{"id":4739,"date":"2016-06-21T00:00:00","date_gmt":"2016-06-21T06:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2016\/06\/21\/reaching-across-cultures\/"},"modified":"2021-11-02T10:20:05","modified_gmt":"2021-11-02T16:20:05","slug":"reaching-across-cultures","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/reaching-across-cultures\/","title":{"rendered":"Reaching across cultures"},"content":{"rendered":"
<\/div>
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The two Vietnamese health care providers sat quietly, absorbing the discussion among UCHealth\u2019s providers on the diagnosis and care of patients. But they weren\u2019t observing simulation training at the UCHealth Clinical Education and Innovation Center in Windsor to find out how to diagnose and treat patients \u2014 though they were soaking in that information as well. Instead, they were there to learn about the teamwork of doctors and nurses in America.<\/p>\n

In the United States, nurses often make decisions based on their observations and communication with patients and their family members. They also discuss treatment plans with doctors. In Vietnam, nurses are prohibited from looking at patients\u2019 test results, responding to acute symptoms or even expressing an opinion. They must always consult a doctor.<\/p>\n

Registered nurse Ms. Trinh Le Lam and Dr. Ban Ha Ngoc hope to change that.<\/p>\n

Laura Wining, the coordinator of the simulation lab at UCHealth Clinical Education and Innovation Center in Windsor, demonstrates an inter-vascular access device as Dr. Ban Ha Ngoc and registered nurse Ms. Trinh Le Lam tour the facility. The visitors from Ho Chi Minh City, Vietnam, spent two weeks in northern Colorado observing and learning clinical standards of excellence and teaching strategies for physicians and nurses. The exchange was hosted by University of Northern Colorado’s School of Nursing and UCHealth. Photo by Kelly Tracer, UCHealth.<\/figcaption><\/figure>\n

Dr. Ban is the chief cardiac intensivist and assistant director of the Heart Institute of Ho Chi Minh City, Vietnam. Ms. Trinh is a faculty member and lecturer of nursing at the University of Medicine and Pharmacy and also teaches with volunteer nursing professors in the Master of Science in Nursing program at the University of Medicine and Pharmacy.<\/p>\n

The latter program \u2014 the first in Vietnam \u2014 was developed and implemented at the University in Vietnam in 2007 in collaboration with Friendship Bridge Nurses Group<\/a>, of which retired UCHealth nurse Ann Henderson and University of Northern Colorado Associate Professor Alison Merrill are volunteers. Henderson and Merrill encouraged Dr. Ban and Ms. Trinh to visit northern Colorado to learn more about coordination between doctors and nurses, with the goal of improving practice and enhancing patient outcomes in Vietnam.<\/p>\n

During their two-week stay, Dr. Ban and Ms. Trinh spent a majority of their time at Medical Center of the Rockies in Loveland, and the University of Northern Colorado\u2019s School of Nursing in Greeley. Dr. Ban and Ms. Trinh also took a trip to UCHealth\u2019s University of Colorado Hospital in Aurora.<\/p>\n

Focus on relationships<\/strong><\/p>\n

Dr. Ban said his visit had two purposes. First, he wanted to learn how to improve collaboration between physicians and nurses, especially in the emergency department and intensive care unit.<\/p>\n

\"Vietnam
Registered nurse Ms. Trinh le Lam, a lecturer of nursing at the University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam, watches a simulation exercise from a control room at the simulation lab at UCHealth Clinical Education and Innovation Center in Windsor. Photo by Kelly Tracer, UCHealth.<\/figcaption><\/figure>\n

\u201cAt present, the nurses [in Vietnam] just do according to the order of the physicians,\u201d he explained. \u201cThey wait and call on the doctor to come and see the patient. Sometimes the physician is not easy to reach and delayed, so it\u2019s really difficult. It puts patients at risk.\u201d<\/p>\n

Vietnamese doctors also expect complete obedience to their orders \u2014 no questions asked, Dr. Ban said.<\/p>\n

Except for his<\/em> nurses.<\/p>\n

\u201cWhen I train the nurses in my unit during the night shift, they have to work without a physician, so [other doctors are] shocked to see what the nurses do. The following morning, a nurse tells me about the conflict over the night with each patient,\u201d Dr. Ban said. \u201cI was surprised when I saw the MCR team had fewer physicians and more nurses. [The] nurses are very well trained and can help physicians more, especially in the catheter lab.\u201d<\/p>\n

Second, Dr. Ban wanted to learn how to teach and organize staff trainings for new procedures, such as treatment for patients experiencing cardiogenic shock after myocardial heart failure. Collaboration between nurses and doctors is important during the performance of such complicated procedures, he said.<\/p>\n

More respect, responsibility<\/strong><\/p>\n

Ms. Trinh\u2019s focus was similar.<\/p>\n

\u201cI would like to know how nurses here show their confidence and professionalism in their career,\u201d she said. \u201cIn Vietnam, I just see how nurses have less confidence. They may be very skillful, but they have so much work to care for patients, [it] makes them tired.\u201d<\/p>\n

Merrill explained that Vietnamese nurses may care for as many as 20 patients at one time, compared with the five or six patients for which U.S. nurses are usually responsible.<\/p>\n

Ms. Trinh added that nurses in Vietnam have no computers, so everything is documented in writing, and they work three 12-hour day shifts and one 12-hour night shift before having just one day off.<\/p>\n

\u201cUniversity provides many skills like communication, partnership or leadership in nursing, but when they become a nurse, they don\u2019t have a chance to provide what they learn at school because they work so hard,\u201d she said.<\/p>\n

Ms. Trinh noted she is concerned about patient satisfaction and the value of nurses in her country as well as how nurses can contribute more to the process of patient healing, communicate better with physicians and gain the respect of doctors.<\/p>\n

Dr. Ban said those changes could take some time, but they\u2019re possible.<\/p>\n

\u201cIt really needs to change in the system of education,\u201d he said, noting he is the only doctor at his hospital giving nurses more responsibility and respect. \u201cIt costs a lot of money.\u201d<\/p>\n

Change on the horizon<\/strong><\/p>\n

Dr. Ban believes hospital physicians need to train nurses, and knowing how to set up simulations like those they observed in northern Colorado will allow him to share that point of view with other doctors and facilities. Incorporating doctor-nurse collaboration into medical school training also will change attitudes, he said.<\/p>\n

Giving nurses more responsibility will not only benefit patients and ensure optimal outcomes, it will also relieve some of the stress and pressure that physicians experience, he added.<\/p>\n

\u201cDoctors and nurses have the same purpose, want the same outcome,\u201d Ms. Trinh said of what she observed while visiting UCHealth. \u201cNurses are specialized \u2014 IV team, wound care team, palliative care. I\u2019m very impressed.\u201d<\/p>\n

Teaching the teachers<\/strong><\/p>\n

But the pair also impressed their American cohorts.<\/p>\n

\u201cI commend you for what you\u2019re attempting to do \u2014 getting the communication between the nurse and the physician,\u201d Marilyn Schock, chief operations officer for Poudre Valley Hospital and MCR, told them. \u201cYou\u2019ll be able to achieve results because of that partnership. I can\u2019t stress that partnership enough.\u201d<\/p>\n

Registered nurse Faye Hummel, director and professor of the UNC School of Nursing, said the visit was a benefit to all involved.<\/p>\n

\u201cIt really isn\u2019t about us helping them improve,\u201d she said. \u201cWe take away so much more than what we give. I\u2019m always so taken by their deep desire to learn and to capture every opportunity that comes their way. They don\u2019t ever minimize their opportunities.<\/p>\n

\u201cThey are able to do so much with so little,\u201d Hummel added. \u201cIt is remarkable and it is beyond compare. Just the fact that they can take tidbits of knowledge you impart to them in one day and explode them into something much more is remarkable. \u2026They take nothing for granted.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The two Vietnamese health care providers sat quietly, absorbing the discussion among UCHealth\u2019s providers on the diagnosis and care of patients. But they weren\u2019t observing simulation training at the UCHealth Clinical Education and Innovation Center in Windsor to find out how to diagnose and treat patients \u2014 though they were soaking in that information as […]<\/p>\n","protected":false},"author":22,"featured_media":2815,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[77,267],"class_list":["post-4739","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-emergency-room","tag-intensive-care-unit"],"acf":[],"yoast_head":"\nReaching across cultures - UCHealth Today<\/title>\n<meta name=\"description\" content=\"The two Vietnamese health care providers sat quietly, absorbing the discussion among UCHealth\u2019s providers on the diagnosis and care of patients. 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