Clinical placements

Student placement in Latin America improved my nursing practice

A clinical placement in Chile highlighted the spiritual aspect of holistic care

A clinical placement in Chile highlighted the spiritual aspect of holistic care

A clinical placement in Santiago, Chile, offered Rachel Dakin the chance to compare
nursing in different cultures

I never anticipated that the first few weeks of my third year of training would begin with a nursing adventure in Latin America.

The opportunity to participate in a two-week study abroad programme in Chile – at Pontificia Universidad Católica de Chile in the country’s capital Santiago – was completely unexpected. It was only presented to me three weeks before the programme start date.

Excited to embrace this valuable cultural experience, I immediately began to research Chilean nursing care and met with Chilean students at my university to find out more about the country’s cultural values.

Having submitted my application, I was thrilled to learn I was one of only two students from my university accepted onto the programme.

Language barrier

After undertaking my four-week mandatory elective placement in Indiana in the US earlier this year, I was eager to compare the healthcare systems of North and South America. Immersing myself in the Chilean culture was the perfect way to do this.

Ms Dakin (left) with fellow nursing students from Nottingham, Birmingham and Switzerland
who also took part in the programme

Arriving in Santiago, at the foot of the Andes, is an experience I will never forget. The mountains surrounding the city were extraordinary, yet the deprivation and homelessness was instantly apparent.

As we were unable to speak Spanish, and didn’t meet anyone who spoke English, the language barrier made navigating the city a big task.

On our arrival at the university, we were welcomed by staff and students with kisses and hugs. This caught us by surprise, highlighting the contrast in formality between Chilean and British greetings.

Health disparities

After being joined by nursing students from the University of Birmingham and Switzerland, we began to explore Chile’s mixed healthcare system. We experienced a range of departments in both private and public facilities, including surgical, emergency, maternity, outpatients and neonatal units in the acute setting, as well as palliative care hospices and mental health rehabilitation centres in the community.

There were noticeable differences in the delivery of nursing care between the private and public sectors. While the private hospitals were very similar to inpatient facilities in the UK, the public hospitals were visibly different, particularly with regard to infection control.

A public hospital in Santiago

It was evident that handwashing was not a priority. Adherence to infection control procedures is vital in the UK, so this aspect of Chilean nursing practice was particularly surprising.

During my time in Chile, I also visited the most deprived part of Santiago. A highly populated urban residential area with extreme poverty, it is mostly inhabited by Haitian people who migrated to Chile after struggling to re-build their lives following the earthquake in Haiti in 2010.

As well as helping to rebuild makeshift housing units, I provided health education on topics such as sanitation. The language barrier made this quite challenging, so I had to be creative in my approach, employing a variety of communication strategies to enable the Haitian people to understand the importance of practices to improve cleanliness and overall health.

Rebuilding a makeshift housing unit

Spiritual element to care

The students meet the Maiti at La Ruca 

During our visit to a rural family community centre, we were shown the ‘La Ruca’ – a large makeshift hut located in the grounds of the facility that is run by the ‘Maiti’, the native leader of spiritual medicine and healing.

The purpose of this traditional facility is to provide service users with spiritual guidance to complement their formal medical diagnosis. Individuals often choose to visit the Maiti to gain reassurance, comfort and a different perspective.

It was fascinating to learn that the multidisciplinary team actively encouraged families to seek a second opinion from the native leader – they perceived this traditional treatment to be essential in the provision of holistic care, which makes sense given the religious nature of the area.

This was certainly the most intriguing part of the programme. It really emphasised the significance of spiritual care as a component of holistic nursing practice, which I have been able to apply to my own nursing care since returning to the UK.

This international engagement opportunity was a fantastic learning experience. As well as increasing my awareness of global health issues, it enabled me to develop my cultural competence and become more culturally sensitive, which is already enhancing my professional effectiveness in my nursing practice.

Rachel Dakin is third-year children’s nursing student at the University of Nottingham and the RCNi editorial advisory board student representative

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