commemorative project celebrating the founding of the Wuhan HOPE School of Nursing.  This was shared at a medical center/university convocation, the dedication of a memorial to a donor to the Wuhan HOPE School of Nursing and the opening of the rehabilitation center.