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UNMC College of Nursing faculty hope 6-day visit of Russian nurse leaders will turn into lifetime of better health for some Russians
UNMC Today (Omaha, NE)
Posted on November 7, 2002
By Vicky Cerino
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| Sheila Ryan, Ph.D. (far right), UNMC College of Nursing professor and Charlotte Peck Lienemann & Alumni Distinguished Chair, explains to Russian nurse leaders in a robotic surgery operating room, how robotic surgery works. | Though separated a world apart in terms of distance, culture, and health care systems, the love of nursing recently brought together American and Russian nurse leaders who forged an instant bond.
Though "da" (yes) and "nyet" were some of the only Russian words spoken between many of the Americans and Russians without a translator, they quickly became friends.
The University of Nebraska Medical Center College of Nursing hosted an educational visit of eight Russian nurse leaders Oct. 17-22, in an effort to share with their colleagues how health policy efforts can improve the health of their communities. The visiting Russian women are chief nursing officers, managers and professors.
Nebraska was one of five sites in the United States to host a total of 40 Russian nurse leaders. The Russians came to Nebraska from Samara, located in the Oblast region about 1,000 kilometers (about 600 miles) southeast of Moscow. Samara is ranked third in terms of economic development.
The visit was part of the Open World Program of the Center for Russian Leadership Development, U.S. Library of Congress. The purpose of the visit was to educate the nurse leaders in order to help build the capacity of Russian communities to provide comprehensive, accessible healthcare services to their citizens.
Although Russians are free to do many things since the collapse of socialism in 1989, the visiting Russian nurses said their country is in a state of chaos.
The agenda was full for the six Russian women who spent time in Omaha and the two who spent time in Kearney. With the help of translators, they learned how civic, professional and health service organizations can mobilize and influence health policy to better fund health programs in communities. They also learned about nursing leadership, education and practice, and toured a variety of health care facilities and indulged in American culture.
Sheila Ryan, Ph.D. professor and Charlotte Peck Lienemann & Alumni Distinguished Chair, spearheaded the visit as a board member of the American International Healthcare Alliance. She organized the Omaha visit, while Kate Nickel, Ph.D., assistant professor, UNMC College of Nursing Kearney Division, organized the Kearney visit.
Drs. Ryan, Nickel, and other volunteers, opened their homes to the women as well.
The Russian nurse leaders said the time spent in the U.S. was valuable, and they were taking back to Russia many ideas about how they can help their community.
"We've seen a lot of many useful things, excellent things, but we have economic problems you don't have here," said Valentina Trunova, vice president of Samara Oblast Nurses' Association and deputy chief physician on nursing, Samara-Polyclinic #2. "Our American colleagues here are highly skilled, qualified individuals just as in Russia, however, the working conditions are totally different. The one thing I've observed is the partnership-the teamwork between doctors and nurses."
"Nurses are trusted-they work more independently, for instance, a couple of days ago, I had an eye infection," said Natalya Muromskaya, chief nurse, City Hospital #2 and chief nursing specialist of Togliatti city. "A nurse practitioner came to see me, made the diagnosis herself and suggested treatment and wrote a prescription. All of this without the doctor's permission. It's unthinkable in Russia."
"In Russia, it's the doctors that mostly do the teaching to nurses," said Elena Kuznetsova, head nurse medical, Sanitary Unit #5. "We see that U.S. nurses are more highly qualified and they would make better teachers. They know what they are doing and are better people to share nursing experiences. And if highly qualified nurses could do the teaching, that would facilitate their profession and growth."
Dr. Ryan said many of the Russian visitors were stunned to learn what nurse practitioner students are learning. Learning about community health nursing and health promotion also was new to the Russian nurse leaders.
"All the things we went through 20 or 30 years ago is where they are now in nursing," Dr. Ryan said. "When they ask a question, we know where they're coming from. We have been there."
"We are trying to teach them how to use their associations and how politics can influence the improvement of health and the nursing profession," she said. "Many of them have only recently organized professional associations."
The women say in Russia, nursing salaries are low ($100 a month) and the physician to nurse ratio is about five to one, whereas in the U.S., it's four nurses to physician. Both countries declare a nursing shortage. Almost all the nursing professors in Russia are male physicians.
In addition, they say the cost of attending nursing school paid for by the government. Students typically live with their parents, who pay their living expenses.
Although Russians are entitled to free health care, those who want to choose their own physician or want additional services not covered by the government, must pay for them. Some employers supplement health insurance costs for their employees.
As they toured health facilities, the Russian women were impressed by many things. They saw syringes used with retractable needles that prevent accidental needle punctures and were surprised to learn that some syringes are prepared with medication ahead of time by pharmacists. The United States, said UNMC faculty, moved toward pre-packaged medications decades ago to prevent medication errors and save time for the nurses who once prepared syringes with medication.
Nadezhda Shakirzyanova, chief nurse of the Sergievsk Central Regional Hospital, who spent time in Kearney, said she enjoyed learning about a variety of things, including intensive care units. "I was also impressed by the distance learning nursing programs, not typical for us. Nursing work is almost always focused on patient care in the U.S., not other ancillary things like transporting patients, cleaning patient rooms, etcetera, as in Russia."
Peggy Wilson, Ph.D., associate professor and associate dean for graduate programs, UNMC College of Nursing, said while describing to the Russian women what she does as a pediatric nurse practitioner, one asked, 'If you do all of these things, what does the doctor do?' "
Dr. Ryan said the women were amazed at the resources available in American health care. Trunova described the differences in health care technology. "The difference in economics, for example, the equipment and technology, we in Russia have 'gold hands.' We work with our hands and minds. That's all we have," she said.
They also were impressed with professionalism and attentiveness to patients.
"Another thing that impressed me greatly is the care of the employee," said Elena Kuznetsova, head nurse medical - Sanitary Unit #5. "There are special workout facilities available designated for employees. We don't have this."
Besides the work-related visit, they were able to sightsee and shop. Shopping was one of the favorite activities.
"I don't know what they enjoyed most, but we did return to Walmart several times," Dr. Nickel said. "I also think they enjoyed our dinners and other meals around my kitchen and dining room table. We all got better at charades and pantomime. The Saturday night dinner party was attended by four English-speaking people and five Russian speaking people. We were out-numbered. Who would have thought this was happening in Kearney?"
The Russian women said they liked American cuisine.
"We like it, said one of the Russian visitors. "But portions are too much. Ordinarily, we don't eat that much. But it tastes great."
Dr. Ryan said the Russian women took many photos during their visit, including at a local restaurants in which they ate lunch. She learned instead of eating salad or sandwiches for lunch, Russians preferred meat and potatoes and lunch is their biggest meal.
Though the first impression the Russian women had of the United States was one spaciousness, clean cities and neighborhoods, order and fast-pace, it is the people that will make a lasting impression.
"We like the people most of all," said Muromskaya. "Everyone's very hospitable. They are taking great care of us, just like parents. There's a language barrier but we're understanding each other."
Dr. Nickel said hosting the Kearney visit was also personally enriching. "I now not only know how to say several things in Russian, but also learned what it is like to communicate with someone who does not speak your language. It was fun, and yes at times, frustrating to try to get a point across," Dr. Nickel said.
"UNMC Faculty and community members reacted extremely graciously. Someone at Grand Island High School spoke to them in Russian and had a map of Moscow on his office wall," Dr. Nickel said. "They were delighted to meet someone who spoke their language. At Good Samaritan Hospital, one of the nurses there had been to Moscow and whose daughter dated a young Russian man. She went out of her way to make them feel at home and sharing her job with them."
Though maybe the women will never see each other again, they now are comrades through an Omaha connection and plan to keep in touch through e-mail. Dr. Ryan said the nurse leaders were enthusiastic when they learned about the online educational program between the college and Armenian nurses. She said she would like to find funds to establish such a program in Russia.
"The Internet makes it such a smaller world," Dr. Ryan said. "They invited us to visit them. We'll continue to communicate with them. This is a way for a global community to be built on mutual respect, commonality and sharing. That will build bridges."
© Copyright, 2002, University of Nebraska Medical Center - Omaha. Used with Permission.
[Reprinted with Permission]
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