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My nursing elective placement in the Philippines 2017

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Josie Morgan realised, adventures are the best way to learn… 

josie morgan

My experience in the Philippines can not be described in 600 words, but my aim is to give an insight into just a few of cases I encountered while being a student nurse.

My placement was held in the ER department of Western Visyas Medical Centre in Iloilo, to say it was shocking is an understatement.

Every day patients flooded in with cases not really known to the UK. My first cultural shock was what an incredibly high pain threshold Filipinos have without the use of analgesia as it is scarcely used.

Patients would flood through the doors having endured traumatic injuries such as one patient who took a machete to the face during a fight. The patient had a extensive laceration across his face to which when he turned over, the side of his face had actually fallen off.

As you could imagine, the extent of his incident was fatal and incredibly painful. He was conscious and no analgesia was used. I was stunned how he could cope.

Out of all the medical emergencies, the hardest for me was when a patient came in with an out of hospital cardiac arrest, I went over to just observe and then found myself doing compressions on the patient myself.

They did an ECG to see if he had a shockable rhythm but there was no response. It was a surreal moment to have found myself in, but it was so important to grab every opportunity while I could.

The refrigerator in the mortuary only held 4 bodies at a time, so sadly the patient was left in the corridor with just a sheet over to which stray cats and dogs inspected.

Infection control measures and manual handling techniques were practically absent. Used syringes would be placed on the side of cabinets, blood stains on the floor and no personal and protective equipment was used such as aprons and gloves.

To transfer patients on the bed, one nurse would hold their legs and another nurse would hold their arms and they would swing them on the bed. Witnessing such practice, which abides by strict clinical guidelines and procedures, makes me want to scream but I had to recognise that this was their culture.

They had limited resources but they were resourceful with what they did have, such as instead of having urinal bottles, they used old IV bottles and cut them in half for patients to urinate. They used latex gloves as tourniquets and they had a few patients to the same bed to ensure all patients were treated in the hospital.

Privacy and dignity was out of question but that was not the patients, nor the clinicians priority in instances where the main aim was to keep a patient alive.

After a week on the hectic ER department, I unfortunately became ill myself and was admitted to hospital due to reaction from the antimalarials I was taking. I was taken to a private hospital where all the staff were so tentative and caring, which made a real difference to someone who was in a completely different country thousands of miles away from any close friends or family.

Here, they did have infection control measures and practices to adhere by which was a relief to me! The total cost of my hospital stay, including medication came to near enough £1000, which was luckily covered by my insurance company!

It made me have a whole new love and appreciation for the NHS, there was no way I could’ve afforded that type of treatment otherwise! Despite the criticisms and negativity towards the NHS, it is one of the best things this country has and if I have taken anything away from my experience in the Philippines is that I will never take the NHS for granted and all the staff that work tirelessly to ensure patients are fully looked after.

Josie Morgan, adult nursing student at Bournemouth University


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