And the academic part of our trip begins

Shandong University Emergency Department

Shandong University Emergency Department

 UMass group touring Shandong University Campus

UMass group touring Shandong University Campus


It has been a very busy two days.  On Monday we started the academic portion of our trip. We began the morning with a welcome meeting between the students and faculty of UMass Lowell and the leadership of Shandong University.  We viewed a wonderful presentation about the university ( albeit in Chinese) and were very warmly welcomed by the nursing and academic leaders of the university. Everyone is so friendly and excited to become better aquainted.  There have been a few other academic collaborations with Shandong University ( UPenn, Ohio State) but I believe that we may be the largest contingent that they have hosted.  Some of the other collaborations with schools of nursing have been with smaller groups and sometimes 1-3 students who are studying at doctoral level.   Our group is very unique in that we represent all levels of education at UMass Lowell.  We have recent BS grads, RN-BS grads and students, MS students and one PhD student.  Yuan is a UMass Lowell educated PhD and I am a DNP. We represent the whole spectrum of educational paths at UMass. I believe that our group has a lot to offer our host school in terms of our professional experience. We represent many areas of practice from outpatient advanced practice to inpatient acute care, ER, outpatient pediatrics, insurance management, veteran’s care and academia.  Our host country has planned an ambitious schedule of events and so far we have been amazed at their organization and ability to allow us to see specific units of their hospital.  Briefly.. the Shandong Hospital system is a large multi-building complex with over 4000 beds!  Compare that to Lahey Clinic which has 400 beds.  The sheer size and logistics of staffing and running this medical entity is a feat in itself but this hospital has garnered many awards for procedures and quality and is a one of the top rated hospitals in the country. We are honored to be able to observe their health care system. We have been allowed to visit and observe units that normally are not open to visitors. It amazes but us that we have been permitted to view these areas. And they are all impressive in many ways.   I am not going to write about specific experiences today in my blog but will ask the students to write a bit about the experiences.  I will enclose a few photos taken in the last few days with our new Chinese friends and colleagues.   I am not sure if our Chinese friends will read this blog but I want to publicly thank the Shandong School of Nursing and the Shandong Hospital for their hospitality. When all is said and done at the end of the day we all share the same heart, the same motivation  and that is to provide excellent care to our patients and improve the health of our nation.

The Qilu Emergency Dept

Yesterday afternoon was a highlight of this trip for me as an ED nurse; a trip to a large Chinese Emergency Department in Jinan. The Emergency Center was actually an entire building of four floors, each with a wing sorting patients by their acuity or condition. We were brought to a conference room with approximately 40 young emergency nurses dressed in dark green scrubs lining the room. The department seemed particularly proud of their male nurses, who made up 51 of the 70+ nurses in their department. I was surprised to find that many were still in college going through a residency program, but more surprised that they were “placed” in the ED rather than having a reason for wanting to be there. The head ED nurse and doctor were also present to welcome us and give us an introduction to their department. How impressive! Their department features a chest pain alert vehicle which is equipped with everything needed to deal with a STEMI in the field, so that the patient is cath lab ready on arrival.

I gave a presentation on how the Emergency Department works in America. I think I may have introduced some new concepts to them, such as standing orders/protocols where nurses are permitted to begin with the patient workup. They lamented that it would be a great tool to implement in the ED, but near impossible because “we need to talk to the patient and family in a meeting before we can really do anything– right now the doctors order all of the tests.” It made me wonder, due to the intensive family involvement, if this cultural barrier to expedited care could ever be worked out. They didn’t seem to think so. My presentation was largely interactive due to the fact that my fellow travelers did not have ED experience and the presentation lead to more questions of the Chinese practices. As one of the top trauma centers in Jinan, they seemed surprised that smaller hospitals “didn’t want” complex patients, like multitraumas. We discussed resources and that often, transfer is in the patient’s best interest if they arrive at a smaller facility first– certainly not that we don’t appreciate the complexity- or the challenge.

Lastly, we touched on EMTALA in the US, and I think at this point a lot of our preconceptions of how healthcare works in China with regards to payment were put to rest. Chinese hospitals do not turn patients away if they can not pay- but they do seek payment from family members. Patients may sometimes qualify for funding from the Aid Society or costs may be absorbed by the University. But yes– it is our ethical obligation, they said, to provide care and address payment later (not the other way around!)

It seems that there are many unwritten rules of nursing and medical care here which seem in line with our laws/values in the US. This was a good time to reflect on how perception is hardly ever the reality, as there does not always need to be official direction for people to do right by their neighbors. We had fun in there, and we learned a lot. In the US, the ED nurse is a definite personality unto itself- and we found yesterday that that personality is a global attribute!

The facility was crowded, to say the least. Similar to home, stretchers lined the hallways but the patients were kept feet away from each other on narrow stretchers in large bays. Blankets, food and water was brought from home and most care was performed by an accompanying family member- maximum one per patient. Patient and family member were a generally self-sufficient pair and nurses were there “for medical care only.” Nurses had ten patients each, but family members did all washing, ambulating, toileting and feeding. When asked if they ever did these things, they said that if a patient didn’t have a family member, yes.  Most everyone comes with a family member; families are very active in caring for the patient’s needs, a sharp contrast from home where family members seldom participate.

Shandong University Emergency Department

Shandong University Emergency Department

Just some photos


UML Nurses go to Baotu Park


UML nurses at Jinan Springs City Park


Nadine doing her yoga pose

Yuan at Water Locust Street

Yuan at Water Locust Street


A Chinese man playing a traditional Chinese stringed instrument at the park today.


Jinan Springs City Park


Some of the students getting out of our “mini-cab”

Inside our mini cab

Inside our mini cab

Valerie at Baotu Spring Park

Valerie at Baotu Spring Park


Our mini cab

What a great post from Kristen regarding our day. She captured the essence of our day.  What a joy to travel with such a wonderful group of women.  I am just going to attach some photos from today for your viewing.


The past few days has been a whirlwind and I am sure I am not alone saying that I am exhausted!  Between the palace visits, climbing the Great Wall, visiting factories and experiencing a lot of local culture, we have been surprised and proud of how much we have seen and accomplished in such a small amount of time– our fitbits are happy, too. Yesterday we said Goodbye to Tiger and Mr. Liu, our amazing tour guide and driver for the previous three days and boarded a high speed train from Beijing to Jinan. Today we explored Jinan in preparation for the week ahead. We visited some of the parks in Jinan and saw not only beautiful views and some interesting wildlife, but also families enjoying each other’s company, kids playing with squirt guns with their parents near the blue green waters filled with hungry koi, beautiful trees and buildings decorated with bright red lanterns, flowers and wreaths. The stone walkways wrapped around the park through porous rock gardens and small bamboo, pomegranate and apricot groves. We sat with a man playing a traditional Chinese Instrument, the Erhu, and listened to several of his songs. Of course, our group piqued the curiosity of other park goers as we are a rather diverse group ourselves. Many people wanted to be a part of our group photo and many more stopped each of us wanting to take “selfies.” After, we took a boat tour across several of the city’s adjoining springs, which Dr. Zhang tells us was a protective moat for the city in earlier times. Less congested than Beijing, Jinan still has massive skyscrapers, plenty of pedestrians, taxis, buses and mopeds zipping by in every direction. Toward the end of the day, we experienced a Chinese “supermarket,” which reminded me more of a mall without walls separating the stores. They have a couple of whatever you are looking for, in case you were wondering. To us, the experience was overwhelming, but to the Chinese patrons, another day at the store. A mother fixing her daughter’s hair, a young couple and their child grocery shopping. Life as usual. We all got a few snacks to keep in our rooms and came back for the night. Tomorrow, we go to college 🙂

ps: camera trouble, will revisit picture situation at later time. Sorry!



Just Introducing Myself!

It’s Kristen here, and I am sorry for the delay on my part. I have been under the weather for the past several days and have much to catch up on. First, let me tell you a little bit about who I am, besides being one of ten travelers to this great country. I am a 2014 Graduate of the BSN program at the University of New England and a current FNP student at UMASS- Lowell. Currently, I am entering my second year as an Emergency Department RggjbjbN. Prior to that, I was a medic in the USAF. In 2009 I was deployed to Bagram Air Field, Afghanistan where I worked in an ICU step down unit for seven months. It was a unique experience there as there were so many different kinds of people being treated– most of them heavy trauma patients but many humanitarian cases including correction of cleft palates and other facial deformities in children. Shortly thereafter, I went to Joint Base Balad, Iraq for 6 months where I performed Contingency Aeromedical Staging Facility Command and Control- but just call me C2– I helped the injured guys (and one lady) get home, by far one of the most rewarding things I have ever done. After that, I have gone on several small trips abroad including one, teaching urban search and rescue and patient trauma assessment to “baby” El Salvadoran Special Forces troops. Currently, I live with my family in NH and we raise chickens, ducks, pigs, turkeys and have five “rescued” cats and a retired racing Greyhound. That’s me in a nutshell. My next post will have lots of pictures!

Honk, Honk… Beep Beep

imageimageimageimageimageimageimageMy fellow travelers are going to do a BLOG entry about some of our adventures today.  For those of you who have read my UML BLOGs before I like to write about my observations.  Well, this morning I got up early and went for a walk ( totally forgetting that I was scheduled to climb the Great Wall of China later today.. Needless to say my Fitbit recorded lots of steps). What I wanted to share with you all today was my early observations about transportation in and around the city. I am fascinated to explore the patterns of society in new places for me.  Today was no exception.  Beijing at first glance could be like any other big US city.  Filled with skyscrapers, paved roads, bridges, cars, buses and people all moving to make it to home or work. The mode of transportation just looks a bit different in some cases. Yes, they have the assortment of shiny new cars like Kia, Toyota, Hyndai and an occasional American car but it is the movement of the non-car people that have me mesmerized this morning.  I am told that there is a lottery for license plates in China due to the overcrowding of the streets so that even if you can afford a car you might not be able to register it and drive it unless you have a license plate. So many people resort to other “wheels” to get around. I saw so many different vehicles and regular people just trying to get to work.  A sanitation worker near her small scooter wearing her face mask to protect her against the air pollution and sun. Mother’s riding motorized scooters with their child eating breakfast on the back of the scooter ( no helmet), peddle bikes with 2 or more people riding to work, small “toy” vans barely big enough for a driver but a passenger in the back. A man on a motorized bike with his wife in the back, another man in a motorized scooter with 2 other workers in heading to work.  I even saw a women in a motorized wheelchair playing “chicken” with big buses and cars in a busy rotary. Many of the motorcycle drivers wear mitts on their hands that look like oven mitts. They are for warmth in the winter and in the summer they protect the hands from sun.  Interesting that they are worried about sun damage but not worried about head injuries.

All of the people appear fit with very little obesity noted. This must be attributed to their diet and exercise.  It makes we wonder if the US developed a restrictive rule with our access to license plates then maybe we could see better health and less obesity.

I am reminded of my time in Ghana when the vehicles ruled the road and pedestrians have to “be aware”.  It appears that is the case here and we must always be cautious with the vehicles because they are certainly not stopping for us. But I am amazed at the boldness or bravery ( or maybe insanity) when I see a disabled women in a motorized wheelchair navigate a busy rotary with full length passenger buses. I clap my hands in celebration of the people of China who seem to be making the transition to “sharing” the road with all vehicles.  But they still do a lot of honking and beeping !   Haven’t seen a crash yet. Somehow the honking and beeping is the magic touch !  Honk Honk.. Beep Beep

Cultural Experiences

IMG_4332IMG_4338IMG_4316IMG_4344Two days of touring Beijing and learning lots about Chinese culture and history,  Toured Tiananmen square, the Forbidden City, the palace museum, the Olympic Stadium and the most impressive Great Wall of China. Our bodies are aching yet we feel very accomplished.  The experience was worth all the pain and sweat!

One interesting behavior of the Chinese people over the past few days has been their request to take pictures with us due to a lack of cultural diversity.  Many of them have never seen people of color or those with blonde hair.

Meals have been family style with six to eight delicious dishes.  We celebrated Nicole’s birthday today.  She was given their traditional dish of very long noodles signifying longevity.  We also had a good old fashion birthday cake with fruit on the top which tasted fabulous,

Our first day

Hello from China. We made it safe and sound.  Our first day was long and uneventful.  We landed on time with one small glitch. Some of our luggage took time to retrieve but once our luggage was in hand Dr. Shang and our guide named Tiger were waiting for us. We went to dinner and had our first lesson in using chopsticks. Some of us were more proficient than others. We then headed to the hotel where we had a much needed rest. Today starts the Beijing tour of the Forbidden city and Ti’an men square. We are very excited to start seeing some Chinese culture.

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Here We Go

20160524_131524My name is Nadine Burke and I have been a nurse for twenty plus years however just recently earned my BS degree at UMASS Lowell. I began taking classes for this degree 5 years ago and never in my wildest dreams thought this journey would lead to learning about global healthcare during a trip to China. I have always been an advocate for eastern medicine and it’s holistic approach to health. I am so excited to learn more about traditional Chinese medicine and the Chinese culture while visiting this intriguing country!

Leaving tomorrow

IMG_0031Hi Everyone. My name is Barbara Smith and I work as a nurse in a small community hospital.  When I enrolled in the RN-BS program I never thought I would be given such a wonderful opportunity to travel to another country.  Throughout my career I have learned many new things, met and taken care of many people from different cultures and backgrounds.  I consider myself lucky to be part of a this group of students and professors travelling to China.  I have never travelled outside the US so this will be the first time for me.  As you can see, I am thrilled to be part of this trip and look forward to embracing all that China has to offer.  Not only will I have the opportunity to grow as a nurse, I will experience China’s culture and beauty as well as health care system. I am extremely excited to visit acute care facilities and universities to compare our system versus China’s. I’m excited to share our photos and experiences we are about to embark upon. To my co-student and professors…we will see each other soon.