Clinical placements

The highs and lows of an elective placement in Mexico

When three nursing students from the University of Birmingham spent four weeks in a Mexican emergency department, they were pleasantly surprised by the high number of nursing staff and friendly atmosphere, but shocked by the lack of routine care and good infection-control practices
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When three nursing students from the University of Birmingham spent four weeks in a Mexican emergency department, they were pleasantly surprised by the high number of nursing staff and friendly atmosphere, but shocked by the lack of routine care and good infection-control practices

Undertaking a four-week elective placement is a mandatory part of the nursing degree programme at the University of Birmingham.

We wanted to experience healthcare in another country, so went to a state-run emergency department in Guadalajara, the second largest city in Mexico.

Arriving for our first shift, we were welcomed by the staff with handshakes, hugs and kisses on the cheek, with patients in the waiting room greeting us with buenos das good morning in Spanish.

This contrasts with the UK, where waiting rooms tend to

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When three nursing students from the University of Birmingham spent four weeks in a Mexican emergency department, they were pleasantly surprised by the high number of nursing staff and friendly atmosphere, but shocked by the lack of routine care and good infection-control practices


 Bethanie Howard, Dana Sammut and Travis Norton of the University of Birmingham

Undertaking a four-week elective placement is a mandatory part of the nursing degree programme at the University of Birmingham.

We wanted to experience healthcare in another country, so went to a state-run emergency department in Guadalajara, the second largest city in Mexico. 

Arriving for our first shift, we were welcomed by the staff with handshakes, hugs and kisses on the cheek, with patients in the waiting room greeting us with ‘buenos días’ – good morning in Spanish.

This contrasts with the UK, where waiting rooms tend to be places of silence.

Positive atmosphere

The high staffing levels in the department, and the good sense of morale, also made for a positive atmosphere. Often there were more nurses than patients, which you don’t really see in the UK. 

Despite high numbers of staff, patient observations and routine care were not always carried out. On one shift an unconscious and intubated patient was alone in the resuscitation room with a temperature of 40°C, and other abnormal observations. 

In the UK, patients in this condition would be under constant nurse supervision, so we felt uncomfortable leaving this patient alone. When we asked about the patient’s plan of care, we were told the immediate concern was her pyrexia. 

However, we were informed we could not use the air-conditioning as the patient was highly susceptible to pneumonia. The only resource available to us was a kidney dish filled with cold water and soaked gauze which we placed on exposed areas of the patient’s skin. We continued to do this for hours, watching as her temperature slowly normalised along with her other vital signs. 

The patient’s skin integrity also caused concern; her heels, sacrum and inner thighs were macerated, so we repositioned her regularly and changed her sheets. This was unusual as bed sheets were not always changed between patients, with overall infection control often taking a backseat to convenience and lack of resources. 

Surprising

Gloves were rarely used in the presence of bodily fluids, aprons were not available and facemasks were overused without any indication for use. In the UK, infection control is a central focus of practice so we found this particularly surprising.  

A patient’s condition can deteriorate quickly without close monitoring, so we were also surprised that in this well-staffed emergency department the patient was not watched as closely as they would be in the UK. 

Our experience of healthcare in Mexico was challenging and eye-opening, yet also rewarding. We are obviously grateful for the resources we have in the UK, but the less prescriptive and controlled environment in Guadalajara allowed us to use our initiative and explore our strengths more freely. 

This, along with the positivity and camaraderie of the nursing staff in Mexico, is what we would like to bring to UK nursing practice.


Bethanie Howard, Dana Sammut and Travis Norton are third-year nursing students at the University of Birmingham 

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