This past semester, I had the opportunity to travel, experience adventures, and learn in Quito, Ecuador. I decided that I wanted to study abroad in Ecuador probably after my first semester at Boston College. My decision was driven by many factors, but the main one was the opportunity to experience nursing from a whole new perspective. Global health and disparities in healthcare are some of my biggest interests, and this experience has truly helped me establish the kind of nurse I want to be in the future, and in the process, I’ve fallen in love with nursing all over again.
The past five months were a rollercoaster ride, to say the least. I never thought that I would have trouble adjusting to the culture, since I grew up in Costa Rica and I still identify with most aspects of my culture. However, when it came to treating patients, I felt completely out of place, although I had the language as an advantage.
I completed my community health clinical at the Subcentro in Tumbaco, which is one of the most underprivileged areas in Quito. The Subcentro is a free clinic, which means that most the patients we received were part of the lower class, and tend to only seek medical help when they really feel they need it. The first weeks of clinical were the hardest. Given that I was the “new gringa” at the clinic, the nurses didn’t fully trust my novice skills, so I spent most of my time observing the way they worked and the patients that came in. Right away, the disparities in healthcare became clear; for example, the indigenous and Afro-Ecuadorian people do not enjoy the same level of care as others. The more I people-watched, the more I started to see the problems that this healthcare system faces. I started to notice all the pregnant 12-15 year olds, the high incidence of scoliosis in men who work 14 hour days for very little pay, the 8/10 patients who suffer from hypertension, and the many children who have started to fall behind in their development. My heart broke every time. The concept that all humans don’t get the same access to care is something that I can’t seem to process well in my mind, and something that I don’t think I will ever understand or accept.
Most of my time in Ecuador was spent explaining why I choose nursing. When you tell someone you’re studying to be a nurse there, the follow-up question is always, “Why didn’t you just study medicine?” Nursing here is completely different than the United States. Most nurses obtain 2-year degrees, and very few graduate with a 4-year education. However, at the clinic, there are only two nurses responsible for preparing all the patients, which tend to range from 100-140 every day. For this reason, these nurses have become very task-oriented, and don’t always get to implement many of the things that nurses in the U.S. do. They rarely ever have the time to sit down with patients and educate them about things like hypertension, protected-sex, or nutrition, and these are things that severely affect the Ecuadorian population. I found myself always “defending” the path I choose to take, explaining the differences between medicine and nursing, and trying to make people understand why I love what I do. I think somewhere along the way, I realized how passionate I was about nursing and all the new things I was learning, and was reminded of why I chose this profession.
This past semester taught me many lessons. I learned what it was like to live in an oppressive-almost-dictatorship government, to care for people with very few resources, to try foods (that weren’t very good sometimes) and enjoy them, and most importantly, I remembered why I love being a nurse.