Manchester Metropolitan University 2020
I did my nursing elective placement in Iloilo, the Philippines. I went for 2 weeks but wish I had stayed longer!
I chose to go to Iloilo because I have never been to the Philippines or any Southeast Asian country before, and I knew that it would be a completely different experience from a placement at home in the UK.
On the first day, we had a tour of the hospital and of the city. We were introduced to the staff we would be working with, and we were given a hospital induction. The visit was definitely eye-opening.
From the outside, it looked similar to a hospital we may have at home; however, stepping into the hospital was very different. There were patients in the corridors and the wards, and as a government-funded hospital, the departments were very overcrowded. I felt a bit nervous at this point, but also very excited and optimistic about how my placement would make me a better nurse in the future.
As the hospital had very minimal funding, resources such as PPE and medical equipment were limited, and so a lot of the staff had to improvise with the resources they had. This included things such as dressings, where they had to use a different one from what was recommended, because this was all the patient could afford to buy from the pharmacy. I was able to develop my skills with thinking on the spot and being able to be more resourceful, taking more care when going back into practice at home to ensure I didn't waste the resources we have.
During my placement, I worked in the main ER department, Paediatric ER and OBG ER. Whilst in OBG ER, I had the opportunity to go into the Neonatal Intensive Care Unit, where I was able to hold some of the babies and learnt about how they look after newborns. During this time, I also got to observe some procedures which in the UK would be done in a very different way.
A patient came in who had a miscarriage. For me, being an Adult Nursing Student, I hadn’t had any experience with prenatal or maternity, and so this was already very different to what I was used to. I observed the foetus being removed; this was done in the main room, with other patients there, some of whom were pregnant.
I experienced a mixture of emotions at this time, from shock through to being intrigued, because it was something I had never seen before, as well as an overwhelming sadness for the patient who was there alone and was unable to have anyone with her at the time. At first, I struggled to understand how this was acceptable, as in the UK it would not have been, but after talking to the staff, who all spoke excellent English, I found it a bit easier to make sense of the situation. I was able to realise that they have no choice but to do it that way, they don’t have the resources to make it more private, such as curtains, side rooms or private rooms, and not only this, but the patient would have to pay for it, which for them is not attainable.
As my placement progressed, I felt more comfortable asking questions about their practices and how they make their decisions. I found that the staff were very happy to explain their culture and were willing to let me get involved, which I was very grateful for. I was able to read through some of their policies and speak to patients.
One thing I did notice was that they did not communicate with the patients much. In the Philippines, the families are the main carers while in the hospital. They will do all the personal care for the patients, feed them, wash them, and sometimes they even help ventilate the patients, which was another eye-opening experience. This is so different to how we nurse patients in the UK, as we involve the patients in all the decisions about their care; however, in the Philippines, the doctors make the decisions and the nurses carry out the procedures.
We were on placement Monday to Friday. After placement, we were free to do whatever we liked, along with weekends. Living in the Work the World house for two weeks was so much fun, and I found it really helped me overcome my anxieties and emotions about the placement, as we were all in the same position and were able to debrief with each other at the end of the day.
In the afternoons, we explored the city, we went shopping, had food, went to the local pools and went for drinks in the evenings. As I was there for 2 weeks, I only spent one weekend there, but we were able to travel to Boracay, where we spent the weekend.
The team at the Work the World house helped us organise it, and we went in a group of 5. It was one of the best weekends of my life, and I would 100% recommend it! As well as going away at the weekends, the team at the house hosted a weekly karaoke and BBQ night where we got the chance to get to know each other better, which is a good ice-breaker for the newbies arriving each week.
I couldn’t recommend the Work the World house team more. They were there if you needed anything; nothing was too much trouble for them. If you needed more support on placement or travelling to and from placement, they were happy to assist. I am so happy that I did this placement through Work the World, as I think it was well worth the money spent, and the support you receive makes the whole experience so much better. I am glad I chose Iloilo to do my placement as I learnt so much about the differences in the healthcare system and the role of nurses.
I was able to observe and participate in experiences that I would never have had the chance to at home, and I feel that it has really allowed me to develop both personally and professionally. I gained a lot more confidence and independence in my practice, and I am so grateful to have had this opportunity! I would do it again given the chance.