R. Shelly Lancaster, University of Wisconsin Oshkosh associate nursing professor, leads the medical surgical international clinic in India, which gives her students a global perspective on nursing care.
“I wanted students to be placed in this low-technology, low-resource setting so they could experience what it is like to deliver care with no or very limited resources,” Lancaster said. “That was such an eye-opening experience.”
The course, Medical/Surgical Clinical in India, is an opportunity for UW Oshkosh nursing students to complete clinical rotations in another country and gain insight into how international nursing differs from national and regional practices.
“Students come back with a very deep understanding about what it means to appreciate what we do have,” Lancaster said. “They come back with an understanding of what a resource-rich nation we are, and I really do think it changes their view on what a socially just culture and socially just world looks like.”
Through the course, students visit medical facilities, including Global Hospital and Health City and Sri Ramachandra Medical College and Research Institute, where students complete clinical rotations.
Sri Ramachandra Hospital is a private, for-profit hospital with standards and certifications very similar to hospitals in the U.S. The medical campus also includes two Free Block hospitals, each housing 1,200 patients.
“In the Free Block, patients receive some medical care for free, such as blood pressure checks and listening to the patients’ heart and lungs. The food is free and the cost of the bed is free. But, if patients are having a seizure, I actually have to get the money from the patient or a family before I can give the medication,” Lancaster said. “There are costs associated, but the care is actually better than the care many Indians would receive if they were at a government hospital.”
Lancaster said she wanted her students to experience what it’s like to be a nurse in this setting so they could experience what it’s like to deliver care with no or very limited resources.
“I had a student caring for a post-operative patient with a 103°F temperature whose family couldn’t afford medication and the student was so frustrated. He knew this patient could have succumbed to post-operative pneumonia and was frustrated because in our minds we turn to antibiotics, getting fluids going and really supporting this patient through pharmacological interventions,” Lancaster said. “When you remove the money, you realize you need money to buy antibiotics and your choices are very limited with how you treat that patient.”
Lancaster used this student-patient interaction to teach her students about alternative treatment options. Instead of antibiotics and fluids, Lancaster and her students got the patient up and walking and encouraged coughing and deep breathing, which are known to help reduce fevers in post-operative patients.
“My student was able to get the patient’s fever under control, and the family praised the student about how he saved her life,” Lancaster said. “The take-home message for all of the students and for me was even when you don’t have money there are interventions that a nurse can use. It was so incredible for our clinical group that all of us felt like we had just performed a miracle and it profoundly changed me as a nurse and our students,” Lancaster said.