My Nursing Elective In Vietnam (Part 2)

In this video, Laura updates us on her International Elective Placement in Vietnam. Now halfway through her placement, she takes us through how her elective has been going, what she’s learnt, and differences between Vietnamese and U.K healthcare.

Hi, my name's Laura and I'm an adult nursing student, and I'm filming today from Huế in Vietnam. As you might have seen previously, I did a video explaining that I have been given the opportunity to do an international placement as part of my university course, so today I'm giving a little update as I approach the halfway mark.

So, I have come to Vietnam on a full week international placement. I have done one week on oncology. I'm coming to the end of my first week on A&E, and I've then got another week in A&E. And then I have a week on surgery before I do a few days of traveling, and then I come back home to the UK.

How Has The Elective Been So Far?

So how has it been so far? Getting to Vietnam was a bit of a nightmare. There were a few hiccups on the way, but once I got here that's kind of forgotten about. I mean, it's quite funny, I laugh at it now.

My boarding pass was wrong, so I had to sort that out last minute. The 13-and-a-half-hour flight from London to Malaysia, they didn't have a gluten-free option for me, so I had to live off fruit. So when I transferred flights in Malaysia, I was pretty hungry and moody at that point, but it's fine. I'm here.

How am I finding this trip? This trip has been good. It's been really good. The only bad thing I have to say is that I am always tired. The heat is taking it out of me. It's about 35 to 40 degrees every day and I didn't realize that it would take so much energy out of me. So I do constantly feel tired and it's a constant battle of dehydration as well, which then obviously makes you feel more tired, but that's fine. We can work with that.

The placement itself is eye-opening. I think that's the word. It's really good. I would definitely recommend it, but it is definitely eye-opening.

Differences In Cost

Especially before I left, I was interested to see how money would influence people's treatment. And whilst I was on oncology last week, I got to watch a mastectomy and an axial lymph node removal because there was breast cancer and cancer in her lymph nodes.

I was speaking to the doctor about this; obviously, I brought up the money question. I was like, "Well, so how much has this cost the patient?" And he told me it costs the equivalent of 75 quid for her to have this mastectomy, which I was obviously shocked about because I was expecting it to be quite a lot more.

But it turns out, in Vietnam, children have free healthcare up until about the age of 12 if (I remember rightly). And then adults have to get health insurance, but the health insurance will pay 80% of the cost, so you only pay 20% of the cost upfront.

So that £75 was 20% of the cost of the mastectomy, which the lady paid, and then her insurance will pay the other 80% of the mastectomy, which it didn't have as much of an influence as what I thought it would. I was expecting it to cost a lot more. But it's a good thing that it doesn't cost as much as what I thought it would.

But he did raise a point that with some of the newer cancer treatments, the insurance policies won't cover it. So, if you can't afford to pay, especially for some of the newer and more expensive cancer treatments, you won't have that treatment. So, it does affect it, but not as bad as what I thought it would've affected it.

The Importance Of Family

I have learned a lot about the importance of family here in Vietnam. So as nurses, we don't really do personal care. We rely on the patient's family to provide personal care. Patients don't have a call bell. So again, we rely upon the patient's family to get our attention if there's a problem.

When we were giving chemotherapy drugs in oncology, we would explain signs of an adverse reaction, but we would explain this to the patient, and we would explain it to the next of kin so they could tell us if there was a reaction because there's no call bells.

My eyes are being opened to new ways of working, and new ways of communication within a hospital.

Have There Been Any Challenges?

I think the shocking thing was seeing like an oncology unit with no call bells, and then there's the patients and there's two patients to a bed, so these rooms are very full. You've got six beds. You have some patients that are on one bed, but you could have six beds and you can have nine or 10 patients in one room plus family members. It makes it a very crowded environment, but it doesn't feel chaotic because everyone's quite polite and the family will come out of the room for you to make room for you.

But then where they're in such close crowded quarters- for example if we're looking at this mastectomy and then after the surgery, we've done a wound check on it- this patient will have to get her breasts out in a room full of people. There are no curtains, there is no covering up. It is just get it out and everybody can see.

The closest bit to dignity that we would have at home that happened when all the men got told to come out of the room and the door was shut. So, there was no men, but obviously she still had her breasts out in front of six to 10 other people, which was quite a shock.

And a similar thing happened in A&E this morning, actually. We had a young boy come in with a problem with his man area, and they just again got it out with no curtains, no covering. So, I think the lack of dignity is quite shocking. It sounds really awful, but I think they're used to it here, they're not as ‘covering up’ as what we are.

There are some attempts at dignity, but it's nowhere near as dignified as what it can be in the UK, which has been quite a challenge, I guess. And the language barrier has also been a challenge, but it has been really rewarding. I've managed to get my first successful cannula on this placement, which was quite good.

However, this brings me to the needles: sharps are disposed of in an old plastic bottle. There is an awful lot of free sheathing, like the sheath for a needle will just be on the bed next to the patient. So, you've got to try and slide in and not stump yourself and not stump the patient.

I did manage to give myself a needle stick injury. Thankfully it was a clean needle, so it's nothing to worry about. But where there is such a lack of sharps awareness, should I say... Not even awareness, just like a lack of safe sharps usage; it is an accident waiting to happen. And I have had an accident and that was quite challenging. That upset me quite a lot. But that's fine. We're over it.

I had a successful cannulation this week, so it's done, it's dusted. Just got to be more careful and a bit more aware.

Successes And Going Forwards

On chemotherapy, I've managed to mix chemotherapy drugs, which was really good. I had to wear a full hazmat suit and everything, but that was really interesting and that was quite... I don't know, it made me feel like a proper little scientist wearing a full suit and mixing all these chemicals. But yeah, that was really, really fun.

I'm hoping to learn much more knowledge whilst I'm in A&E. I'm working quite closely with the doctors, so I'm learning a lot of background medical knowledge, but I'm still focusing on my nursing skills, so I'm still focusing on cannulation, bloods, blood pressure, heart rate, respiratory rate.

We had a full-blown sepsis case last night, which obviously had a lot of nursing required for that. But at the same time, I'm quite excited to work with the doctors and get a background knowledge on what's going on. But yeah, I would definitely recommend it.

Stay Tuned For The Next Part!

There will be another video in a couple weeks’ time when I'm finished, with more information of what's gone on, but there is honestly too much to cram into a 10-minute video and I could sit and talk for ages about what's gone on. But I'm happy. I'm really happy that I've come here. I'm learning so much.

My eyes are being opened to new ways of working, and new ways of communication within a hospital. How lucky we are in England in a way.

But yeah, that will be that for now. And then there will be another video to follow up. Thank you so much.

You can watch Part 1 here.