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Hi Guys,

Wow! it's been so long since I get back in to my writing again! I miss you guys! 
Now, I am going to share with you the article I made for my school paper. I wrote about my personal experiences when I was working as a nurse in Saudi Arabia. I never expected that I got a ninety percent above grade from my paper work.  Some of them are being put in to a quote for some copyright reasons. I hope you can learn something about my article. Please do not hesitate to share your thoughts. I would be delighted to read them all. Happy reading!

  
"Beyond the Language Barrier in the Healthcare Setting"

I would say Nursing is not my first profession, but when I was introduced to Nursing and began to incorporate my life with it, I had to say, it is the one for me. I practiced as a Nurse in Saudi Arabia. I was a stranger in the middle of the dessert, literally a deserted secluded place in that part of the world. I said to myself, “It doesn’t matter, as long as I love what I am doing – that is to connect with people, I think I will be on the right track.” Days, weeks and months had passed and I noticed that I was having difficulty establishing a rapport with my patients. Based on my self-reflection, I began to ask why it is so difficult for me to connect with the Saudi People  I was wondering, what was wrong with my approach? Based on the experience I had during my stay there, I came to the conclusion that Saudi is a very traditional and highly conservative society in all aspect of living. The government is very strict and one must adhere to their policies. The Saudi Family is also highly patriarchal , which explains why particularly in the 1970’s, women have low literacy rate, at about only two percent . It is only now that the people and the government are working hand in hand to support women for equal education to that of men.  This is opposite to how I was raised. I grew up in a society full of opportunities to grow and learn.  After my careful observation, I have understood that language (the verbal communication) and culture (the non-verbal communication) are just the two of the many barriers affecting why I couldn’t connect with patients. I have discussed it with my Nursing Manager and acknowledged the issue. At that time, I didn’t know how to speak Arabic and the Saudis doesn’t speak much of English. “Saudi as being a shrouded society” resulted as an elusive neighboring country across the globe specifically to the West.

Methods

The hospital where I worked spends a tremendous amount of money and time providing Continuing Education to their employees. The Training and Education department created programs like the Cardio Pulmonary Resuscitation, Fire and Safety program and Personal Skills that is a mandatory training courses about "communication and interaction skills" and "customer service" to each employee for greater interaction levels with customers and patients.

Based on the presenting verbal and non-verbal communication barriers, I have thought of some realistic and time efficient goals to make it easier to deal with the patients. I have presented the goals to my Manager and asked if it’s possible to support us in this matter. As a group, the first strategy that we proposed was to offer an English – Arabic class to the staff during their free time or days off. Another strategy was to hire an interpreter, we call them our Liaison Officers. We need interpreters for clients who don’t speak English very well or for those who don’t speak English at all. This is crucial especially in obtaining consent for a procedure. However, nurses must be sensitive enough to acknowledge the client’s feelings in an environment with interpreters. Last but not the least was to conduct a weekly group meeting in order to discuss and explore our experiences towards the engagement we had with the Citizens. In the meeting, we had to compare our own values with the culture of the Saudis. Everybody in the department had agreed about the ideas because they too, were having issues with regard to how to communicate properly and effectively with their patients. One advantage of these goals if met, is that staff can provide safe and effective care to clients, regardless of age, culture and race. These experimental strategies will be subject to ongoing evaluation every three months for six months. This is to monitor the progress of the employees in terms of their interactions with the Saudi patient.

Results

The strategies that we chose were very helpful to us in order to meet our two specific goals – these are 1.)How to effectively communicate with our patients and 2.) To learn about the culture of the Saudi People and incorporate our own culture with theirs. After three months, our Nursing Manager invited us to attend our group meeting and announced that the program we created was a great success. She laid out all the details on how it became effective not only to her staff but also to the patients that were admitted within that time frame.  The ability of the Nurses working on the floor being able to speak an Arabic language made a great positive impact towards the delivery of safe and effective care to the patients. Therapeutic and Interpersonal communication skills with patients were strongly developed as part of an ongoing care plan. In effect, the approach towards our patients were more personal yet still maintained the professional boundary between Nurses and Patients.  Clients became proactive in their plan of care because staff were able to explain the situation and were able to educate them. 

Conclusion and Future Study

           Communication in various ways is essential in order to understand people and in order to be understood. Being able to express empathy by knowing others’ culture is an invaluable skill an individual can possess. Especially in a healthcare setting where discussing a healthcare plan and educating patients are of paramount importance.  Among our colleagues, we discuss and coordinate the patient’s ongoing health status through verbal and non-verbal ways e.g. day-to-day interaction with colleagues and through chart documentation. In my experience as a nurse in Saudi Arabia, I had the privilege to learn about the people and their culture. I had a choice of whether to practice those values or not. I chose to incorporate some of the values I learned that I thought were essential to my own beliefs. I have learned so much in that experience that I will carry it on when the time comes for me to practice as a nurse here in Canada. I will reflect on my past experiences and I will use it as one of my strategies in dealing with clients in this multi-cultural and diverse country.

"Canadian Fundamentals of Nursing by Potter & Perry, 5^th Edition, Chapter 17 p.243"

"College of Nurses of Ontario"

"Karen Elliott House’s work On Saudi Arabia: Its People, Past, Religion, Fault Lines—and Future"

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