Clinical placements

Don’t underestimate the experience you’ll gain on a placement abroad

An elective placement in Peru challenged my perceptions of nursing practice – and myself

An elective placement in Peru challenged my perceptions of nursing practice – and myself

Jessica Fichardo at Lake Humantay in Peru

In my second year of training for my adult nursing degree, I spent five weeks in Peru on an elective placement.

I can speak basic Spanish and thought Peru would be a great place to develop my language skills while experiencing a different culture and healthcare system.

Different practice

My placement was in a public health clinic in the downtown area of Cusco, a city in southeastern Peru. Many patients would come to the ‘tópico’ (topical) room to have their wounds cleaned and dressings changed, and one of the first things I noticed was the difference in approach to infection prevention and control compared with the UK.

‘There was a huge focus on diet-related treatment – every time a patient was treated by a doctor or nurse, they received dietary advice related to their condition’

There were no protective coverings on the beds, which were not wiped down between patients either, and staff used non-sterile gauze and gloves when treating patients’ wounds. This differs markedly to the aseptic technique used in UK practice, where we use sterile equipment to help prevent the spread of infection.

The wounds were cleaned with saline then covered in a green paste (nitrofurazone 0.2%) and dressed using gauze and a bandage. The same paste was used for almost every wound, whereas in the UK we use many different types of wound management products, depending on the type of wound being treated.

Efficiency over confidentiality

Another difference I observed was the approach to patient confidentiality. Staff would walk in and out of the room during patient consultations, and towards the end of the appointment the next patient would be invited in before the last one had left.

Ms Fichardo on placement in the wound clinic

This may have been an efficient way of seeing as many patients as possible in the time allowed, but the patients had very little privacy and the system did not prioritise patient confidentiality.

One of the most interesting things in the clinic was the huge focus on diet-related treatment – every time a patient was treated by a doctor or nurse, they received dietary advice related to their condition. Although patients in the UK do receive nutritional advice, I was impressed by this structured approach and would like to see it used more often in UK practice.

Hierarchy among the staff was also different to the UK. The clinic was largely nurse-led, and the nurses had a lot of responsibility. Most of the examinations were carried out by nurses, who would refer their patients to a doctor if necessary.

There were a lot more nurses than doctors, with many having advanced clinical skills – one told me they are taught how to suture in nursing school. The emphasis was very much on team work, with all the staff working together in the best interests of the patients.

More conscious of waste

Resources were scarce at the clinic in Cusco, so the staff did their best to conserve equipment, ensure waste was limited and make their supplies last as long as possible. This made me reflect on how much we waste on a daily basis in the NHS. Since returning from Peru, I have been more cautious when using supplies and no longer open products ‘just in case’ they are needed.

When I first arrived in Peru, I was nervous because I had never travelled by myself. I was worried I might not meet anyone and would be on my own, but this was not the case – I met people from all over the world who were also travelling by themselves.

Staying with a lovely family made it easier for me to interact with new people and make friends, and the healthcare workers at the clinic were also very welcoming. They were really grateful that I was there to help them, and as I was also there to learn from them, they were keen to share their knowledge and skills with me.

While in Peru, Ms Fichardo completed a four-day trek to the Inca ruins at Machu Picchu

Grab the opportunity

I couldn’t go all the way to Peru without seeing Machu Picchu, one of the country’s most famous treasures and the most familiar icon of Inca civilisation. I completed the four-day Inca trail to Machu Picchu, passing through many Inca ruins along the way. Arriving at the top was breathtaking, and the stories about the Incas building the ancient city were fascinating. I also visited Rainbow Mountain, Humantay Lake and the Chinchero Mountains, which were amazing.

My elective placement in Peru was a fantastic experience that I will remember throughout my nursing career. I learned so much about the culture and the healthcare system, which differed in so many ways to healthcare in the UK. Travelling alone really boosted my confidence and I got to see some amazing sights.

To all nursing students considering undertaking an elective placement abroad, I would say grab the opportunity with both hands. You won’t regret it.

Jessica Fichardo is a second-year nursing student at King's College London 

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