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.
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.
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.