Crossing cultures to learn about local nursing practices

Japanese Nurses
Maimonides Nurse Team Leader Dahlia Dumpa Villariez brings a small group of visiting Japanese nursing students up on the floors to introduce them to residents and long-term care nursing practices.

Japanese students broaden their perspective in a visit to Maimonides

Even in an era of instant, digital communication, gaining a thorough understanding of a foreign culture’s innovations and practices in health care means witnessing them for oneself. That’s why a group of Japanese nursing students travelled half-way around the globe this past spring to experience first-hand how care is provided at noteworthy health institutions in Montreal, including Donald Berman Maimonides Geriatric Centre.

Learning about advanced technologies and innovative health and social service programs is only part of the equation. Cultural sensitivity and effective communication also play a central role in our users’ health, well-being and satisfaction.

Recognizing that far-flung cultures have a great deal to share and learn from each other, the Language and Intercultural Communication Unit (LICU) of the McGill School of Continuing Studies has been hosting nursing students from St. Luke’s International University in Tokyo, Japan, along with participants from other partner universities.

For the fifth consecutive year, the LICU welcomed undergraduate and graduate students, as well as in-service nurses from affiliated healthcare centres, who study a range of specializations in their native Japan—everything from ICU nursing to midwifery to mental health care. For this reason, their tour encompassed a variety of Montreal establishments, including hospitals, community facilities and homecare settings.

Beyond the realm of classrooms and textbooks, the students visited authentic clinical environments, where they met and, in some instances, interacted with healthcare users. There they acquired a more intimate understanding and appreciation of patient-centred care through services offered across life’s trajectory, from antepartum to end-of-life care.

“To prepare for our visit of Maimonides, we teach the nursing students about the different types of residents, healthcare staff and services available at long-term care sites,” says Effie Dracopoulos, Associate Director of the Language and Intercultural Communication Unit. “We introduce geriatric care through literature, lectures from in-service nurses and healthcare educators, and a workshop. Participants are then led in a brainstorm on what they know about caring for the elderly, particularly in terms of comparing Japanese and Canadian approaches.”

Inspired to reimagine geriatric care

Frank discussions about geriatric care and traditions around dying are sensitive issues that are not easily discussed among Japanese people, notes Ms. Dracopoulos. On hand to greet the students and help them voice their experiences and expectations was Roz Friend, Maimonides Volunteer Services Coordinator, Training and Development.

Japanese nurses boardroom
Roz Friend, Maimonides Volunteer Services Coordinator, Training and Development, meets with Japanese nursing students prior to their tour of the long-term care facility. Ms. Friend engaged the students in a dialogue about geriatric health care, and explained how various cultural traditions are respected at the Jewish institution.

“Roz truly has special powers to get the participants talking, and she listens like she really wants to hear their answers,” says Ioana Nicolae, an LICU Program Coordinator who accompanies the group each year. “We know that it can be challenging for the students to open up, but they often remark in retrospect that they feel more confident asking questions and sharing their knowledge. On the bus ride back toward McGill they often talk about their own dynamic with aging relatives and consider how this interaction might be influenced by their culture.”

The participants are especially intrigued by Maimonides’ dual nature as a long-term care setting—both as the residents’ home and a highly specialized healthcare facility. “The visit to a Jewish residence like Maimonides really brings to life just how elaborately a culture is woven into the residents’ daily rituals, from diet, to recreation, to worship,” says Ms. Friend. “We also reflect on how each of these areas relate to aging and dying. It’s important to nurture that awareness. It opens up opportunities in their nursing practice to reach out to patients and their families, to find out more about their needs and cultural traditions.”

The nursing students visit Montreal in a “whirlwind” two weeks in March, says Ms. Nicolae, because it coincides with the end of a school year in their native country. The cherry blossoms are in full bloom in Japan but the weather in Montreal is often grey and dreary. “From the moment they step into the door at Maimonides, though, there is a real sense of energy,” she declares. “I think it subverts their expectation of what they’ll find in a long-term care facility. They’re amazed by those moments when a patient or staff member says hello to them or shares a word or name they know from Japan. It’s a dynamic place and the participants feel welcomed to get to know it.”

Learners without borders

To acquaint the students with yet another facet of end-of-life care within a Jewish health institution, a visit to the nearby Mount Sinai Hospital’s Palliative Care Unit was coordinated by Ida Caputo, Administrative Assistant and Special Events Coordinator at Maimonides. A prior workshop on palliative care gave them some theoretical grounding, along with lectures by McGill nursing specialists on the pillars of McGill and local nursing practices, such as patient-centred care. “It’s a great learning experience because most of the participants have not yet had a chance to spend much time with patients,” says Ms. Nicolae. In their nursing programs, she explains, they do all their courses first, then acquire clinical experience.

The trips to Maimonides and Mount Sinai provide first-hand opportunities to learn about Jewish cultural traditions. “In Montreal, we take for granted that nursing students may have some cultural experience either personally or as part of their clinical practice. This is not the case in Japan. We talk about the role and expectations of cultural competence, as described in the McGill Nursing program and the Canadian Order of Nurses. The students recognize the importance of becoming more culturally aware and open, but I think just talking about it in the classroom or hearing examples is not enough. This is why it’s such a great opportunity that they have this experience abroad,” she says of the program, which was originally coordinated in partnership with Ms. Caputo.

Discovering professional development opportunities

The visiting students are also eager to learn about how the healthcare team is organized and what opportunities and roles are available in nursing.

“Roz has been instrumental in highlighting local working conditions and bringing to life the day-to-day experiences of the staff,” says Ms. Nicolae. “For example, they are curious about how nurses interact with each other and with patients, as well as the type of instruction nurses receive. Similarly they enjoy hearing about professional development opportunities, such as the specialized training nursing staff take part in to continue to meet the needs of users. Of course, they always want to know about work-life balance—how many nights and consecutive hours a nurse works. This knowledge often motivates them in turn to practice voicing their opinions as healthcare professionals.”

Feedback about the LICU program from the nurses upon their return to Japan conveys how helpful it is for them as students to observe local nurses “in action” in long-term care and palliative health care establishments. They appreciate the exposure to new cultural traditions, and the opportunity to reflect on how their own heritage might impact on their nursing practices. “Especially in light of Japan’s burgeoning aging population, these are all instructive and inspiring experiences that the aspiring nurses take back home.”