My Nursing Elective in Vietnam (Part 3)

In the final part of her series, Laura discusses her international elective placement in Vietnam. With her placement ending soon, Laura talks about her experience of working in A&E and if she would recommend an international elective to other Student Nurses.

Hi, my name's Laura and I'm a Student Nurse, and today's video is the last part of a three-part series about my international elective to Vietnam. 

As you guys already know, I have been in Vietnam now for four weeks. I've just finished packing my cases, ready to leave the student accommodation that I've been staying in, and so I thought now would be a good time to give a final video of this trip.

So, this trip has been four weeks long. I have spent one week in oncology, two weeks in A&E, and one week on a surgical ward.

Working In A&E

I think my favourite part of this trip has been A&E because I enjoyed how different it all is and how there were so many different cases all the time.

The situation in A&E was quite different to our situation at home. When patients came in, they chose a bed, and then they were seen pretty much straight away by a doctor, which is obviously completely different to how it runs at home, and it was quite interesting to see.

In the UK, a lot of appendicitis cases tends to happen in younger people, whereas here in Vietnam there's a lot of food poisoning and appendicitis and, especially appendicitis, in all age ranges. So pretty much every shift, you were guaranteed to see maybe two or three cases of appendicitis, regardless of age.

There was also quite a lot of road traffic accidents that happen because everybody here rides mopeds and scooters, and I'm not going to lie, the roads are very chaotic. So, there were a lot of traffic incidents, and they were made worse because people here don't wear leathers. You'll have girls dressed how I am with their arms out, and their legs out, and then when they do come off with the moped and have a crash, they have really bad road rash.

There was also quite a lot of allergic reactions to bug bites. So, there was a couple of anaphylaxis cases. I think what was quite scary was seeing how different the resus bay here was. If you see the photo that I've sent with this, it isn't very technical at all. We had a guy in there we thought we had sepsis, and the blood pressure machine wasn't working accurately, so we had to do manual blood pressures. That's how not modern and up to date it is.

"A resus bay."

Learning New Skills

What else has happened? I have actually learned how to cannulate on this placement, which has been amazing, but I feel like when I get home, I'm going to have to relearn that skill with the English way of doing things, because the way of doing things here just isn't the same as doing it at home. And I feel like if I was to cannulate a patient the way that I've done it here, the nurse who supervises me next year will have an absolute fit.

I've done a lot of dressing changes, and it was quite interesting to see how they use quite a lot of iodine to dress things, which was quite interesting. And how their dressing packs come in fabric. So obviously ours are just plastic packaged, pre-sanitized. Here, the dressing packs come in like a fabric sheet that's folded down and then the nurse puts it aside and it gets organized and sterilized in-house, and then re-wrapped up in the fabric. So, there's a lot less waste from it. But obviously, from what I understand in the UK, it's cheaper to put stuff in the bin than it is to reuse it and sterilize it.

I would definitely recommend the whole placement to people, whether you are qualified or not qualified… It's been absolutely amazing. I've learned so much.

Has This Placement Met My Expectations?

I think this placement has and hasn't met some of my expectations. I think, because I'm not the most confident and outgoing person out there, it's held me back a little bit, and I haven't meant for it to. I think the oncology and the surgery placement, I was only there for a week, so I didn't really have time to settle into it, and get to know people, and start becoming confident enough to put myself out there, which I think I would've benefited more from doing two and two rather than one, two, and one.

But like I said, on A&E, I was there for two weeks, and once I got to know people, and I got familiar with the environment, I was able to get a lot more out of my placement than what I was on the others where I hadn't had enough time to settle down.

I think the language barrier was also really hard, especially because I lip-read quite a lot when I'm talking to people, I don't always process what you're saying to me straight away. So, when someone's trying to talk to me with broken English... And also, people here seem to talk really quietly as well. So, they're not talking very loudly, they've got a mask on, it's broken English, and then the environment that I'm in is quite busy and noisy, I struggle quite a lot to understand sometimes, but Google Translate has been the lifeline here for pretty much every situation.

But I think it's met my expectations in terms of wanting to see a different healthcare, in terms of wanting to see how different things are, and it's really highlighted how much we have at home. And I know that at home we'll moan about waiting times in A&E and whatnot- I feel like that can be avoided if we didn't have such a wishy-washy process.

But then seeing what people are coming to A&E for here versus what people are coming to A&E for at home, I feel like a lot of people don't need to go to A&E, but then at the same time, if you need something and you can't get a GP appointment. I think as a patient you often feel like you have no choice but to go to A&E to get what you need in a timely manner.

"Outside A&E."

Privacy On The Wards

I think before I left, I had the expectation that it would be overcrowded, and there would be no sort of privacy, and that expectation was definitely met. As I've already said before, there were multiple patients on beds, with no curtains, no form of privacy, not really much form of dignity. It was like you had to become indecent in front of a room full of people that you don't necessarily know.

But at the same time, it created a nice community in each little room because the patients were laughing and chatting with each other, and it created a nicer atmosphere. Because in England, you're on your own. You've got your bed, you've got a curtain around you, you don't really talk to people, and if someone's too noisy, people often complain about that.

Whereas here, where they were all crammed so much, they didn't really have much of a choice but to get along with each other, and just to be more tolerating of other people's noises and actions and things. And I think that was nice. Obviously, I don't recommend that we start crowding two patients to a bed and have no dignity, but I think the way that it created a more tolerable friendly atmosphere was nice.

Staffing And Pay

My expectation of staffing was not what it was. I actually think that it was reasonably well-staffed. Obviously, it's not as well-staffed as it could be, but I wouldn't say it's any worse than the staffing issues that we have at the moment in England.

And I like the way that nurses have more clear roles to do. For example, if you are in the morning, you're doing the medications and then you do a dressing change on the wards. Obviously, in A&E, the nurses did the cannulas, the ECGs, and medications, and injections and stuff. That staffing side of things wasn't as bad as I expected, which was quite nice actually.

My biggest realization, so I was talking to the nurse on A&E, and staff pay here is horrendous. So, when she first qualified as a nurse, she was getting about 3 million VND a month, which equates to about £100 a month in salary, just over a 100 quid a month as a Newly Qualified Nurse in salary, which is quite shocking.

I understand that the cost of living here is less, but it's still appalling, and quite a lot of the nurses have to take extra side jobs just to afford things because of how bad the pay is here. I mean, I'm not saying our pay is great, but it's not £100 a month.

"Transporting oxygen with a patient rather than using O2 cylinders."

Would I Recommend An International Elective Placement?

And lastly, would I recommend this to people? I would definitely recommend the whole thing to people, whether you are qualified or not qualified, to the point now, I think I want to come back and do another international placement before I qualify.

So, I'll finish my studies, maybe come out for a month, and then start my full-time role. I would definitely do this again. I think it's been really eye-opening. It's been absolutely amazing. I've learned so much. I've learned to tolerate more. I've learned to be a bit more expressive in my communication. Obviously, I've learned clinical skills, and just the culture, the whole thing, I would recommend.

But I come here knowing nobody, so the only thing that I would suggest is, if you're going to come, come with a friend, because it makes it a lot less scary. And if you're someone like me who struggles with groups of people, having a friend helps to infiltrate the groups of other students in the house, because I quite struggled when there was a group of people that already know each other. Coming into that group, I found quite hard as someone who can be quite socially anxious.

But apart from that, 100%, I would recommend this to anybody. So, thank you so much for watching.

Watch Part 1 and Part 2 of Laura’s Vietnam Nursing Elective vlogs.