Nurses bring medical training to a ‘country that has suffered’

by Susan Anderson
Wednesday, December 2, 2009 8:13 AM MST

Mary Behrens has traveled 8,190 miles from her home in Casper for this moment. In a classroom in Vietnam, she is showing an advanced degree nursing student exactly how to tap on a patient’s back to discover pneumonia.

This is an important lesson for a Vietnamese nurse, who may not have access to laboratories, x-rays or many of the basic tests nurses in the U.S. use every day.

Behrens and Sandy Conklin of Casper traveled to Vietnam in November to offer an intensive course in “Physical Assessment” to students in the only nursing master’s program in that country, through the organization Friendship Bridge.

They donated their time and paid their own expenses to work with students for eight hours a day, teaching them the physical examination skills that are sometimes “all they have” to diagnose an illness, said Conklin. One reason these nursing classes are so important, Behrens said, is because the nurse is often the only medical help available in rural areas of the country.

Hungry to learn

Conklin is the director of nursing services at the Wyoming Medical Center, and taught at Yale School of Nursing for 14 years, before moving to Casper.

This small group of Vietnamese students from all over the country was learning in English, their second language, but Conklin said that they performed as well as her Yale students.

And their dedication was obvious.

“They hung around after class for hours,” said Conklin. “They wanted to make sure they knew everything we expected.”

Behrens was amazed on her first trip at “how hungry they were to learn. They really worked hard.”

For Conklin, this opportunity to take her vacation time and pay the expenses of an international trip to teach is what nursing is all about.

“I think it’s important work,” she said, “And I think those who have should give to those who have not.”

This was the sixth trip to teach in Vietnam for Behrens, a family nurse practitioner who is active in the American Nurses Association as a former first vice president and current president of the ANA PAC.

In 1995, when Friendship Bridge was setting up the program, Behrens was invited to teach the first class in Physical Assessment.

She had been teaching at the University of Wisconsin in 1967 when her husband, Jerry went to Vietnam as a battalion surgeon for the Marines.

“The war affected both of us greatly,” she said, “and I thought that the opportunity to go and help nurses in a country that had suffered a great deal would be something I would like to do … I didn’t have to think twice about it.”

Things have changed

It was a different scene in 1995 than it is now.

The English spoken by the students 14 years ago was minimal, Behrens said, so an interpreter had to translate almost sentence by sentence. They worked in a hot classroom with narrow wood tables in the humid, 95-degree Vietnam weather. They set up a few fans, but electricity only worked sometimes. Behrens had loaded her suitcase on the trip with nursing textbooks, which the students treasured.

“They had nothing, but I was so struck by their ingenuity and interest,” said Behrens.

“The U.S. didn’t have diplomatic relations with Vietnam (in 1995), and we had to get our visas through Canada,” Behrens said. And when they began teaching advanced skills to the nursing students, some of the doctors were skeptical.

At that time the Vietnamese word for nurse meant “doctor’s helper,” and the typical pay was 90 cents a day. Through the efforts of the active Vietnamese nursing association, nurses are now called “professional nurses.”

And they make enough money that one of Behrens’ first students from 1995 insisted this time on hosting her at one of the city’s best restaurants.

Now the students have studied English for years when they come to the master’s degree class. Each has a computer and a cell phone, and they are studying to become leaders in their country.

Among former students are the current director of the nursing school and nursing directors at hospitals throughout Vietnam.

Tran Thi Lieu is a current master’s student who has managed a women’s clinic in Long An Province for 24 years. She made the commitment to the master’s program despite an already packed schedule and a family back in her province because she believes she could learn from the “foreign teachers” and become more professional in many areas.

One of the two men in the class, Mai Phuong, hopes to improve his professional prospects for the sake of his two daughters. He wants to improve his English and become of teacher of nursing.

‘A universal language’

Conklin was teaching about listening to the heart on her second day of class.

“It’s a universal language … it sounds like ‘lub dub,’” she told the students. Then it was their turn to listen to each other’s hearts.

This is another change, according to Behrens. The original students 14 years ago were accustomed to sitting in large lectures, not to learning in a “hands on” way.

Conklin is the second Casper nurse to make the trip to teach at the University of Medicine and Pharmacy in Ho Chi Minh City. Her supervisors at the Wyoming Medical Center wanted her to go, she says, as part of the hospital’s outreach effort.

Though she has traveled abroad before, Conklin was surprised at some of the infrastructure problems in Vietnam. She was equally surprised at how welcoming the people were.

“I felt very safe on my own, and the people in the hotel were very attentive,” she said, adding that when she needed an adapter for her computer, a hotel employee “went out and bought me one.”

Conklin struck up some friendships in the class, eating lunch each day with the students and feeling touched when they presented her with a framed piece of artwork on her last day with them.

“I’ve probably never met a more caring group of people,” said Behrens.

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