Numerous UK nurses altruistically volunteer to work in low and middle income countries, but what is often overlooked is how the NHS and each nurse benefits from working in partnership with global colleagues.
The UK volunteers return appreciating ‘universal health coverage’ and how great the NHS is – they never again take for granted NHS resources when they have watched patients gasp for breath when there is no oxygen or heard the screams of agony of a child with sickle cell when no pain killers.
They passionately accept the importance of our UK immunisation programme having seen vast numbers dying from measles or the blanket swathed cots containing little ones painfully dying from tetanus.
The nurse volunteers return better and indeed safer nurses. They are less reliant on monitors, blood tests or investigations to assess patients, returning with heightened observational and assessment skills and some believe more intuitive practice; when caring alone for 100 patients regular observations cannot be taken but nurses develop the ability to recognise and ‘home in’ on the critically sick and deteriorating from the end of a bed.
UK nurses learn the true meaning of partnership with family members, the vital importance of educating and indeed trusting relatives as observers, educating them on care practices, what to look for and when to call for help.
“UK volunteers return with a wider knowledge of illnesses and conditions”
Seeking answers in low resource settings leads to nurses developing innovative solutions and practice that they can on their return introduce into their UK practice. Some examples include: introducing kangaroo nursing in neonatology rather than expensive warmers; developing distraction techniques in clinical settings, and the use of a torch or cold lamp to find a baby’s vein for cannulation – essential in low and middle income countries when a lack of cannula’s means success at the first attempt is vital but also good practice in the UK to reduce waste and the trauma of repeat attempts.
UK volunteers return with a wider knowledge of illnesses and conditions, often seeing for the first time advanced symptoms rarely seen in the UK. This, for example, has led returning nurses to diagnose kwashiorkor in malnourished, neglected children and to identify cases of tuberculosis in the UK.
Recognising vaccine preventable conditions is important as international migration to the UK ever increases with many refugee children not fully immunised.
UK nurses now practise in a multicultural society and returning nurses describe how their assessment of patients has changed. They now ask about a family’s background and beliefs; exploring how traditional and alternative medicine may be being used and the acceptability of western medicine, which may affect compliance.
Being involved in global volunteering is an honour, reaffirming for some of us our original motivation and commitment to nurse. However, I recognise that global volunteering is not for everyone. It requires an inquiring and open mind, as well as resilience and commitment. In the past it was a major ask as most volunteers were required to use personal holiday time and funds.
However, the vital importance and mutual benefits of global volunteering by UK nurses is now increasingly recognised and there are many funded projects that nurses can become involved in. Health Education England are launching a global volunteering portal where you can register your interest and many royal colleges include nurses and midwives in their multi-professional volunteering activity.
I am proud to be a UK nurse. We have lots of knowledge and expertise to share but also, hopefully, the humility to know how much we can learn from our global colleagues, knowledge and ideas that I believe can benefit our patients and our struggling NHS.
Professor Judith Ellis is children’s nurse and chair of the Tropical Health and Education Trust