Last week, we started clinicals in the hospital. It has been very interesting to see the differences between the health care systems in the United States and in China. Here in China, nurses have a lot more responsibilities than they do in the United States. There are no techs or nursing aides to help out. Instead, families are expected to help out, but nurses are ultimately responsible for their care. Also, they do not have any physical therapists to work with the patients, so all of these activities are the responsibility of the nurses. A lot of the designs on the units such as how the walls are decorated or what resources are available are the creation of nurse managers. Some examples of this are two way windows in the endoscopy center so clean instruments can be transferred between the cleaning room and the treatment rooms, educational walls for patients to view, and a wall decorated to welcome the patients to the unit. Also, nurses in China typically have at least eight to ten patients at a time to care for.
There are also several similarities that I have noticed between the two countries. Both strategically place patients so those that have the highest acuity or risk are placed closest to the nursing station while those who are more independent and stable are placed further away. A lot of the nurses have mentioned to us how they have adopted techniques used in the United States such as knocking on patients’ doors before entering and doing more frequent pain assessments. Also, a lot of the units here in China are implementing the usage of English either by having daily quotes in English, doing reports in English and Chinese, or having other English immersion activities.
Currently, nursing is growing in China. We got to visit one of the newest areas in the hospital we are staying at, which is a specialty area. Inside, they have wound/incontinence/stoma care, diabetes education, pain management, and PICC placement/management. These nurses all have specialized training for their domains, and they are so new that the certification comes from the hospital because the nation has not developed one yet. One of the most interesting parts of this area for me was the cabinet of food that showed portion sizes for patients with Diabetes. This was unique for me because it had models of traditional food found in China such as lotus root, rice buns, and pomegranates as typical foods a person might consume. I am used to seeing Western foods in this type of display, so it was different to see what other cultures considered to be staples.
Besides school, we have done a lot of walking around and shopping. We recently went to the silk market where we found scarves for as little as 10 RMB, which is the equivalent of $1.63 USD. We also have gone to the night market and several streets filled with shops. Here in China, it is acceptable to barter for prices at most places, which we have begun to learn to do. A lot of vendors refuse our offers because they know we are American, but some have worked with us.
Next week, we are headed to Songyang, Beijing, and Xian so we can see more of the country and different parts of the culture.