Why do you go away? So that you can come back. So that you can see the place you came from with new eyes and extra colors. -Terry Pratchett
While in Brazil, we (the students) were given the chance to job shadow in our respective fields. Today, Anna and I (Chemistry and Nursing majors) had the amazing opportunity to tour one of Brazil’s Public Hospitals in São Paulo! After a short Uber commute made lengthy by traffic (São Paulo is NOTORIOUS for its traffic), we arrived at the destination and were greeted by Fernanda, the Director of Administration and Infrastructure at the hospital, who graciously gave up four hours of her busy workday to take us on a guided tour-on short notice, I might add, since the hospital we were supposed to visit yesterday cancelled at the last minute! A great example of the generous Brazilian spirit.
Fernanda started the tour by sharing a fact that you may find surprising: Brazil has a universal healthcare system! She explained that all Brazilian citizens and even foreigners receive care free of charge at public hospitals in Brazil (Private hospitals exist but are expensive). Around 70-80% of the population rely on this public system. While universal healthcare sounds ideal, Fernanda explained that the system faces many challenges, the greatest being having the resources to meet the immense demand placed upon it. One way in which this challenge manifests itself is in crowded waiting rooms and long lines. Anna and I witnessed this in person but were pleasantly surprised to see how calm and patient the waiting clients were (America, take note! Nudge, nudge 😉 ).
As we began our tour, I noticed a strange phenomenon. While we had been working with the language barrier all week, for some reason, today was especially challenging! I quickly realized that this was because our translator was non-medical so not only did she have to deal with Portuguese and English, she had to navigate medical jargon which is almost a language in and of itself! In fact, sometimes I had more success translating even without an extensive knowledge of Portuguese since I had the medical background. It shocked me but reminded me that when I interact with my patients in the US, I need to be mindful of communicating information in a “language” that they can understand! Not only do I get to work as a nurse, I get to be a “translator!” 🙂
Walking around the different floors, I was struck by both the similarities and differences between nursing in Brazil and in the USA. I had to laugh because some things are so universal! While the nurses in Brazil still use paper charts to record information about their patients rather than using an electronic health record, they were recording some of the same exact things that I do on a nightly basis at the hospital! I immediately recognized the Glasgow Coma Scale, which is used to record the neurologic status of the patient and the Morse Scale which is used to determine if a patient is at risk of falling in the hospital. Everywhere I looked, I saw equipment that was familiar to me. Sometimes, because I was in my element, I forgot that I was even in a different country!
Besides the paper charts, there were other differences that I noted. One was the number of patients that each nurse was assigned. In the Intensive Care Unit, where patients need the most attention, a nurse in the US typically has 2 patients. In Brazil, each nurse can have up to 10! I’m impressed with the nurses’ ability to balance care for so many patients, and I want to learn the secret of their time management skills! Another difference is in the number of patients in each hospital room. In the US, patients typically have either private rooms where they are alone or semi-private rooms (2 patients). In Brazil, there can be up to four patients in one room, without any kind of a divider such as a curtain. Again I was surprised by the calmness and willingness of the Brazilian people to share. Fernanda explained that while they would prefer private rooms, they are content to share since the care they receive is free.
When we finished our tour, Fernanda took us to her office and presented us with certificates of completion for job shadowing and was gracious enough to sit and answer all of our remaining questions. After we hugged goodbye, we headed back to the University for our last day of Portuguese class and again had to say many sad goodbyes to the friends we’ve made. While we’re sad to go, we’re excited for the trips to the rainforest and Iguazu Falls that the near future holds!