As the first week of the Oxford program comes to a close, I reminisce on all that I have learned thus far. From having guest lecturers discuss Brexit and the National Health Service to presenting on healthcare in various continents, I have truly gained invaluable knowledge in the last seven days. To delve more into the specifics, learning about the healthcare in England has been an eye-opening journey in itself. With England’s adoption of universal healthcare, I cannot help but make comparisons from its free and highly accessible care to the system in the United States. We have learned that in the U.K., healthcare is for all and — get this — free! Well, residents do pay tax, however pharmaceutical companies and private practices do not have their hands tightly wrapped around their healthcare system, unlike in America.
The focus of nursing in the U.K. is more towards preventative care on a primary level rather than in the States, which famously focuses on tertiary and acute care of patients. This innovative process in the U.K. allows nurses a greater role in public health and education. While British nurses teach their patients how to remain free of certain illnesses and infections, the U.S. essentially waits until the disease process has occurred to take action. I admire this perspective and am planning on integrating this into my practice as a nurse in the U.S.
In addition to the nursing role, we also learned while the nursing profession is highly respected in the U.K., the compensation is lacking. In fact, nurses deliver skilled care while humbly accepting an income that is much lower than that of an American nurse.
I am now writing this from my dorm room, surrounded by my classmates, in Oxford! In the short amount of time we have been here I have already fallen in love with the culture in the United Kingdom and with the people around me. There have been many trips out during the day to go visit gardens, museums, lecture halls, historic monuments, amazing restaurants and even just trips to the dorm room kitchen to make pot luck style dinners at 1 am with my peers — all of whom are starting to immensely open my eyes by showing me a new perspective.
I account my newfound perspective on the culture, people, myself, my class but mostly, to all the diversity I have encountered on this trip. Diversity has been shown to me in the classroom with the topics, with my classmates, in the locals that I meet, in the culture here, and has also been the answer to every social issue that we discuss. Recently, the entire class went to John Radcliffe Hospital and I was able to see the actual act of diversity played out. In the United Kingdom, there is a huge emphasis placed on the holistic approach to medicine, and family-centered care, which as we know is quite the opposite of western medicine.
In the maternity ward, they had multiple units that were dedicated to birthing, yet each unit was purposed to utilize different methods for birthing. In addition, they push to have their patients whom give birth stay a total of 10 days for the sole purpose of making sure the mother feels comfortable and secure in her new role. I found that here in Oxford, there is a much higher emphasis on meeting the patient’s psychosocial needs, meaning they focus on mind, body, and soul instead of just medicine. In fact, they don’t even have locks on the medicine cabinets because it is not their first intervention choice!
After our hospital visit we were asked by staff if we would want to work at the hospital – and my answer was no. My rationale for this was because I want to bring home everything I have learned from England’s healthcare and apply it in the United States. If we chose to show more compassion and support to our patients lives, and not just their disease we could all make the world of difference for each individual seeking treatment.
Courtney Rae Pattugalan
From Day One, we've hit the ground running, from learning discussing the pros and cons of universal health care to the impact of Brexit on the U.K. I never imagined that I would have expanded my horizons so far.
What I find to be most interesting is the career path to becoming a nurse in England and the difference in terms of the scope of practice between a nurse in the U.K. and a nurse in the U.S. For instance, a nursing student in England studies to be a nurse for three years and does not take nursing core classes like we do but rather, they jump right into a specialty and take these courses for the duration of their education. Also, in contrast to our program, nursing students in the U.K. rack up roughly 2,300 clinical hours in the hospital. My personal favorite is that U.K. nursing students do not have to take an NCLEX-style examination to become a registered nurse. Instead, they are certified by means of a competency sign-off and recommendation by their preceptors.
Today, we visited the John Radcliffe Hospital, where I toured the adult acute, ambulatory, women's, and stroke unit, as well as the neonatal intensive care unit.
I was most excited to see the stroke unit as I am currently employed as a telemetry technician/clerical coordinator on an advanced brain and spine/stroke unit myself back home. I was very surprised at the nurse to patient ratio as some nurses were taking on five, even six patients! This definitely speaks to their time management skills as the flow of the floor was orderly and not frantic by any means. In summary, I found that the nurses and inter-professional staff at the hospital embodied their mission of providing complete, holistic care for the patient as a whole, rather than just treat physical symptoms. I am thus intrigued by the concept of promoting preventative, primary care rather than tertiary care as is more prominent in the US.
Back in the classroom, I'll admit that I did not realize how challenging, not to mention tiresome, three back-to-back group presentations would be. I am currently on Team Australia/Oceania with two other wonderfully intelligent, driven, and infectiously kind-hearted girls, and together we have already shown progress from our first presentation together to the most recent. This past week, we were allowed the creative freedom to act as representatives for the "Australian Health Fair," and persuade our "audience," prospective nurses, to come to Australia to start a career in nursing by selling the benefits and multitude of channels that the profession entails "down under." For instance, nurses in Australia have the opportunity to join an overseas registry in which they may travel to Fiji (which, like the rest of Oceania, has a shortage and need for nurses) for instance, to work and reside for six months before exploring another country or territory. At the end of the presentations, our class voted collectively on which continent's presentation was most convincing, and our team won! Working in a group with these stellar individuals has not only allowed me to learn, research, and present information in a cohesive, natural way, but it has also catalyzed my own personal growth as a public speaker, nursing student, and future nurse.
I never thought that I would grow so close to the individuals I have had the pleasure of spending time with in Oxford as I have in the last week. As testament to how much of a family we've become, one of our favorite resident advisors even affirmed that as a group, he's never seen a group of students from WCU come together and become so close so quickly in the years that he's worked with the program. I have to say that I am honored to not only work alongside these brilliant individuals, but to know them personally and call them my new friends. I knew before I left that traveling to Oxford was going to be the opportunity of the lifetime, but it wasn't until I looked at all that was around me that I realized how lucky I really am to call this beautiful city my home for two weeks, surrounded by the most iridescent and refreshing souls, pushing myself to become the best that I can be.
This is the most amazing trip I have ever been on. I am so grateful that my first trip out of the country — and to England — was with West Coast University. I have learned that there are many differences in England as opposed to the U.S.. For example, they have a Universal Healthcare system in the UK, whereas in the US we do not. The healthcare is free for the people in Europe, unless they choose to get private insurance, which I think is really nice.
As for the nursing profession, I have learned lots. The nurses in the U.K. have a salary cap that is the same for everywhere in the U.K. This sounds good on paper, however, someone who lives in Oxford gets paid the exact same amount as the nurses that live in Manchester. With this, the nurses in Oxford are barely, or not able to live a comfortable life, because the cost of living in Oxford is higher. Another thing that I have learned about the nurses here in the U.K., is that they choose their specialty towards the beginning of their schooling, and focus on that specialty for the remainder of their school years.
Working in groups has been very interesting. I feel like the biggest challenges to working in a group would be that often times I have found that people want different things, and want to do things a certain way, so finding a balance that is suitable for everybody has been a little challenging. There have been many rewards by working in a group. For example, working in a group this whole trip has helped me to become a better person, and has helped me learn a lot about myself. Also, I have gotten the chance to work with some really amazing, smart, and fun-loving people. To me this is always a plus, because it makes experiences like these so much more rewarding.
During this trip, I have grown tremendously. I have grown physically, because of all the walking we have had to do and because of the variety of good food. I have grown mentally, because I have been challenged by having to do projects to the best of my ability in a short amount of time. This has helped me to know my limits, know that I can do better, and that there is always room for growth and improvement.
Ashley Desamours, Jingzhi Wan and Kimberly Salcines
Healthcare in England is multifaceted; in addition of focusing on the clinical aspect of providing care, they place a high emphasis on the psychosocial aspect of individualized care. Some of the activities they provide include alternative medicine, music therapy, aromatherapy, cooking activities and magic shows. John Radcliffe Hospital is affiliated with Oxford University. They are one of the largest NHS teaching trusts in the U.K.
Hospitals in the U.K. focus on nurse-patient communication. The nurses recognize their patients as individuals and tailor their nursing interventions to the patient’s needs. While focusing on details, they try to improve by actively seeking feedback from patients. For example, take a patient with diabetic retinopathy waiting for a procedure; they educate their patients in regards to the importance of eating. They offer biscuits and tea as well as a pager to be alerted of their appointment if they decide to leave the department during the wait time. A flow chart created by a nurse is provided to all diabetic patients with resources to turn to when hypoglycemic symptoms appear.
While in the OHP program, we are assigned to different groups to work on presentations throughout the program. All students from five different campuses are put together to work in a group. This requires us to be able to adapt in different situations while working with different diverse backgrounds. One of the biggest challenges with working with a group is stepping out of your comfort zone. This program provided us with a great opportunity to work with each other, filled with appropriate activities that promotes not just academic teamwork, but also social interaction. During our first day, we introduced ourselves to each other and shared some unique facts about ourselves. This helped us break the ice and form bonds.
The program taught us to push beyond our academic abilities, and made us think outside the box; channeling our creative side that we were not aware of prior to working with our groups. Teamwork led us to understand each individual’s strengths and weaknesses, while encouraging each other to grow.
When taking a look at health care in England, I have been able to see a contrast between England and the United States. This past week, I had the privilege to have been able to sit in a lecture by Anna Hemphill, who spoke about England's health care system.
Ms. Hemphill explained how much of free health care is covered by the taxes that working people pay for and how their population is ageing, which raises the need for health care workers in England.
We visited John Radcliffe Hospital and had the opportunity to tour through some of their units; today, we were able to see how England's National Health Service worked. It was amazing to see what was taught in lecture come to life before my eyes. From the safety practices to mental health awareness, it was very comforting to see a health care system put an enormous amount of time into patient care. I was also grateful to have had the chance to speak to a fellow nursing student, Lily, from Oxford Brookes University. Lily shared her insight on England's nursing curriculum and the process of becoming a registered nurse.
From all of this, I am learning that although health care systems may be differ from one country to the next and resources vary, the scope of practice remains the same and focuses on the patient's well-being. It has been rewarding to share the same ideas with my peers. The shared ideas are allowing us to discuss changes we have seen or like to see to improve ourselves as student nurses and as future registered nurses. This experience has taught me that my growth as a future nurse is limitless. There have been so many moments in this trip in which my knowledge, skills, and practice have grown. To be able to continue to listen and experience is my goal for the rest of the trip.