Written by: Amy Sacco, RN, MS, OCN
In March of 2023 while I was scrolling through my e-mail, a new post on the Oncology Nursing Society discussion board for Global Health caught my eye. It was an opportunity to participate in a two-week oncology nurse training course in Hanoi, Vietnam. I had heard of HVO and had even applied back in 2016 to volunteer in Uganda which didn’t pan out due to life circumstances. HVO’s mission resonated with me back then and even more so now having volunteered abroad in multiple countries. I have sadly witnessed medical tourism at its worst. Although well intentioned, the projects were generally uncoordinated, poorly planned, and ineffectively utilized my skills and experience. After reading HVO’s mission to “improve the availability and quality of health care through education, training, and professional development,” I trusted that this would be something different.
Once I completed the application, we had our first team Zoom meeting and the wheels were set in motion. We learned that we were going to be training the oncology nurses at K Hospital, Vietnam’s National Cancer Center in Hanoi. HVO had never held a training like this before in Vietnam, and we were responsible for developing the two-week course from start to finish. I and the three other nurse volunteers (two of whom were HVO project directors) were up for the challenge. As we got to know one another, I learned of all of their individual global health experiences. Annette Galassi, Alyssa Grissom, and Jodi Hyman were highly versed in the world of global health, and I felt so fortunate to work with them. It can be challenging to work in a foreign setting due to the differences in culture, language, and priorities but they navigated every aspect with complete respect and composure. They were always cognizant in never imposing our Western values, beliefs, or practices without taking into full consideration the circumstances in Vietnam.
The course’s goal was to expand upon the nurses’ existing foundation of oncology knowledge. Alyssa Grissom, a Clinical Nurse Specialist from the US, has been living and working in Hanoi for the past three years. To have a project director with a genuine understanding of nursing in Vietnam was instrumental in creating relevant content for our participants. We used Alyssa’s knowledge of nursing practice in Vietnam along with results from a Learning Needs Assessment that we created to help guide the topics that we would cover in order to best suit the participants’ needs. Luck would also have it that HVO Director of Programs, Lisa Vu, is Vietnamese and graciously translated various content for us. She created an interactive website in Vietnamese for the participants that went along with the course. Along with Lisa, we had another amazing and invaluable translator, Dao Thi Thu Ha, who translated the bulk of our course material, which was a lot! Additionally, we had the steadfast support of not only our partners at K Hospital but the HVO staff as well. I felt supported every step of the way.
After six months of hard work, we had lectures, detailed discussion guides, and group activities. “Advancing the Oncology Nurse in Vietnam” would soon be rolled out in-country to fifty of the head nurses. Ten additional nurses would later join us from Ho Chi Minh City for the second week. It was a humbling notion that nurses from other cities wanted to take our course. Before I knew it, it was September, and the time had come to actually go to Vietnam and roll out the course!
We were greeted with such warmth and welcome from day one. During the first week at K Hospital, we were toured around to the different wards by the head nurse educators. Having the chance to visit the wards allowed us to better understand the reality of the nurses’ job and how to best support them.
The first week of our two-week course, participants received lectures given by doctors and nurse leaders at K Hospital covering topics that we intentionally selected such as cancer biology, cancer epidemiology, cancer treatment overview, cancer treatment-related side effects, staging and diagnosis, and oncologic emergencies. These lectures were all given in Vietnamese and helped to lay a foundation for the following week which was more nursing focused. During the second week, we led group discussions with the help of HVO interpreter, Minh Chau, who was an essential member of our team. Together, we discussed nursing management related topics such as head to toe assessments, supportive nutrition, myelosuppression, treatment related toxicities, pain, and effective communication. This was our time to really interact and hear from the nurses and an opportunity for them to share their practices. It allowed us to learn from them just as they were learning from us. We also had the privilege of having guest speakers from the US and Vietnam speak both in-person and virtually on topics such as evidence-based practice, compassion fatigue and burnout, and caring for patients and nurses under psychological distress. After the discussions, we led group activities which was my favorite part. It was so much fun to see the nurses working together to come up with the answers. The enthusiasm and excitement during the discussions and activities was contagious. It was such an incredibly rewarding feeling to see our ideas come to life and to get the chance to support and observe the participants learning in real time.
With the help of one of our irreplaceable volunteers, Jodi, we landed funding from AstraZeneca to purchase stethoscopes for each participant. Hands down, my most memorable day was witnessing their reactions while we distributed the stethoscopes. To feel their appreciation and elation was a profound reminder of just how much this course meant to them. Using a stethoscope is a mandatory and routine part of our job as nurses in the US, but, per Vietnamese culture, stethoscopes are primarily used by doctors. I helped lead a demonstration on how to use a stethoscope on a patient and then observed as the nurses enthusiastically practiced on each other. I was beyond proud to be a part of that moment and will never forget that feeling.
Not many people can fully understand what it means to be an oncology nurse and the physical and emotional toll it takes. Although oncology nursing looks different from country to country depending on resources, education, and patient population, the one thing we all universally experience is the array of challenges in caring for cancer patients. At times it can be the most uplifting and happy experience–for example, when a patient receives news that they’re in remission. Other times it can be a physically demanding and heart wrenching experience caring for those in emergency situations, in pain, suffering, and dying. We hope that the information and tools imparted on the nurses at K Hospital will have a long-lasting impact on improving cancer care not only at K Hospital but throughout Vietnam. I can easily say that despite the hard work and challenges we faced while creating and implementing the course, I had the most incredible team, and this was by far the most meaningful experience I’ve ever had in global health. Looking forward to the next one!