I have been a nurse educator for more than twenty years and I have had the pleasure of mentoring and fostering the education of hundreds of nursing students attending diploma, associate and baccalaureate degree programs. I have witnessed many changes in the characteristics and attitudes of students over the years. As I age, I reflect back on the many years as a nurse educator and wonder where we are headed? What values are important to teach our future nurses? What do we expect of our future nursing professionals?
Recently I had an opportunity to work with nursing students from another country and my observations were much different than those attending programs in the United States. During a trip as a Visiting Scholar in China I became immersed in the nursing educational process. A faculty exchange program was established between the nursing program at a university in Hangzhou China and a health science university here in the United States. A nursing faculty member from China lived on campus in the U.S. and attended classes for a year; in return I traveled to China and stayed with the host university for two months. I lived on the university campus, I had daily interactions with undergraduate and graduate students as well as with the nursing faculty members. I ate in the dining commons, attended classes and labs, visited clinical sites and had the honor of teaching a few classes to students in China. I was invited into homes, and traveled on many outings with faculty and students.
Absorbing the Culture
I became immersed in the culture of the people of China, but more importantly the nursing program and life as a university student. I spent my days absorbing the ethos of China as much as possible. Initially I was concerned about my inability to communicate with others, but all students attending the university were enrolled in English language programs and most were fluent in English. They loved practicing their English conversation skills. These modest and self-effacing students apologized for their perceived lack of English mastery. I found myself embarrassed at my own shortcomings; the only Chinese words that I mastered prior to arriving to their country were hello and thank you. The students patiently attempted to teach me words and phrases and showed no frustration at my repeated absurd pronunciation of their beautiful language.
The students were all very humble; they had few possessions and yet did not complain. When I was greeted at the airport by a graduate student she was amazed at my two large and bulky suitcases, she asked politely what belongs I brought from home. Knowing that I was to stay for a prolonged visit I planned my wardrobe to include day and night wear, formal and informal wear. I noticed the students on campus wearing the same outfits day after day. Each day as I looked in my closest to choose the appropriate outfit I cannot remember that I ever repeated the same an outfit in one week's time.
I was invited to a student dormitory; the rooms were approximately the same size as dormitories in the United States but the conditions of living were very different. Six students reside in one dorm room. Each room held three sets of bunk beds. They slept on wooden slats with a thin quilt for a bed, no mattress or bedsprings were available for a restful night's sleep. Miniscule storage space was available for each student and one tiny bathroom was shared by six young women. My own daughter began her junior year of college in the fall and was thrilled that this year she will be assigned to a single room; she has felt too crowded sharing her dorm room with one roommate.
Respect for Tradition
Respect is an important value to the members of this culture. I experienced this during interactions with both the students and faculty members. During a lecture that I provided, I asked for questions from the audience, a student would stand once recognized and would ask a question. The students gave the lecturer one hundred percent of their attention. I did not note chatter in the classroom, no distracted behavior was noted; no use of laptops, cell phones or other electronics. The students gave one hundred percent of their attention to the presenter. Initially I wondered if that was because I was a foreigner and considered a distinguished visitor, but I observed this same attention and respect when I attended lectures presented by other faculty members.
Tradition and conservatism are very important aspects of the Chinese culture and was evident to the School of Nursing in Hangzhou. The white nursing uniform and cap worn by both the students and faculty members in the skills lab echoed tradition of the nursing profession. The nursing uniforms were such as those worn twenty and thirty years ago by nursing students and professionals. I have not seen nursing caps worn in practice for more than 20 years. A patient engrossed in health care would have no difficulty identifying a nurse. I noted conservative dress of these college aged students from nursing students to those studying in all majors. I saw no exposed undergarments, I did not see excessive skin or cleavage. Most neck lines were high and hemlines were moderate; no holes in the jeans or tattered clothing were worn. I did not see tattoos, piercings or multi colored hair.
Traditionally young women and men are not permitted to date during their middle and high school years; the focus on education is paramount. Living on a college campus I witnessed the interactions amongst young couples with their first experience at dating. There were no public displays of affection between the two. I would occasionally see hand holding but absolutely no other form of affection. I asked about this and was told that it is 'not nice' to be demonstrative in public. In addition I noted no evidence of drug use, alcohol consumption or large parties were held on campus as one would expect on a U.S. college campus. Gatherings of groups of students involved participation in physical activities such as basketball, swimming and even ping pong matches.
These nursing students and faculty reminded me of a time in nursing that I hadn't realized that I missed. I felt transported back in time, when life was simpler without the many trappings of modern times, and values previously held high that are now forgotten. I long for those times as I reflect back on thirty years as a nurse and more than twenty years as an educator in the United States. I wonder aloud where are we headed and what do we expect of our future nursing professionals? What values do they hold on to as they move forward, and what will they miss after thirty years in professional practice as they reflect back? I hope to return to China someday and visit with my many new friends and colleagues, and learn of the new progress of the nurses from that country. My hope is that the inevitable changes to the nursing profession in that country will not leave their seasoned nursing faculty wondering aloud as well.
Paula Bylaska-Davies is an associate professor of nursing at MCPHS University in Massachusetts.