Nursing Applicants

I have a compiled a list of the frequently asked questions (FAQ’s) for prospective nursing students inquiring about mission life in Chimbote, Peru. This is my second year to be advising future applicants to the program. I mainly get inquiries from nurses wanting to know what the environment is like. Many new grads are a little nervous from their lack of work experience. I hope the potential applicants find the information below helpful and the rest of you find it entertaining to read.


Q: What do nurses do there that we do not do in the U.S.?

A: Outside of your license, I have seen the nurses here suture, take off toe nails and prescribe medicine.


Q: What should I bring?

It would be helpful to have an international drug reference – that information is not in the house and difficult to find on-line. Most of the drugs in Latin American are different. Different names and different formulations, so you will need to do your homework as you encounter drugs that you are unfamiliar with.

There is no standard of care here. People are formally trained in nursing school but everyone seems to have their own way of doing things and there is no skills checklist or precepting. If you have a skills/ clinical procedure book you might choose to bring it because at some point you might want to reference how things are “suppose to be done.”

Also, the lack of basic resources makes it almost impossible to observe universal precautions. Gloves are not available for every patient, nor is soap and water always found when you need it. For that reason many of the health care volunteers have invested their own money in gloves monthly and carry alcohol hand sanitizers.


Q: Will I receive any training once I am there?

No. The basic skills you learned in nursing school is enough to be of service here. Much of nursing in Peru is similar to how nursing was 50 years ago before nurses delegated patient care to respiratory therapists or nurses aids. You will find yourself providing basic, basic care such as baths and vital signs. There is lots of room for initiative especially in the area of education. It is up to you how you go about doing this whether it is for the patients or staff. It is good to know ahead of time that no one will tell you what to do, when to do it or how to go about doing it once you suggest something so the more initiative you have, the more purpose you will find in your work.


Q: What have you found the most difficult?

A: The main difficulty in any volunteer site is in the language. You will gain more credibility if your Spanish does not make you sound like a 5 year old.


Other observations:

Sterile technique does not exist here nor is it really possible. The best you will see is a clean technique. This includes invasive procedures. They just do not have the resources or machines to validate and maintain a sterile field.

Health care is not a right here it is a privilege. There are very few patient advocates other than their own family. You will see people who need surgery, even emergency surgery but will suffer the debilitating and sometimes fatal consequences because they just do not have the money to have their tumor excised, an appendix taken out or have their open fracture repaired. All services, including emergencies are paid for ahead of time. If the family does not keep up with buying a patient’s antibiotics the treatment is halted when the supplies run out and is resumed when the family members show up with the necessary items in hand which includes drug, syringes and injection needles.


Suffering

Prepare yourself. It is difficult to see people in pain especially those with AIDS or end-stage cancer knowing they are receiving something that is just a little stronger than Advil.

Some families may choose not to inform a loved one they have cancer but they also will not shield the younger ones from the death or suffering of a sick family member. Multi-generational, mixed houses leave little room for privacy.


Dangers

No effort is made to isolate TB patients apart from opening a window if you even know that they have TB. Very few patients will ever be presented to you with their full clinical picture so you will not always know what disease process they might have contagious or otherwise. For instance, you will see a patient that has a diagnosis of cancer but clearly has a neurological deficit maybe even loss of consciousness but no mention will be made to the cause of the deficit such as viral, bacterial, motor vehicle accident etc. You just never know what they have and that information is not available anywhere on the chart.


Take Time Out

One of the things I had to remember after one year is that I am a volunteer so if you find you are experiencing burn out take a step back and be kind to yourself. The need is so great that sometimes it may seem that whatever you do, it will not be enough and it will not always be appreciated. Just do your best, pray, take time to build relationships for support within your community and know the poor will always be with you.