Clinical placements

You don't have to speak the same language to know when someone is in pain

An elective placement in India taught nursing student Carmel O'Boyle about communication and cost-effectiveness
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An elective placement in India taught nursing student Carmel O'Boyle about communication and cost-effectiveness

In my second year of training I had a four-week elective placement in India. I had wanted to go to India since I was a little girl, so the opportunity to travel while learning was a dream come true.

We were welcomed at the M S Ramaiah Nursing School in Bangalore, and assigned a buddy to help us during our placement. Our busy timetable included visiting general wards, orthopaedic departments, intensive care, labour wards, operating theatres and the emergency department, to observe care and gain a good understanding of health care practices in India.

Some of what we witnessed was surprising, even disconcerting. In intensive care, for example, intubated patients are not sedated but restrained, which

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An elective placement in India taught nursing student Carmel O'Boyle about communication and cost-effectiveness


Carmel O'Boyle (centre) spent four weeks on an elective placement in Bangalore, India.

In my second year of training I had a four-week elective placement in India. I had wanted to go to India since I was a little girl, so the opportunity to travel while learning was a dream come true. 

We were welcomed at the M S Ramaiah Nursing School in Bangalore, and assigned a buddy to help us during our placement. Our busy timetable included visiting general wards, orthopaedic departments, intensive care, labour wards, operating theatres and the emergency department, to observe care and gain a good understanding of health care practices in India.  

Some of what we witnessed was surprising, even disconcerting. In intensive care, for example, intubated patients are not sedated but restrained, which I found quite upsetting. 

The communication barrier also worried me initially, and I was terrified of not being able to understand the patients and their needs. I desperately tried to learn a few words, but my Kannada was terrible. 

Hard work and grace 

What this taught me is that nursing has its own language, a communication that transcends all barriers. You don't necessarily have to speak the same language to know when someone is in need or in pain. 

One of the patients I helped to care for was a young female in intensive care who needed a blood transfusion. Her vascular access was poor, it was a busy environment, and she was obviously very frightened. 

I tried to talk to her and explain what was happening, but I didn't have the language skills, so I knelt on the floor and held her hand and wiped her tears. It felt like the right thing to do, just to be there for her and comfort her.

This is what nursing is, and I believe it was that moment that I truly became a nurse, with hard work and grace.

Whilst the NHS is free at the point of care, Indian health care is different, with some of it private and some of it funded by the government. 

Humbling and enlightening 

The lack of resources mean nurses practice in a different, more cost-effective way. Recycling of waste is common. More appropriate attention is paid to the use of dressings and medical devices, with nurses being more frugal with sterile items and medicines, particularly analgesia. 

As a healthcare assistant, now a nursing student, I never stopped to think about cost and its implications for care. How many dressings I use, for example, and the things that are thrown away. But I should. We all should. 

In an NHS funding crisis, perhaps there are lessons to be learned from our Indian colleagues, whose health care system thrives despite limited resources. I hope that I can learn to work in a more cost-effective manner. 

My placement in India inspired me. It was a humbling and enlightening experience that will impact my career and the rest of my life.

I travelled to the other side of the world to realise how amazing our NHS is, what it means to learn and work in it, and how privileged I am to be a nurse. 


Carmel O'Boyle graduated from Liverpool John Moores University in March 2017 and now works as a trauma orthopaedic nurse in Merseyside. 

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