People to People Ambassador Programs Journal of Professional Proceedings

Transcription

1 People to People Ambassador Programs Journal of Professional Proceedings Columbia University School of Nursing Alumni Delegation to Vietnam Bobbie Berkowitz, PhD, RN, FAAN Dean and Professor, Columbia University School of Nursing Sr. Vice President, Columbia University Medical Center New York City, New York Delegation Leader Nov. 7 16,

2 Professional Journal Columbia University School of Nursing Delegation to Vietnam Nov 8-16, 2014 Delegation Leader: Dr. Bobbie Berkowitz November 8-9, 2014: Traveling Half Way Around the World Twelve delegates and guests, seven of whom are Alumni of the Columbia University School of Nursing, traveled from all over the US on a long journey to Vietnam; arriving in Hanoi the afternoon of November 9 th. Greeting our delegation at the airport was Shiv Pratap, our National Guide extraordinaire who assured that the roadweary group was escorted to the beautiful and elegant Hotel de l Opera Hanoi located near Hoan Kiem Lake in Hanoi. We dined together at the Wild Lotus, the first of many delicious meals. November 10, 2014: Those Beautiful Temples Our first full day in Vietnam was a cultural day and we were certainly steeped in the culture and beauty of Hanoi, the pagodas and temples, and its many museums and monuments. Our group had a chance to expand our knowledge and understanding of Vietnam history, culture, politics, religious and spiritual life, art and the bustle of the outdoor markets and street life. It was a very active day! Our first visit was to the Tran Quoc Pagoda which sits serenely on the shore of beautiful Tay Ho (West Lake) and 2

3 dates back to the 6 th century. Pagodas in Vietnam generally pay tribute to Buddhism, Taoism, and Confucianism and include alters with offerings to each. Our knowledgeable local guide explained the role of temples and pagodas in the everyday life of Vietnamese people and described the major religions of Vietnam and the significance of the Banyan Tree in the beginning of Buddhism. We experienced the peacefulness and beauty of the Feng Shui (the philosophical system of harmonizing everyone with their surrounding environment) of the gardens and waterfall. Visit to the Tran Quoc Pagoda Our second visit was to Ho Chi Minh s mausoleum and the grounds of his palace and home. We learned of his ambitions and drive in his quest for a Vietnamese independence. Across from the mausoleum are the grounds of the presidential palace which was originally used by the French colonialists. We saw the lovely gardens, a small lake, and the modest home of Ho Chi Minh located on stilts along the lake of Ho Chi Minh. The afternoon included visits to the One Pillar Pagoda which is a temple designed to resemble the lotus blossom. 3

4 Ho Chi Minh s Home We also visited the Temple of Literature and the Fine Arts Museum. The Temple of Literature is now a beautiful indoor-outdoor museum but was originally Vietnam s first university. The Fine Arts Museum is lovely with a very interesting collection of propaganda art created during the time of Ho Chi Minh. It also shows the French influence on Vietnamese painting in the 19th and 20 th century. Many of the artworks were painted on silk or carved in lacquer. 4

5 Conventional Transport in Hanoi After a good dose of art and culture, we took a very brisk walk through the old quarter. We walked briskly because the sidewalks and streets are packed with cars and motorbikes. It is a beehive of activity with people, shops, sidewalk commerce, kids, dogs, vendors, bicycles; all competing for the same limited space. 5

6 The Busy Streets of Hanoi The streets of the neighborhoods in Hanoi are very narrow with skinny houses rising four to five stories above the street level. Each home has some type of shop on the ground level and the businesses spill out onto the sidewalk and street. Each street has a specialty in terms of goods and services and form a wonderful patchwork of commerce. In the evening we attended a performance of the Lotus Water Puppet Show. This ancient form of puppetry depicts stories told with puppets in a large pond accompanied by singers and instruments. Nov 11, 2014: Public Private Hospitals: What a Difference it Makes Our first day of professional visits began at the large public government hospital, Bach Mai. The health care system in Vietnam includes public and private and primary and secondary facilities. Individuals who cannot be diagnosed and/or treated at their local public hospital are referred to a secondary hospital such as Bach Mai where more sophisticated equipment and medical specialties are available. Bach Mai was built in 1911 and currently has a capacity of 2000 beds with various institutes, centers, clinical departments and a nursing school. The hospital staff of 2000 serves over a million 6

7 patients a year. Construction of a new facility is underway 60 km away that will increase their capacity by 1000 beds. We were greeted by Bui Minh Thu Ba, Head of the Nursing Department, and Do Van Thanh, Head of Foreign Affairs and International Cooperation Department. They discussed the care and services provided by the nurses and physicians on staff at Bach Mai. The nurse to patient and physician to patient ratio is high and as a result families are instrumental in the care of patients while they are hospitalized. The outpatient facility was extremely busy with patients and families waiting for an appointment to see a physician. There is a shortage of nurses and we discussed with our hosts how they are developing strategies for meeting the needs of the hospital for qualified nurses including the utilization of their nursing school as a source of future nursing staff. We also discussed how an individual s death is managed in the hospital; quite unlike our own processes in terms of care of the body and funeral rituals. Delegates with Bui Minh Thu and Do Van Thanh at the Bach Mai Hospital in Hanoi 7

8 On our way to our second visit to L Hopital Francais de Hanoi we toured the Museum of Ethnology. This was a fascinating museum featuring the culture and lifestyles of the major ethnic groups in Vietnam. Particularly interesting was the depiction of village life focused on communal housing, religion, customs, dress and foods. Full size models of homes were explored and lifestyles were introduced. Outpatient Visit We were greeted at L Hopital Francais de Hanoi, a private French-Vietnamese hospital, by Annoussamy Lourdes, Nursing Director. This hospital, established in 1997, offers a dramatic contrast to the public governmental hospital. This private hospital has only 73 beds with one RN for every five patients. The hospital was quiet and organized with a professional nursing staff. Our hosts included the hospital s marketing director who gave a presentation about the programs and clinical services provided by the hospital and their outpatient clinics. They place a high emphasis on patient care excellence including the utilization of Six Sigma for quality performance. Staff are fluent in both French and Vietnamese. We were provided a tour of the emergency department, intensive care unit, perinatal units, perioperative areas, and pediatrics. Their average 8

9 length of stay in the hospital is 2.5 days. Their patients tend to be middle class Vietnamese or foreigners. They are planning a new hospital to triple their capacity. Delegates with Annoussamy Lourdes at the L Hopital Francais de Hanoi It was quite interesting to see the vivid contrast between these two health care facilities and the impact these differences have on the utilization of nurses and the care provided. The delegation was impressed with the interest of both hospitals in the importance of nursing and their challenges with the provision of quality care; not too dissimilar with challenges in the US healthcare system. Nov 12, 2014: Rural Vietnam and the Incredible Halong Bay Today we left the bustle of Hanoi as our delegation traveled through rural Vietnam to beautiful Halong Bay for an overnight cruise. The trip to Halong Bay took us along the Red River Delta and a number of smaller towns and villages to experience the more rural aspects of Vietnam, particularly the farmland and rice fields. We made a short stop at a large shop specializing in Vietnamese crafts including embroidered 9

10 pictures, lacquer ware, jewelry, and ceramics. At midday we reached Halong bay and boarded the Bhaya Classic II; a mid-sized ship with sleeping cabins and a main floor for dining. After lunch, we boarded smaller boats and motored to one of the many small islands in the Bay where we toured one of the dragon caves; named because of the rock formations that resemble dragons. The caves are of varying sizes. The interior of the caves have been carved by water over centuries. There were many small boats in the bay including fishermen and boats selling crafts and food. Commerce on Halong Bay 10

11 We anchored in Dung Tien cove for dinner and our overnight stay. Evening entertainment included a cooking demonstration and cook-off among guests on the ship. The staff on the ship was friendly and the food was delicious. Transport on the Bay Nov 13, 2014: Life on the Bay The next morning we took a small motorboat to Titop Island for a hike to the summit and a splendid view of the bay. Since we had spent a number of hours on the bus the previous day, we felt the need for a little exercise and most made the journey up a steep path to a small outlook with a panoramic view of the bay. It was stunning to see the giant rock outcrops and many small and medium sized boats and ships. 11

12 View from Titop Summit With our Guide Shiv Pratap on the Beach on Titop Island in Halong Bay After a short bask in the sun on the beach, we headed back to the ship for lunch and our trip back to shore. We took an evening flight to Ho Chi Minh City (Saigon). Our hotel in Ho Chi Minh City was the beautiful Caravelle Hotel; made famous by its Saigon Bar frequented by the news media and US soldiers on leave during the Vietnam War. 12

13 Nov 14, 2014: French Influence on Health Care and the Education of Nurses Our day began with a visit to the Pham Ngoc Thach University. Our hosts were Dang Tran Ngoc Thanh, Vice Dean of the Faculty of Nursing and Medical Technology, and Cao Van Thinh, Associate Professor and Dean of the Faculty of Nursing and Medical Technology. They provided a very comprehensive overview of the University and their nursing education programs. They discussed the nursing education system in Vietnam. The Pham Ngoc Thach University provides nursing education at the BSN and Master s level as well as programs in midwifery and medical technology. Just as we observed in Hanoi, the health systems in Ho Chi Minh City are also concerned about a shortage of nurses. In Vietnam there are over 90 million people and approximately 90,000 nurses to address the medical needs within the country. Therefore, the University is critical to the solution to this shortage. The University is associated with 14 hospitals in Ho Chi Minh City and students train at various locations throughout the city. They also provide continuing education in nursing administration, leadership for change, infection control, and elder care. With our Hosts at the Pham Ngoc Thach University of Medicine 13

14 Our delegate, Dr. Diane Pastor, presented her research on having difficult conversations. She reviewed the types of communication that can be difficult for nurses to have with patients and families, particularly when they are delivering news related to a serious medical diagnosis, a poor prognosis, the failure of a treatment, or a conversation about end of life. The presentation was well received by our group and hosts. We ended our visit with a tour of the university facilities; the highlight being their very modern and sophisticated clinical simulation center. Our group joined in the fun and tried out a few of the simulation scenarios. Hands on Practice at the Simulation Center at Pham Ngoc Thach University Between our professional visits we were able to make a quick visit to Ho Chi Minh City s old central post office; an incredibly beautiful building and to the Notre Dame Cathedral and Opera House. After lunch, we visited the FV Hospital (Far East Medical Vietnam Limited) which is a private tertiary foreign-owned hospital located in south Ho Chi Minh City. It is accredited by the French Haute Autorite de Gante and is currently working to achieve Joint Commission International accreditation. The hospital has 180 beds with approval for up to 220 and 6 operating rooms plus labor and delivery. 14

15 With our Host, Pauline Lee, of the Far East Medical Vietnam Limited Hospital The primary population served by the Hospital live in the surrounding neighborhoods and economically privileged Japanese, Koreans, and Cambodians. The neighboring districts are populated by US citizens, Australians and other foreigners living in Vietnam. Wealthy Vietnamese also obtain care at the FV Hospital. Our host, Pauline Lee, Director of the Nursing Division told us that 40% of the patient population are self-pay while others have a membership with the hospital, either VIP level which covers all care and safe members which is designed for those who have health insurance but may need access to the FV Hospital. The delegation was very impressed with Ms. Lee s leadership. She provided a detailed review of the hospital programs and a comprehensive tour of their facilities. The hospital has inpatient and outpatient consultation clinics. She was knowledgeable about the Hospital s services and seemed to know all of the nurses and other personnel. She discussed the many initiatives she is leading to advance the quality of care at the hospital and raise the professionalism of the nursing staff. 15

16 Nov 15, 2014: Mekong Delta: The Bread Basket of Vietnam On our last day we visited the Mekong Delta. We traveled by bus through the rice fields and learned that this area is a major agricultural center. Rice is harvested three times a year and the crops are rotated with beans and sugarcane. We had the opportunity to visit the Caodai religious temple. The Caodai temple combines multiple religions in one temple in the hope of promoting unity among different religions. When we reached the Mekong Delta we boarded a motor boat for our cruise along the river. What a view! Colorful boats of all sizes and shapes were carrying a vast variety of cargo up and down the river delta. We left the boat to tour a coconut candy factory. After learning all about how to make the keo dua (coconut candy) we loaded into horse drawn carts for a ride through the small village of Ben Tre. We stopped for lunch at an outdoor café that had a boa constrictor available for petting. Ready to Board our Horse Drawn Cart 16

17 We left the small village via one of the many canels that run along the river delta. We were transported by small boats powered by lovely Vietnamese women. We were glad to be doing the sitting and not the paddling! Traveling Up a Canal in the Mekong Delta 17

18 We returned to our vessel on the Mekong Delta and enjoyed a soothing treat of coconut milk right out of the coconut. We had out last opportunity for shopping at a rest stop that included crafts and souvenirs. Then we were off to Ho Chi Minh City and our farewell dinner. Farewell Dinner in Ho Chi Minh City Nov 16, 2014: The Long Trip Home Morning came early for those departing for the US today and provided a little extra time for those going on to Cambodia. Lots of hugs and fond farewells to each other and to the incredible country of Vietnam. 18