Public health nursing education: Beyond American borders

Background: In the global environment of today's world, nurses must be educationally prepared to meet the needs of people from diverse backgrounds in order to provide safe, appropriate, and high quality care. This entails understanding how cultural, racial, socioeconomic, religious, and lifestyle factors affect health and the provision of care. A powerful strategy that allows the students to step beyond the confines of a classroom is learning through immersion (living and learning in another culture). These experiences have several strengths: increased student awareness of their own beliefs, values, practices, and behaviors and how that affects care; ability to learn from clients and provide culturally appropriate care; and ability to cope with factors affecting the client's health and living conditions.

Program design: A three and a half week public health nursing immersion experience for 17 senior undergraduate nursing students was organized in Bangladesh in collaboration with the Independent University, Bangladesh during January 2008. The majority of the Bangladeshi population is rural, and more than half live in poverty. Working with interpreters in rural villages, students learned about the people through surveys and interviews on topics such as gender health, environmental concerns, and poverty. Students also discovered how health care was provided in clinics, hospitals, and through home visits.

Results: Preliminary data analysis (descriptive statistics and thematic analysis) is providing knowledge on which to base strategies “to give back to the Bangladeshi people” for the next student group; e.g. teaching about health at the local girls high school, and village health fairs. Additionally, a beginning model of the immersion experience is emerging that will be tested in following years.

Conclusion: Students learned in particular that they need to look behind behavior for possible cultural explanations in order to understand clients and be able to provide culturally competent care. As well, they saw first hand that public health nursing can makes a significant impact on the lives of people, no matter where they live. The immersion experience in Bangladesh has forever changed their world view.