Reflecting on my experiences in Nepal, it has been a remarkable and life-changing trip. It has been so interesting to see how medicine is the same all the way across the world, yet at the same time how differently things can be done. Culture has a big impact in the healthcare here. One key observation I made within seconds of being in the hospital is the lack of privacy. There are windows all around the outside of the hospital in which people stare into the rooms. Distinctly, inside the hospital patients do not have their own rooms, most people share rooms with five to ten other patients. The only times they have their own room is in critical cases. With Nepal being a collectivist culture rather than individualistic this plays a big role in the privacy. People are watching one another receive care along with coming together and talking. This was very interesting to see and was very beneficial at times as people could provide support to one another. Even report among the nurses was done in the middle of patient’s rooms with anyone being able to listen. Another cultural observation was the family’s role in care. They are in charge of many things for the patient including getting them food, helping them to the bathroom, emptying catheters, bed pans, and taking care of their hygiene. Along with culture comes the respect people show to those older to them. For the nursing students anytime a doctor, nurse, or their instructor walked by they would stop what they were doing and say “Namaste” and refered to their instructor as “Ma’am”. Finally, the clothing people wear is very modest. No one in Tansen wore shorts, their pants were loose, and skirts had to be below the knee.

Another key observation I made is because of lack of resources how differently things were done. Every morning they would have bed-making before the doctor rounds. This included taking the linens off, folding them very particularly, wiping the bed down once with a cleaning solution and then with a dry rag, and finally putting those same sheets back on the bed. This is the way they did it for every bed unless the sheets were soiled. This is very different from America as we would get a clean sheet every time. However, they found a way to do it that works for them with limited resources. Additionally, they rarely used gloves other than in sterile procedures, used washable rags to clean things, cleaned and reused many containers that in America we would simply throw away. Additionally, sterile tools were wrapped in a cloth together rather than lots of plastic. They also take manual blood pressures rather than having big machines and take temperature axillary, so they do not have to clean as well. It was very interesting to see the creativity and the way they use resources to optimize them and reduce waste.

I will take many things away from these experiences and the way they do things. The love and welcoming nature they showed us really impacted me. I desire to show this kind of love to other in my life and through my work as a nurse in the future. Before this trip I never quite realized how big of an impact extending a welcome can have on someone and I would love to be able to do the same for others. Additionally, I envy the community they have and support they show to one another. Our culture seems to be filled with people putting themselves first and being absorbed in social media and devices. I’ve seen much more love for one another and good community with less of these things. This experience has also emphasized the importance of treating the whole patient rather than just tests and lab values. With the hospital having less resources to take all kinds of diagnostics they were able to really observe the patient, ask questions, and come to a conclusion with knowing less. Overall, I am grateful for the resources we have but want to remember this cannot replace face-to-face contact and communication with the patient and their family.