Saudi Arabia - Good Idea or Not

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    As seen by a Registered Nurse from the United States, who is now on assignment, it can be hard to adjust to hospital nursing in Saudi Arabia. That is particularly true in the hospital complex that serves the Saudi Royal Family. The very size of this facility is daunting. It is a 1 km straight walk from the front door to the back entrance.

    Saudi Arabia - Good Idea or Not

    To an American nurse, it seems like an upside-down system of Policies and Procedures that fails to fall within any framework of prior hospital experiences. This is a place where the patients tell you when it is time for an assessment or for treatments or for meds. When a member of the Royal Family is admitted to a unit he/she is accompanied by a minimum of 3 and up to 14 servants. This includes a private nurse. You will get to know this nurse well because you do not administer the meds, but rather give them to the private nurse who gives them to the patient.

    There is a high degree of racial prejudice against persons of color, South Africans, Hindus, and Filipinos, in this hospital. They are not allowed to work in the Complex of the Royal Family. A nurse with an American passport is considered white and is highly sought after. Co-workers will go to the American nurse and take her along with them when they want to communicate a plan of treatment to a family member of a patient. She is introduced as an American nurse and does the speaking for the co-worker.

    The lifestyles of the Royal Family have contributed to staggering poor health. By the time they are 40-50 years old, you will find patients in this unit, male and female, have osteoporosis from lack of activity. By the time they reach 50 most of these patients have often given up on life because they have nothing to do except indulge themselves. It is sad to see them on heparin because they choose to stay in bed. They can be observed sleeping all day and eating all night. Since they are royal, you cannot tell them what to do or how to do it, even if it is for their own good. A patient may be on an insulin drip for a week while gorging on food the whole time. These patients have an inordinate amount of cancer and genetic disorders, and one in three are diabetic. It is not unusual to see a handsome prince, dressed in pristine white, clean and sweet smelling, with a body wasted by muscle atrophy.

    An order for DNR does not exist, except on paper. There are upwards of 6,000 members of the Saudi Royal Family. Each one is eligible to receive a share of the Family fortune, as it is doled out. Therefore, the aged and/or infirm are kept alive by all means possible. This hospital houses an entire wing of patients who are in persistent vegetative states or are on vents or other means of artificial life support. As long as they live, their family members have a closer link to the crown and they are eligible for stipends that will be managed by their guardians.

    Advantages of working in this outpost are notable. American nurses command the highest rate of pay. Transportation, to and from Saudi for each assignment, is paid. A one year contract can include a 2 week paid vacation. A Re-up bonus for a second year is often offered. There is no Saudi tax to pay and very few living expenses, since housing is provided. There may be favorable tax treatment by the IRS as well. Uniforms are provided and will be worn, without covering, only while on duty. At all other times, when in public, a nurse must be covered head to toe with the burka. Segregated swimming pools, tennis courts, and fitness centers, etc. are provided and offer diversion. Taxis or buses are available to provide transportation to leave the complex to go shopping or site-seeing. Everything in the shopping center seems to be made in China. But, the Super Markets are great. There, you will find food from all over the world. You can spend hours just tasting special imports of the best honey , or 28 different kinds of olives on the olive counters. Hint: You might find the sweet olives are horrible. However, you may never have seen such dates. They are to die for.

    Disadvantages of going to this outpost need to be pointed out. American nurses are sometimes vulnerable because they can be naive. They have enjoyed the Constitutional protection of a democratic government. They do not always carefully consider that they do not have that same protection when they leave the borders of their homeland. A study of the customs and culture of the country to which they are going is a must. Most important is an understanding of the system of government and laws.

    According to the U.S. Department Reports on Human Rights Practices for 2000-2001, this Islamic country is ruled by Sharia Law, and Women's Rights are virtually non-existent. Although a state of world-wide unrest exists with the Radical Islamic countries, because of oil reserves, a policy of appeasement has been adopted by the United States. Americans in Saudi Arabia must depend on this fragile relationship to continue in order to have a semblance of safety while they are in that country. It is important to know the facts and not live in the romantic fantasy of The Arabian Nights.

    In Saudi Arabia, the government seems to be made up of a system of checks and balances. The Royal Family controls the money. Money is "Power". The Islamic Radicals are the Rulers because they interpret the Law of Sharia; a system of national laws derived from the Koran and the traditions of Mohammed. The Mutawwa'in are the religious police who are the enforcers of the Law. Religious Law is Civil Law in this country. Because it is interpreted literally, it is enforced without mercy. Sharia Law identifies anyone who is not a Muslim as an Infidel and an enemy. Muslims are specifically ordered to not befriend unbelievers. Mateen Elass explains the implications of this in her book, Understanding the Koran. According to standard Islamic jurisprudence, Sharia Law today, interprets the Koran as obligating Muslims to be under the rule of expansionist jihad (holy war). This is understood as armed struggle against unbelievers, whether or not the Muslim community had been attacked. This is a country that has a history of 1,600 years of revolutions, political assassinations, and massacres, and has ruled it's populace by subjection or death. Today, Arab media often incite Arabs to street rage and violence by feeding misinformation. You will remember that the world witnessed Muslims dancing in the streets, celebrating the destruction of the World Trade Center 9/11.

    There is a difference, between being a judgmental person and being a person of rational judgment, that is worth remembering. If you choose to go Saudi Arabia, be careful about how you conduct yourself. Right now, the long arm of the U.S. Embassy gives a sense of safety. However, there are things that you must do to protect yourself from embarrassment, from derision, from humiliation, from attack, and from arrest. Be prepared for unwelcome gazes and advances from the Saudi men while you are working in your uniform. They have been brought up to believe that a woman who does not cover herself is available for sex or is a prostitute. Never accept an invitation to accompany a Saudi man anywhere for the same reason. He has an expectation that you can be bought and because of his wealth may offer very expensive jewels and gifts. Outside of your unit, you will always be covered with a Burka. You will ride in the back of a bus, by Law. You will not get into a Taxi unaccompanied because you cannot be alone with a man. Men and women are separated even in the Marketplace. If you want to buy a cup of coffee in Starbucks, you will go to a segregated area for women. Is Saudi Arabia a good idea for you? Only you can decide.
    Last edit by Joe V on Mar 27, '18
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    About 43RN20

    Joined: Nov '06; Posts: 57; Likes: 208
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  3. by   newtress
    Very informative information regarding the drastic differences between a Saudi facility and American. Along with most of the differences, one can't help but wonder what the pay scale is for an American nurse working in Saudi Arabia. I was surprised to hear that working along side of Saudi nurses was so accepted by them. As you stated, a totally different code of ethics and royal patients summoning for treatments and meds themselves is quite royal indeed. Is there a high need or demand for American nurses there? This is facinating, and I think my nursing student classmates would be interested in hearing about these cultural differences as that topic is incorporated into our course work quite often. Thanks for the insightful write!
  4. by   perez33
    Your article is true.I've worked there for four years as hemodialysis nurse without experienced from the Phils.but I had my training before I handled patient.I just want to share my experience is that most saudi nurse are lazy.They will come to the unit to continue their sleep from their house,often seating and eating without any motivation to learn that's why they are obviously fat.Knowing they have high salaries!That for us is nothing to do because were just foreigner.Salary deduction or bad mouthing from the wacher or director if something happen to the patient.But if the the native who had fault 'malise'for arabic sorry!
  5. by   MacD
    How interesting. When I was in the US Navy I saw the large numbers of foreign workers in the middle east and often wondered about the hospitals. Are there any male nurses in the hospitals? Where do the doctors come from foreign or locally educated?
  6. by   oramar
    No thanks, not going to Arabia anytime soon. Very interesting article, gave me an education. Some day the oil economy will cease to exist, what it will be replaced by is anyone's guess. Then these little kingdoms will sink back into the sand. This country will look completely different also.
    Last edit by oramar on Jan 23, '08
  7. by   ginger1023
    Interesting...informative and thruthful
  8. by   43RN20
    For anyone wanting to know more about travel dangers, it would pay to go online to the U.S. Dept. of State. or place a phone call to that dept. @
    1-888-407-4747. They have posted several warnings for Saudi Arabia. The U.S Embassy & Consulates also have the Warden System, that issues messages to keep U.S. citizens apprised of travel restrictions issuing Travel Alerts. The Riyadh Embassy website is
  9. by   seretide
    Very infomative topic.

  10. by   shah
    :angryfire Dear 43RN20,
    Though your comments and experience about Saudi culture are valid, you have demonstrated cultural insensitivity by interpreting Islamic laws and commenting on what Muslim behavior as related to 911. I would be just like defining all Americans by KKK behavior.

    Remember that there are 7 million Muslim Americans and many died in 911.
  11. by   KCIN
    what a nightmare.
  12. by   Diahni
    What an excellent article! Being a nurse provides one with an opportunity to work in another culture. There are many interesting things about Saudi culture, but I honestly wouldn't even think of working there, for the very same reasons outlined in this article.
    But wait, if you want to work in a Middle Eastern country - check out Dubai, as it is far more modern. The Saudi culture is in the stone age, and even in Egypt and Turkey, countries that are far more modern, one has to watch oneself at all times. Unless I got a sex change operation, I wouldn't even set foot in Saudi Arabia. Bravo to 43Rn20 for the wonderful writing, and even more so for the guts to do something outrageous!
  13. by   43RN20
    The subject of the article is specific to the experiences within the confines of the local region. Within this region, it is best to understand how the ruling class interprets the Law and how it is enforced. As for demonstrations in the streets after 9/11, we saw news clips of isolated incidents that we know occured. Again, these were local incidents involving the more radical element of Muslims & should not be interpreted as an expression of the rest of the Muslim population world-wide. The U.S. Dept. of State has published advice to travelers going to S.A. for those who want to know.
  14. by   clare123
    Hi there,
    What an informative read - thank you for taking the time to do this. Am I wrong in thinking many/most of the hospitals there are governed by USA healthcare standards? It does'nt sound like it.
    I am currently looking at working there for a year, and really just at the information gathering stage. I did work in the USA for almost 6 years and thoroughly enjoyed it.
    I will continue to track this discussion