Where Nursing Needs No Language: Stanford Hospital Nurses Volunteer Abroad

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Before Stanford Hospital & Clinics nurse Julie Kersey went off on her first trip overseas to volunteer her skills, she received some very practical advice from close at hand, from an old hand at such missions - "You're going to see a sea of people and when you're done there's still going to be a sea of people," Kersey's unit manager Cecilia Cadet told her. "Be prepared: You can't fix the whole world yourself."

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so many lungs and so many blood pressures

    But a remarkable number of Stanford nurses, over 400 - almost one in four - are out in the world trying, whether striding out for a local 10k Walk for Cystic Fibrosis or using weeks of their own vacation time to travel to India, Africa, Central America and other international destinations for intensive medical care visits. "As a volunteer you learn to appreciate and work with people's differences," said Stanford Hospital nursing administrator Kathy Hickman. "As our nursing staff return from volunteer experiences, they share their lessons learned. Their enthusiasm is contagious and often inspires others to go out into their local communities and to make a difference in someone's life."

National Nurses Week, May 6-12, focuses attention on the profession and Stanford Hospital nurses are a perfect example of the complexity of nursing skills, how they are built and how patients at their home hospital benefit, too.

International volunteer experience, in particular, Hickman said, expands nurses' appreciation of cultural and ethnic differences and teaches them how to work with those differences, honoring and celebrating them. "Stanford nurses really do touch patients' lives through their actions, compassion and kindness, and after a volunteer experience in an underprivileged country, I believe they are able to connect at a deeper level with patients and families here at Stanford."

Beyond that, said a Stanford Hospital nurse manager Sue Nekimken, "they are so much more tolerant of stuff that happens in the workplace. They are so appreciative of the resources and support they have in their workplace - and they're more flexible because they've seen what it's like in other places."

Stanford Hospital nurses have volunteered in a long list of countries: Guatemala, Ecuador, Mexico, Belize, India, Honduras, Bolivia, Ethiopia and others.

Kersey, joined in India by another Stanford Hospital nurse, Candice Coursey, saw people who might have had no alternative but to walk for miles for a chance at the few days of medical care offered by the visiting volunteers. In makeshift settings of tents, or just a series of tables, the volunteers worked 12- to 16-hour days, evaluating and treating as many as 350 people a day. Coursey saw conditions she'd only read about in her nursing textbooks. "We dewormed almost all the kids we saw," she said. In theory, preventing worms requires what would seem a basic staple of life. "It's such a simple solution - that they should have clean water. The reality is - they don't."

She learned that sharing her up-to-date medical knowledge had to be done with an awareness of that place's culture. She'd argued with an Indian doctor about the use of hydrogen peroxide to clean wounds. That chemical kills healthy as well as infected or wounded tissues - which can hinder healing. Not only was the doctor shocked that a nurse would argue with a doctor, but, as Coursey learned, a gentler approach was more effective. The outcome, ultimately, was a change in wound dressing materials. Coursey had come up against what she called a "cultural hedge" and recognized where she fit in the ongoing lives of these patients. "We were only there for three days. That doctor knows her people and the environment and she's the face of the clinic when we're gone. In the big picture, she was in charge."

Coursey returned with a new understanding of her role, one that included guiding instead of just doing - the teaching piece. In places where medical care and knowledge is rudimentary and overwhelmed by need, Stanford Hospital nurses educate and train as much as they can, to leave behind something of shared value.

Kersey, who went to Ethiopia this year on another volunteer medical mission, came back with practical experience that might have taken her years to acquire. In her two weeks, she did several hundred assessments of basic health measures - and, after "so many lungs and so many blood pressures," upped those skills through that intense practice.

Stanford Hospital's strong support of community partnerships and individual volunteerism was one of the elements that helped it achieve Magnet(TM) status last year, the highly prestigious designation awarded by the American Nurses Credentialing Center, currently held by only 4.5 percent of hospitals nationwide. Stanford supports and encourages its nurses' involvement in the community by making certain types of community service a component of the leadership criteria for professional advancement. Managers work with staff allowing flexible work schedules supporting participation in community service broadly defined to include everything from assistance with health related screenings in schools and community centers, to the long-standing Interplast, founded almost 40 years ago by a Stanford physician and now a worldwide program.

Three Stanford Hospital nurses - Betty Kolbeck, Cynthia Myslinski and Rosemary Welde have all made trips with Interplast for more than 20 years, supporting its surgical treatment in countries for children with cleft lip or palate and contractured burn scars. Welde is now on Interplast's board of directors. Other Stanford Hospital nurses of the many who've gone abroad with healthcare teams include Colleen Wright (with Flying Doctors), Linh Doan (Interplast), Cecilia Cadet (Interplast), Peter Miskin (Cornerstone), Leonides Penaflor (Phillipines Medical Outreach) and Kimberley Bonnett (with LCMS World Relief.) Other nurses, like Deborah Bone, have volunteered to help in the U.S., in the Katrina relief efforts or, locally, in Rota-Care free clinics, Lifeflight, CityTeam Ministries, Salvation Army, the Boy and Girl Scout programs, the Asian Liver Center, the Leukemia/Lymphoma Society, LemonAide, Meals on Wheels and many schools and churches.

Once begun, the habit of volunteering is difficult to end. Stella Marinos started before she reached Stanford - teaching English in Hong Kong to Vietnamese refugees, helping Mother Teresa in her work in India, responding to the American Red Cross relief after the Oakland fire and the 1989 Loma Prieta earthquake. While at Stanford, she's taken time off to fly out with Interplast to Ecuador. "If I didn't need money,'' she said, "I would be a full-time volunteer."

About Stanford Hospital & Clinics

Stanford Hospital & Clinics is known worldwide for advanced treatment of complex disorders in areas such as cardiac care, cancer treatment, neurosciences, surgery, and organ transplants. Ranked #15 on the U.S. News and World Report annual list of "America's Best Hospitals," Stanford Hospital & Clinics is internationally recognized for translating medical breakthroughs into the care of patients. The Hospital is part of the Stanford University Medical Center, along with the Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford. For more information, visit http://www.stanfordhospital.com.

Photos available upon request.

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