I just returned from a surgical mission trip to a third world country. This was the first time I had ever traveled outside of the US (the Bahamas don't really count).
The hospital was in horrible disrepair. In the wards, windows had been broken, and the nearest piece of cloth covered them. Wards were accessed by outside 'open air' hallways, so it was not unusual to see cats, dogs and birds wandering about the wards. The hospital did not supply linens, food, or even toilet paper for the patients. The families had to bring them. If the pt had no family, they were lying on bare, ripped and dirty mattresses. I saw several families offering food and toiletries to the pts who had nothing.
Sterility was a joke. The same linens that covered the back table from the previous pt's surgery became the linen that covered the OR bed for the next pt. When I protested and tried to explain blood borne pathogens, I was shut down. This was simply the way it was done. I was pushed aside while the circulating nurse covered the (not even wiped down) back table with the next set of drapes.
I saw pediatric patients who had horrible illnesses due to alcoholism. There were several pts admitted due to failed suicide attempts in which we were asked to repair shattered bones, cut nerves, and disfigured limbs. There were countless machete wounds-the youngest being 7 years old. One woman had one of her hands cut off by a machete because her husband didn't like the way she prepared dinner that night.
Our translator told me not to question anything that the local docs say. She said to keep quiet. When I asked her about this, she told me that the nurses were slapped DURING ROUNDS, in front of the entire ward when they ask for any sort of clarification. They don't work specific hours, but work until there is a lull in the workflow. Some of the nurses travel for 4 hours by bus to and from the hospital. Many of them don't even have electricity in their homes. The nurses make $2,000 dollars per year. The surgeons make $7,000. The politicians make $80,000.
I will be the first to admit that I do my fair share of bellyaching when it comes to the challenges we face as nurses here in the US. Although I don't promise to be silent when I see something that endangers my patient, I do promise to be more patient overall and will further promise to nip petty complaints in the bud.
We are so lucky to live in this country. We as nurses continue to achieve more and more. We have that right, we have that freedom, and we have a board of nursing to rely upon. We have departments in which we can file complaints, we have laws that prohibit violence in the workplace. We have mentoring programs, we have quality control committees, safety committees, retention committees...we have so much here that enable us to grow and learn. We have clinical ladders, we have scholarships for new students, we have the right to voice our opinions.
I took for granted the amount of resources we have here in our fine country. I will never take that for granted again.