Saudi Arabia - Good Idea or Not

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. World General World Article

To an American nurse, it seems like an upside-down system.

The 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 as a nurse 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 an 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.

Saudi-Arabia-Good-Idea-or-Not.pdf

I am from the states and a DON in an addiction/mental health facility in Dammam. We have about 250 nurses with approximately 210 male staff. My nurses come from Egypt, Tunisia, Philippines, India, Sudan and over the past 2 years, Saudi. The trend now is to hire Saudi staff.

A serious issue is the level of training. Most, if not all who have posted from Saudi work in the higher grade hospitals and these hospitals generally do not hire the level of staff I have. Many of my staff, particularly the Egyptians did nursing training as a technical high school and in Saudi they are classed as 'technicians' by the Saudi Council for Health Specialties. Professional nurses are western (dip, ADN, BSN and up), other countries at the BSN level. Egypt has BSN and grad level nurses but that is just now opening for men. Sudan and India have the same level of nurses with BSN and higher also in India.

Technical nurses are considered by the ICN and WHO as similar to the LPN level but frankly, some of my staff are not close to that.

A problem now in saudi are the many private nursing insitutes that are spewing out 2 year diploma nurses. In my experience no one fails. I do pre-employment exams allowing for a 60% pass rate and some fail that but passed their programs. These nurses are having difficult times finding employment which is not surprising.

In this mix I have some very good nurses. Character means alot to me. A person can lack skills but have a beautiful character, be motivated, sincere with integrity. These people want to excell and one of my responsibilities is to help them to do so and they do with the proper attention, training and encouragement.

I have also had some very difficult individuals that tried their best to apply their 'own rules' but we have prevailed to date because first we behave professionally and don't use underhanded tactics and second because I have excellent support from the hospital director and administration. We have managed to set a few individuals 'straight' but with quite a bit energy expended in doing so but it was worth it.

A problem in the system itself is what I believe is a sense of entitlement that creates two classes in the work place; Saudi and non-Saudi. For example, in the MOH Saudis get paid time of for CE, foreign staff do not. This can create moral problems and a two tiered system leaving some nurses feeling less than enthusiatic about their work. Another area I concentrate on in my leadership position is narrowing this gap and in some ways not allowing a gap to exist at all.

In the end, it is true, there are good and bad in all groups of people. The system needs a great of nurturing and their are many factors that one must understand and deal with in order to successfully navigate as a leader and anyone working here long enough will understand what I mean.

While nursing training in the States is some of the best in the world, I find it interesting to read issues presented on Allnurses and the ANA nurses network regarding serious issues with nursing managers and other behavior anonmolies that reveal that character and personality issues occur in every place making for undesirable working conditions.

Dear Sir, With good intention, may I know if you still hiring male nurse in that specialty ward your working? I am a Filipino with less experience here in the Philippines. I once work in the psychiatric home in Connecticut for one month just for the experience. here in the Philippines I work as a nurse trainee in a government hospital. thank you.

Specializes in endo,medsurg,dialysis,home health.

Fascinating....thank you!

Specializes in General.

Hi..

I have my experiences working in two different mental hospital as staff nurse and EEG operator, A year in Riyadh and couple more years in Thaif. One thing that I learned that once you decide working abroad, including Saudi Arabia, pay full attention and be compliant to the local rule. I envied US nurses who considered as more knowledgeable and more skillful.

Every country has preferences. I agree with Rasha, not all Saudian Nurses are lazy, some do, but I treated them as co workers that need to be reminded of their duty because if thing goes wrong they are also liable to it. Nobody will believe if I had courage to rent a car, went around city to city with no local driving license. Being polite and firm is the key to everything. Say yes if you see the good, say no if you believe is wrong. Don't play something that you think the same as in your homeland. As an example, don't ever touch anyone's butt if you don't want to be accused as inviting homosexual action, and don't be tempted to act one also. Food are greats, supermarket also. Just remember what your purpose being in Saudi Arabia and stick to it. I worked with mostly male and female nurses from Philippines, UK, India, Pakistan, Marocco, Tunisia, Palestine, and Indonesia. Onehalf of them are Catholics but been working and enjoying their time for 10-15 years.

Though I am moslem, but I still had to adjust my self to get along with things.. As it is not my country.. And had my best time with it from 91 to 93.

Specializes in neonatal - geriatrics.

Thank you for the insightful article. I have requested information from an international agency in regard to accepting a temporary position in Saudi Arabia. I am glad to happen upon your experience in the area. This gives me much to ponder.

Specializes in Post Cardiac Care/Telemetry, L&D.

Hello

I'm an American nurse (Cali gal) currently working in Jeddah,Saudi Arabia on a 1 year contract. To the original poster, only male doctors are allowed to bring family members with them. All others are provided single female or male studio apartment housing, and we all live on one huge complex. My apartment is very quiet. So here's the run down...

the hospital is nice

Women can't drive here, you WILL not miss it trust me lol

english speaking employees from different countries (America, India, Egypt, Austrailia, New Zealand, UK, large number from the Phillipines)

General salary is $68,000 (tax free)set by hospital, not agency

53 days of vacation per year

Single studio apartments on beautiful grounds with pool, jacuzzi, gym, nail salon, small convenience store, tennis court, swimming lessons

All utilities paid

Free shuttle buses for transport to work, shopping (16 different malls and souks)

inexpensive car service/cab available

no safety issues (this city is very laid back and cool)

its not like on CNN, its very modern, esp the malls, same stores as U.S.

nurses scuba dive ALOT here

social club offered at the hospital to book activities

we have cell phones and cable satellite

We don't have to wear our hair covered but do have to wear an abaya(robe) when not on apt complex or hospital grounds

The ratios are the same here as back home, but most of the units do primary nursing. We have to rotate shifts from day to night every 3 weeks, or you can have a shift buddy if you prefer so you can swap during rotation. I prefer day shift so when its time to rotate, I keep her day shift and she can stay on night shift permanently. We wear all white uniforms, provided by the hospital, except O.R. wears green scrubs. Most of the patients speak arabic but have a family member that speaks english, or we have a coordinator to grab to translate.

I know people think its not worth it, but trust me pocketing $70 k and not paying rent,insurance, or utilities for a year is SOOOOO WORTH IT!! My salary in California is $89k/year, but I never see it between taxes, rent, bills, etc.

Also I get to travel to nearby places like Egypt and Dubai without using my vacation time. I've made some great friends from other countries and learned alot. Most of the girls I've met here came on a one year contract but ended up staying for alot longer , anywhere from 4-10 years. If you don't like it here you always have the option to break your contract and leave, but you have to pay for your airfare home.

When you first get here, you don't go straight to work. You have classroom orientation for almost 2 weeks, then 2 weeks of floor orientation. I must say I'm not in love with primary nursing, but I guess American nurses are a bit spoiled lol. My coworkers are all friendly so I enjoy my unit. However, there is no such thing as home health, palliative, or hospice care. Well, only some of the richer families can afford home health, so you may find patients refusing to be discharged after the doctor has cleared them to go home. The government picks up the tab so the hospital lets them stay. Sometimes for years...Anyway, overall I love my experience here so far. I hope I've answered your questions with my small novel :-)

What do you mean by primary nursing?

p.s.: I thought patients not nurses were spoilt in America. We nurses here too are just glorified maids.

Specializes in Post Cardiac Care/Telemetry, L&D.

Lol what I mean by "spoiled" is in America we do team nursing, meaning the RN has a nurse assistant to do vital signs, feed the patient, change the bed, empty foleys, etc. And we also have an IV team, RT,PT, lift team, social worker, etc. Here in Saudi we do what's called primary nursing, which is the RN is solely responsible for all of the above.

What country are you working in as a glorified maid?

The US of A, of course.

So you have to do all that by yourself with no help with the same patient load as the US? That is a lot. So then how is it low stress?

I actually worked in a Rehab here, where we did all that, including showering patients, with 7 to 8 patients a piece. What happened in reality was, that the 9 a.m. med pass spilled into 11:00 a.m. because you were busy showering people and changing beds. The DON did not last long and they had to hire some CNAs. Yup, we had to hand out and pick up trays too. Stupid. Why pay someone $30 to do do that when you can pay $8 to one extra kitchen staff and let them do it?

Specializes in Post Cardiac Care/Telemetry, L&D.

I think it depends on the type of unit you work on. My max ratio is 4:1, but we usually have 2-3 patients. I tell the patients that are able to bathe themselves, or let their family members assist. There are anywhere from 2-8 family members in the room at all times. So it only gets trying when you have a total care patient. I work with a good group of nurses so we help each other out. Nobody will code if they take a late bath :-)

However, I have worked on units where the ratios are 6:1, which will definately stress you out.

Hello Everyone,

I read in a previous post that in KSA there are prejudices and American nurse is concsidered as a white american. Are there any African american nurses who worked in KSA? How was your experiences? Does it work to your advantage to be Muslim vs non- muslim? Also, I do believe I read that only single women are allowed, does that mean families would not be accepted even if you pay for your own lodging? Also may i please have the name of some agencies which hire in the middle east I am more looking to be in Dubai or Oman.

Thank you