Author: Hazel Self
Perhaps the second great need is cultural awareness. One vivid example of this was illustrated in the post-operative care of our patients. Knowing that many people travelled several hours over rough roads in crowded buses to obtain surgical care, we assumed that the opportunity to recuperate several days in the hostel adjacent to the clinic would be most welcome. Hence, we were more than a little bewildered when the news of delayed discharges frequently met with tears and anxious pleading. The language barrier prevented us from being party to intimate family discussions and these grateful, gracious people were perhaps reluctant to offend by informing us of their cultural beliefs. Once again, we only glimpsed the bigger picture by visiting local hospitals and clinics. There we were puzzled by the number of empty beds which seemed incongruent with the line-ups of apparently very ill people waiting to be assessed. Persistent questioning revealed a prevalent misconception that admission to a hospital equated with a poor prognosis. With this new understanding, we redirected efforts to provide important post-op teaching early in the recovery period and allow patients a timely discharge with the assurance that they could avoid or treat any complications.
For months prior to each trip, kind people donated little toys of every description which we in turn happily distributed to eager children at each clinic. Once again, we were initially slow to perceive the meaning of disapproving glances from Nicaraguan staff. They would never interfere without invitation, but when asked, they kindly explained their constant struggle to educate people to seek routine, preventative health care. Too often trinkets had been used as an enticement and children had come to expect gifts but not understand their need to take responsibility for their own good care. However, when shared in the community outside the setting of health care, the gifts were very welcome and opened the door for friendship
The third prerequisite to be discussed in this brief overview is the need for a high level of professional expertise combined with flexibility and ingenuity. Working in a totally unfamiliar environment with limited facilities and few resources is a challenge for the most experienced, gifted professional. Without solid assessment skills, a broad knowledge base and willingness to acknowledge limitations, there is potential for serious adverse outcomes. It is important that each volunteer assume individual responsibility for obtaining a clear understanding of expectations and for acquiring and/or updating skills. Never has a day passed when our team has not been stretched to improvise, collaborate and “make do” but the satisfaction of seeing happy people and positive outcomes at the end of the day far outweighs any inconveniences.
Love for people, enthusiasm and a positive attitude are the magical qualities that make lasting impressions, turn hardships into adventure and inspire people to happily give their time and resources year after year for missions such as M.A.S.H. The pay back is personal and professional fulfillment that cannot be measured. Volunteering in this capacity is undoubtedly one of the highlights of my forty year nursing career.
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