This summer, four students participated in the IU School of Nursing’s first study-abroad opportunity in Kenya and gained new clinical experiences, friendships and perspectives on global nursing and healthcare.
“This trip will definitely impact my future career. I never expected to consider global health in relation to nursing until now,” said student Briana Miller. “Nursing is a worldwide profession that is highly influenced by culture, and that is very interesting to me.”
During their two-week trip, the students worked alongside Moi University nursing and healthcare students in community clinics and at Moi Teaching and Referral Hospital. They also participated in the first AMPATH Global Nursing Scientific Conference.
“The relationships that the students developed with the Moi University students (nursing and other healthcare) was invaluable,” said Bethany Murray, PhD, RN, PMHCNS-BC, clinical assistant professor at the IU School of Nursing, who led the trip. “Students were teaching students. We had so much to learn from the Moi University students. This was not an experience of Americans flying into Africa to bring knowledge, rather, this was an experience of learning with and from the Moi University students at a deep level.” Moi University nursing students are currently visiting IU as part of the AMPATH bilateral exchange.
One of the unique opportunities that the students had in Kenya was participating in the labor and delivery unit. At IU, students get one day of labor and delivery experience, and it is rare to participate in the birth of a baby during nursing school. In Kenya, nurses and midwives attend to most uncomplicated deliveries.
“The memory that stands out to me the most was being able to watch many deliveries and actually participate in one of them,” said student Arianna Winchell. “Maternity and obstetrics are my main interests and being able to work closely with the MTRH midwives on the delivery and immediate care of the newborn after delivery was so amazing! I will forever remember my time on the Labor and Delivery ward and how much I was able to see and do.”
“I had observed a C-section and participated in deliveries at clinicals back home, but it felt different to be involved in Kenya,” added student Hannah Rebey. “Labor and Delivery, like many other wards, was extremely busy and moved very fast. One of the nurses told me that they usually have about 20-25 deliveries each day. One patient in particular was having a really hard labor all alone. With her permission, I stepped in as a support person. It was really special to be involved in that way and sort of slow everything back down and make her labor experience a little better.”
Student Kaytlin Dow was also given the opportunity to “scrub” (the process of scrubbing, gowning and gloving) into a surgery. “Since I am so interested in circulating or scrub nursing, this opportunity was tremendously appreciated. The surgeons, nurses, med students, surgical technology students and nursing students all supported me the entire case and were eager to teach me. I felt so comfortable in what would potentially be an uncomfortable environment at home,” she said.
The students spent three days in a subcounty hospital in a more rural area with second-year Moi University students in various healthcare disciplines. Dow and Miller were able to participate in a community interview with leaders and members from a local tribe. “One of the Moi students translated the meeting for us, which was very kind,” recalled Miller. “The men and women had organized themselves separately, and the interviews addressed each group separately as they often had different opinions and viewpoints. The questions were related to public health, water contamination concerns, insect protection such as mosquito net distribution, sexual health, psychiatric health and more. I remember feeling surprised by how gender roles affect their lives, and the stigma around mental health.” Rebey and Winchell spent their time visiting rural homesteads and meeting with the residents along with their healthcare teams.
Dr. Murray believes it is important for nurses to be able to place the care they provide in the context of a person’s complete environment, taking into consideration social and cultural factors. “I feel it is important for students to empathize with another person’s perspectives on life and be able to gain insight into problems that they may experience. My hope is that students who do study abroad will be able to generalize this experience to persons they care for ‘back home’ and understand that there are many factors that influence a person’s health – not just the disease process.”
“This trip truly opened my eyes to caring for patients of a different culture,” said Dow. “It allowed me to practice cultural humility, check my self-bias and practice cultural competence.” She reported that working with women in labor and delivery who only spoke Swahili helped her to practice nonverbal communication and adapt to her environment.
Winchell added, “Not only do I have a better appreciation for the hospitals in the United States, but I was able to be very hands on and have nurses who trusted in me, so I gained a lot of confidence. I was able to learn how to do a lot of assessments manually instead of relying on technology. I was also able to apply what I have learned in my classes to real life scenarios. My brain was always moving trying to come up with a care plan or intervention or trying to learn a new way of doing a skill.”
“Being a part of the AMPATH Conference was great. I realized how much knowledge sharing, partnership and collaboration are big components of improving worldwide nursing,” said Miller. “This is especially true for the clinical educators at MTRH. It is very clear that they each work very hard to push education and best practice on their units. I think all of us (students) feel very compelled to return to Kenya at some point, and we each have talked about returning for research.”
The students were unanimous in encouraging other students to take similar opportunities to study abroad.
“It’s easy and normal to be intimidated by ‘what ifs’, but it’s really important to not let it deter you from trying and applying,” added Rebey. “Applying isn't a commitment, but it's the first step to give yourself the opportunity to do something amazing.”
“This trip was a once in a lifetime time experience that I will never forget. Not only did I have so much fun, but I learned so much in such a short amount of time. I know things can get expensive, but I learned that money comes and goes but experiences like this don’t. Don’t be afraid to try something new, because in the end you will have so much personal growth and memories you will take with you for the rest of your life,” concluded Winchell.
