Hannibal, a native of Jamaica, was one of 14 nurses from the BVI who
spent the summer in Buffalo-area hospitals and clinics fulfilling the
final requirements for their UB nursing degrees. Two more arrived this
fall.
Their January commencement ceremony at H. Lavity Stoutt Community College
on Tortola, the largest island of the group, will climax an unusual
collaboration between UB School of Nursing faculty and this British
principality aimed at helping it upgrade its health-care system.
Planning for the cooperative venture began in 1998, when several nursing
consultants were invited to Tortola by Vesalie Mathavious, assistant
director of health services for the BVI Department of Health, to discuss
possible participation in an overhaul of their health-care system. Upgrading
nursing education would play a crucial role, and the UB School of Nursing
was chosen for the job.
The program got under way in February 2000 following two years of planning
and negotiations.
The curriculum content met all normal UB baccalaureate requirements,
but the structure was unconventional. Students took prerequisites at
the community college, BVI's only institution of higher learning. UB
nursing faculty traveled to the BVI to teach the specialized courses.
Some were delivered in all-day, weeklong sessions, some were taught
twice a week for seven weeks. Other courses were videotaped at UB and
mailed to the BVI, with class discussions conducted via real-time email.
Students also had electronic access to UB's libraries.
There was no "dumbing-down" of the curriculum, stressed Karen Radke,
associate dean for academic affairs in the UB nursing school, who taught
the pathophysiology courses on Tortola. "That was very important to
everyone. We used similar exams—and in some cases the same exams—in
this program that we give on campus, and these women did just as well,
sometimes better, than our traditional students," Radke said.
"These nurses are very bright; they are very engaged, active learners.
We couldn't give them enough. It was an absolutely delightful experience
for me," she said. "Everyone was extremely friendly and very supportive."
The students, all adult registered nurses, had received their registered
nursing training from hospitals and community colleges in Guyana, Grenada,
Dominica, Nevis-St. Kitts, Barbados, Jamaica and the American Virgin
Islands.
"We have no home-based bachelor's degree program," said Hannibal. "We
had to go off-island and leave home or relocate somewhere else for two
to three years. That has always been a deterrent. This program is still
a sacrifice, but we're away from home for only three to four months."
Yvonne Morgan, another degree candidate, is a critical-care specialist
in the BVI accustomed to caring for a two-bed department occupied primarily
by cardiac patients. Working in Erie County Medical Center's 17-bed
trauma intensive care unit was a bit of a shock. She was struck in particular,
she said, by the incidence of attempted suicide, especially among young
people.
Hannibal's experience in ECMC's emergency department was equally eye-opening.
"In the BVI, the emergency department is used mainly as a primary-care
facility and not for emergencies," she said. "We see near-drownings,
jellyfish stings, ocean-related accidents and auto accidents. Gunshot
wounds are very rare in my country. It was a very wide, very varied
unique experience."
Both women, accustomed to working in a formal environment where professional
status is clearly identified and strictly observed, were taken aback
by the informality among the hospital staff and degree of teamwork.
"That was a cultural shock," said Hannibal. "In the BVI, nurses dress
and behave differently from doctors and aides. It's a very hierarchical
system. Here, the only way you can tell people apart is by looking at
their I.D. It was pretty confusing, but it makes for better teamwork."
Morgan, who always has practiced in a hospital setting, did her first
clinical rotation in home health care.
"That was challenging," she said, "but we worked mostly with Hispanic
patients and it was interesting to see their culture." In the BVI, home
care is less structured, she said, consisting mainly of patient-advocacy
services, such as refilling prescriptions.
Working in an unsubsidized health-care system, the students for the
first time confronted the issue of cost containment.
"It is not a mandate yet in the BVI," Morgan said, "but it's evident
it's becoming necessary." They also were introduced to standard policies,
such as the Patient's Bill of Rights and patient information mandates.
Hannibal and Morgan gave the experience high marks, grading the instruction
"very, very good."
"I'm hoping to bring some more changes to the intensive care unit in
terms of setting up new policies and new guidelines," said Morgan.
"This programÉhas provided an enlightened global awareness in terms
of nursing," said Hannibal. "It's been a truly wonderful experience."
Adding to its wonderfulness was the ability to find ingredients in
Buffalo for their favorite native dish—salt fish on funji (a type of
cornmeal paste)—as well as green bananas and yams, both BVI staples.
Hannibal found Buffalo much friendlier, if slower paced, than Manhattan,
where she once lived.
"Here it's almost like I'm a little adopted kid," she said.
Meanwhile, the Buffalo program introduced Morgan to the United States
and, based on her experience here, the country rates "A-OK."
"People were very warm," she said. "It was easy to fit in…. It
was a whole new way of life, taking the subway and the buses, but actually,
it all went pretty well."
