NursingZen

Three months of culture shock at the community clinic gave my ego a mean bruising, but it’s recovered and I’m suddenly enjoying my job there one day a week. I’ve learned to focus my energy on the patients and on my own growth.

For example, I’m having conversations with patients that I had no skills for three months ago. Last week, a patient came in concerned about his blood pressure. I asked him if he smoked and he said yes. I asked him whether he knew that smoking increases his risk for hypertension, coronary artery disease, and stroke. He said no. I scolded him, explained in simple terms how smoking constricts blood vessels, and scolded him again. (All this I learned by listening to a health podcast in Cantonese, over and over again.) A more seasoned Chinese nurse might have pulled out other culturally competent communication tools (listed below), but this time, I was simply happy that I could bring myself to scold him and speak well enough to be understood.

In another cultural setting, I might have taken a different, softer approach, but since working at this clinic, I’ve observed the following about communications between Chinese providers and Chinese patients:
- our patients are deferential to doctors and nurses, and expect us to speak to them authoritatively
- old Chinese people can be sassy — and to be heard you have to be sassy back to them
- it’s not rude or offensive to raise your voice
- sarcasm can be quite effective

These are not communication skills that will get taught at any politically correct school; they come out of real life. Needless to say, we all know that these things are not generalizable to any providers or patients outside of my clinic!!

Lesson learned: Apply for that job you really want, even if you don’t think you meet the “minimum qualifications.”

My new job as a per diem triage RN at the community clinic has been exciting and overwhelming in many ways. Clinic triage involves fielding phone calls and drop-in visits involving everything from simple prescription refills to ambiguous complaints of “I don’t feel well” to “My chest hurts” to “I think I’m having a baby.”

The majority of the patients speak Chinese, the remainder speak Lao, Mien, Mongolian, Korean, Vietnamese, and English. I’m quite certain that in just a few days my listening comprehension has improved 100-fold and my vocabulary has doubled. It’s thrilling! Not only is my brain working in hyperdrive to process the Chinese into English and English into Chinese, I’m also learning about a multitude of medical conditions, how to make quick assessments of a patient’s condition, how to ask the right questions about signs and symptoms, and about what nursing interventions are appropriate.

Although the job description asked for a year of acute care experience and good Chinese language skills, the nurses are training me with patience and enthusiasm. Over and over again they say to me, “Don’t worry, the more patients you see the more conditions you’ll recognize,” “Don’t worry, when I started here, my Chinese was terrible but now everyone says I sound like a native speaker.”

Sometimes I laugh at their confident proclamations, but I try to trust in their experience and I try to believe in myself. Sometimes I feel badly because I know I’m not doing the patients justice yet, but most of them have been incredibly forgiving. I don’t mind that some of them laugh at my American accent and poor grammar; I laugh–and groan–with them.

When a patient does speak English, I get so excited and speak with such confidence and enthusiasm that I’m sure I come across a bit manic.

So far, I’ve been leaving work with a slight headache, my brain stuffed to the brim, but I have a feeling it’ll be worth it!

It all happened so fast. One day, I was worried about finding a job, the next day I got a call and interview, and then this week I started a per diem triage job at a community clinic where the majority of the patients are from low-income and underrepresented communities. Working for this clinic and with this population has always been one of my dream jobs, one that I didn’t think I could be hired for until I had more experience and better language skills. All week I kept wondering if they made a mistake…

I have much to talk about regarding this job, but will do so after I return from my camping trip.

Joy!