Intern Talk – First Impressions, Nursing Internship in Vietnam by Niki Pham
Niki Pham is a student from the University of Texas in Austin – School of Nursing. She came to Hanoi for a one-month Nursing Internship in Vietnam. During her time here, she interned at the Emergency Department and ICU at a national hospital for one month. Niki shares her experience of working in a Vietnam’s hospital compared to a medical facility in the U.S. in her blog posts that we share with you below.
The first Vietnam National Hospital was bombed during the Vietnam War. Since replacing the building lost, more buildings have been added to the “campus,” each building having a specialty of its own.
Vietnam National Hospital has a total of 1,500 in-patient beds on campus. Additionally, the hospital treats 3,000 – 4,000 outpatients per day. To put it into perspective, the newly opened Dell Seton Medical Center has only 211 beds in operation with the ability to add 135 more beds in the future. Overcrowding is a major problem for the National Hospital. During my brief tour of the hospital campus, crowds of people were mingling throughout the hallways. Family members can be seen sleeping on the floors in the hospital or in colorful chairs lining the hallways.
Niki (right) at her workplace.
My first week (June 5th – 9th), I was placed in the Pediatric ER. The pediatric hospital building is the newest addition of the campus, thus it was equipped with a few air conditioning units in major rooms (a blessing in 104F high heat). Additionally, western medicine is practiced here so the hospital was equipped with vital sign monitors, nebulizers, western medications, etc.
In healthcare system:
- According to a physician I spoke to, children under age 6 get treatment free of charge. The government covers these
costs. However, they must get proper referrals. For example, if a family is based in a province of Vietnam, then they must get a referral from the provincial hospital to get transferred to the National Hospital for treatment.
In hospital setting:
- Instead of individually separated rooms per patient, the ER is one gigantic room divided into 3 by big glass panels. This room contained a total of 28 beds. Because overcrowding is a problem, Dr. Phong (Pediatrician) explained that at times, children would have to share beds (up to 3 per bed). Furthermore, the children have a parent by their bed making it even more crowded. Luckily during my week here, I did not see this occur. (Another physician did disclose that hospital acquired infections are a BIG problem in this facility and it is due to the overcrowding and sharing of one big room.)
- No Electric MAR to chart in. Dr’s orders are written in a paper chart that is clipped onto the patient’s bed. Because the orders were written in Vietnamese, I did not get the opportunity to pass meds.
- No patient armbands. Oftentimes, nurses will just call out the child’s name and the child’s parents would respond, thus identifying them. On certain occasions, fabric tape would be stuck on the child’s forehead with their name on it.
- Hospital staff do not wear closed-toed shoes here, rather, they wear sandals and Crocs. When I asked a nurse I followed if she was ever scared of a needle falling and sticking her feet, she said “no.” She also said that wearing shoes was too hot and that sandals were more comfortable (we’re talking regular flip flips in some cases!).
- They have a machine that tests arterial blood gases in the ER so they get almost immediate results, which I thought was very interesting! No sending blood to lab.
- There is no Omnicell or Pixis to withdraw medicine. Instead, there is a cabinet and fridge with a lock to open by the main desk. I have yet to see the cabinet locked.
- Morning shifts start at 7am – 2pm. Afternoon shifts begin at 2pm – 7pm. Breaks are 2 hours long, usually from 11:30 to 1:30pm.
- It takes 3 years of schooling to become an entry-level nurse in Vietnam and 4 years to be a BSN. In my unit, there are 2 charge nurses who delegate tasks to the other nurses.
- Nurses do not partake in head-to-toe examinations here. This is considered within the physician scope of practice. Nurses only carry out technical skills like starting IVs (tons!), Foley catheters, collecting blood samples, hang fluids, and giving medications.
- Child came in with Septic Shock (proceeded to intubate)
- Kidney Failure (very distinct choluria – when they teach you “coca-cola colored urine,” it’s true!)
- Newborn with imporforate anus
Overall, everyone I’ve met at the hospital is very friendly and very keen on hearing the differences between their facility and the ones in the US. Furthermore, they’re not shy about asking me to teach them more English. I usually jokingly respond by saying, “as long as you help me with my Vietnamese too!”
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