Travel letter from student exchange Student exchange in Bangkok, Thailand Name: Marlene Andersen E-mail: Tapir@ofir.dk Phone number: Who did you travel with, if any: We were 12 nurse students in my exchange program from all over Denmark. Home institution (Denmark): University College Lillebaelt, department Vejle Class-number-(Denmark):2010M Host institution/university (Thailand): Contact person: Suleewan Sathiansukon Hospital/Place of clinical placement (Thailand): Faculty of Medicine Ramathibodi Hospital Speciality: Eye, Ear, Nose and Throat ward and Orthopaedic homecare Exchange period: 15/8-2011 21/10-2011 Before going abroad Why did you decide to study in Thailand? During my educations as Social- and health care assistant, I exchanged 30 days to a southeast German city, Finsterwalde. There I learned the importance of communicating with patients even though we do not speak the same languishes, experiencing with my non-verbal communication. I developed my professional-, personal and social skills so much more, than I ever could have done in Danish theory and practice. So when I started my nursing education, I knew I would exchange again, because I knew it was an unique opportunity and I know it looks good in my papers, that I have exchanged. As a bonus I needed to get away from my usual daily life and get some new energy to finish my internship and bachelor degree. Why did you choose Thailand? I choose Thailand because it is a culture so far from Danish, both professional and social. I have always wanted to travel in the east and as an exchange 1
student I would have an excellent chance to get to know the real Thailand and not only the tourist part of the country. I also want to see how they combine modern and eastern medicine and maybe get some knowledge how we can implement alternative medicine in Denmark. How did you prepare for your stay abroad? I bought a Talk Thai cd-rom and two travel books about Bangkok and Thailand. Thereby I could learn about the land and culture I would be living in. It also gave me an advance in the upcoming Thai-learning course in the first week of our program. We, the girls, made a closed group on Facebook, where we exchanged information and frustrations about our trip. Travel: Via Facebook I arranged to travel with 5 other girls. One of the girls got an offer from Air- Berlin for 5600 kr. for a round trip ticket. I knew I could get a cheaper ticket from other companies, but I preferred to travel together with others than by myself. Immunizations: Tetanus, hepatitis A+B, typhus, Japanese encephalitis and tuberculosis. Other preparations: From the Thai Consulate in Denmark I got a non-immigrant visa, so I could stay and work in Thailand for 90 days. Experiences and outcomes Professional outcome: How did you work with learning goals? Together with my exchange teacher, we went through my module 11 goals and found out which goals were realistic to work with and which was not a possibility because of the languish barrier and the cultural differences. During my stay I talked to another module 11 student, who was in the same work group as I, and we discussed what we have learned and experienced and how that could be transferred to our learning goals. Our preceptors did not directly work with our learning goals, but as we reflected, we could see that we have fore filed the goals. How did you find the contact to supervisors/preceptors? At EENT we had a leading preceptor, a head nurse, and three preceptors, when the head nurse where not available. They all had an understanding level of English and using a mix of verbal and non-verbal communication, we understood each other. Thai people are very shy and afraid of speaking 2
English, but as soon as they knew us, they were willing to talk to us. They were all very great full that we, as Danish nurse students, wants to come to their country and work for free. They were very eager to show us, how the hospital procedures and they want to learn about our procedures so we could compare. The preceptors were also interested in our spare time and helped us to where we could go and what we could see, when we were off from the hospital. At homecare I was attached to 3 orthopaedic nurses and the four of us trough out to our patients. It gave me some alone time from the other students and I could ask as much as I wanted to, without taking into account the other students. They, like the EENT nurses, were very eager to exchange experiences. The number one communication problem was that Thai people smile and say yes, if they do not understand what you are asking them. That coursed a lot of frustration and misunderstandings, but we got use to it and could see I their faces, when the yes was true or false. How did you find the contact to the patients? The nurses often picked out patients with some level of English skills, so we could talk a bit with them. My case in home care, Mr. Atwan, talked good English, so him I could interview and ask him about his experiences with being a patient. It was a good learning, to compare the theory about the healthcare system and the patient s point of view. With the patients with none or limited English, I learned how I still could communicate, using a few Thai vocabulary and my nonverbal. Thai people are a smiling and extremely grateful, if you try to speak their languish. During our learning Thai course, we were giving some papers with relevant words and I have glued the notes into my pocketbook. Then I could look up, when I d forget the words. Cultural outcome: Your experiences regarding the culture of the health care system? We learned that Thailand s public health protection schemes are divided into three: public employees with free health care (4,2 million.), private employees who had bought insurance (9,1 million) and the rest of the Thai (47 million) are registered at the hospital near their home and treatments are free, but if they need treatment in another hospital, they can only stay there for 72 hours and they have to be transferred back to their registered hospital. Because they often live far away from their hospital, there are many pharmacies al over Thailand. There they can self-medicate, because they can buy antibiotics and all kinds of medicine, we normally need prescriptions for 3
in Denmark. This way, patients safes the hospitals for many admissions, but if the selfmedication goes wrong, it is a big expense for the hospitals, because of the long admission time. When I worked in the hospital, I did not notice the difference, but when I was in home care I could see that the poor people without insurances did not have the same level of aids. We were told that Thai government were about to make a paradigm shift to chance to focus from acute care in hospitals, to primary care in the community. They wants to be health promoted and to inform patients caregivers about aftercare. That way admission time is reduced and hospitals safes money. I think that the paradigm shifts makes the Thai health care more western and modern. Your experiences regarding the culture of health care? I had a preconception that Thailand only had a scientific approach, but I learned that in the hospital and in homecare, nurses have a holistic approach and uses a long time to teach the patient and family about the disease and how the recovery process is going too happened, both physical and psychosocial. Social outcome: How did you interact with your colleagues at the hospital and at the university? I talked to the preceptors about professional and personal stuff, so we got to know each other. Did you interact with the local population? In Denmark I got in contact with a local tattoo artist, Chili Joe, whom I visit 4 times because we were 4 who got a memory tattoo of our trip. There I got to see a private home and talk to Joe how it is to live in Thailand and I talked to him, when the water threatened to flood his house. He told me about the rich and the poor sides of the country, the tourist part versus the private part and so much more. At Kao San Road I often came in contact with local Thai. Which important experiences did you gain during your exchange? I learned so much about myself. I learned to life close with 11 other girls and how to take into account, that we all have our differences and still I have to get along with them. 4
I learned how I reacted in unforeseen situations and how I have to think creative, to find the best solution for my patients. For example during wound care, I had to find the optimal solution with the bandages I had available. I learned how to manage to get a daily living in a foreign country and culture. How to talk to people, although we did not understand a word of what we were saying to each other. During my stay, I learned to appreciate the Danish health care system. Thanks to our high taxes, we all have free access to medical help. Anything else you think other students need to know about studying in Thailand? My advice is to take the chance to study in a foreign country. It is a unique chances you never going to get again. You develop your professional, psychological and social skills more than you ever would have during a Danish internship. You have to be strong enough, to be away from your family and your usual network, but instead you get a close family of 11 other girls. 5