Learning of practice in Thai

Destination: Chiang Mai University
Term: 2, September 2013 ~ 2, September 26
KobeUniversity, Faculty of Health science
Michiha Yoshimura

3, September 2013: introduction to the Faculty of nursing, Chiang Mai University
About education of nursing, I understood the difference between Thai and Japan. For
example, in Thai, all nursing student must study midwifery. I surprised all nurse can doobstetric care, but I learned there is the not only difference of the thing that nurse cando, but difference of the medical situation. Thai nurse can do more things thanJapanese nurse. But in Thai, nurse must renewal of license every 5 year. So I thinkquality of nursing and patients safety is kept.
4, September 2013: study visit ICU and CCU
Chiang Mai University Hospital has three ICU and one CCU. We observed medical ICUand CCU. What was especially striking was that there were many nurses for eachpatient, and there was no nurse call button. In Japan, all ICU and CCU has nurse callbutton because the number of nurse is few and nurse always can’t stay around patient.
So we thought it is good environment for patient that nurse always stay around thepatient because patient can stay safely and can feel less anxiety.
5, September 2013: lecture and study visit orthopedic ward
I surprised this ward has many patient who has traffic trauma. But during my stay inThai, I saw many people ride motorcycle without helmet and many Thai people don’tkeep the traffic rules. So I learned characteristics and environment of the country isrelated characteristics of patients.
And I almost surprised this ward has many infected patient. I think this is problem
happen many reason. For example, there is shortage of instrument and difference ofhabit of washing hands. I think shortage of instrument can’t solve easily, but if medical
staff makes more effort to wash hands, it may decrease the infection. And more, I feltthat Thai nurse is always smile and kind to patient. So I think if infection is decrease,
Thai nursing is better than now.
6, September 2013: study visit pediatric ward
In this ward, patient’s room is divided into three rooms by patient disease. We thought
it is good system because nurse can take care of patient efficiently. And the family
members who stay same room can share the experience each other and encourage eachother. And the most impressive thing is that the children’s family supports nursing carewith nurse. For example, they measure the volume of children’s urine and drinking
water. In Japan, many hospitals have the system that all of nursing care is given bynurse without family care. This system’s good point is it can be decrease the family’sburden. But we think if Children’s family supports nursing care with nurse like this
hospital, they can be decrease children’s anxiety and fear. And the family member andnurses can feel that they cure children’s illness together.
And I almost observed practice of nursing student. I surprised that they can prepare thepatient’s drug and give the medicine patient. Thai nursing student can do many thingsand nursing skill is higher than Japanese one. Japanese nursing student has manythings can’t do, but they can think patient’s individual history of living, habit, andcharacter. And based these things, we take care of patient. So I learned that inThai andJapan, nursing style is different.
7, September 2013: observing ban rom sai
Ban rom sai is the facility for the children who have mother-to-child infection ofHIV/AIDs and who have lost parents by HIV/AIDs. There are 30 children, 2~18 year’sold. When this facility was opened, discrimination against HIV/AIDs is strong. So thechildren of ban rom sai can’t go to school and play with neighborhood children. But now,discrimination against HIV/AIDs is decreasing and HIV infected children who have lostparents is also decreasing.
Ban rom sai was managed by not only donation but also selling original goods andmanaging guest house.
8, September 2013: sightseeing temple and Sunday night market
About temple, I understood the difference of Japanese temple. For example, before I
enter the temple, I must take off my shoes and I can’t enter if I wear splendid cloth.
I thought that the belief in religion is stronger than Japan.
At Sunday night market, I saw that many people who have handicap playing music andsinging songs. So I think there is no or very few place that handicapped people work.
9, September 2013: sightseeing elephant camp and tiger kingdom
At elephant camp, I had nice experience. I saw and touched elephant nearby. And more
I saw the elephant drawing picture and playing soccer, it was exciting for me.
10~13, September 2013: practice of community nursing
Most impressive thing for me in community nursing in Thai is about volunteer. In Thai,
primary health care and public health care unite have volunteers. In Thai, nurse andnursing student cooperate with volunteer and support community health. At first, I wassurprised that volunteer can do some nursing care. But I noticed that it was more
surprised thing that there are many people working for community people without pay.
In the situation of shortage of nurse, I thought that volunteer’s work is very valuable.
I thought it is because Thai people have strong spirit of service.
And I was also surprised that in primary care unit, nurses can diagnose prescription of
medicine and some medical treatment because doctor doesn’t always stay in the clinic.
But there is the difference of the medical system. I thought that in Thai, in the surgery
care unit like university hospital doctor play a key role, but in the primary care unit,
nurse play a key role. From the above, I learned that medical system is deference by thedifference of country’s environment.
14~15, September 2013
Sightseeing in temple and art museum
16~20, September 2013: practice of obstetric nursing
I was surprised that antenatal clinic has education room for pregnant women and theirfamily. And it is emphasized the benefit and the way of breast-feeding. I heard it isbecause the rate of breast-feeding is decreasing in Thai. In Japan, the rate ofbreast-feeding is also decreasing. But it is not so emphasized for pregnant women aboutbreast-feeding. From the above, we think mother can consider about breast-feeding inearly stage because the education of breast-feeding starts earlier than Japan. And I
observed lactation clinic. This is the facility that the mother who has some problem tobreast-feeding can do milking and keeps it freezing. When I observed this facility in
postpartum ward, I thought it is good system that nurse not only recommend
breast-feeding but also prepare the environment that can actually do breast-feeding.
23~25, September 2013: lecture and study visit Thai Spa and Thai massage
I understood that in Thai, Spa is given for health and wellness. In Japan, Spa andmassage is rather thought as leisure, so I was surprised at this deference.
And about Thai massage, it is almost thought as a medical care. So Thai government
recommend that every hospital should have the room to do Thai traditional medicine.

So I thought this country has a belief to protect the tradition.
In such way, I learned many things for example characteristics of nursing, the role ofnurse, education, lifestyle, culture and national characteristics for these four weeks. At
first, we thought about only the difference between Thai and Japan, and we can’t

consider why the difference is happen. But through our practice and live in Thai, wecame to be able to understand that why the difference is happen. And more, in the livingof foreign country using different language, I felt the difficulty to express my mind inEnglish. Therefore, I learned that the positive attitude is very important.
I don’t forget to this experience, and I will make effort to be a nurse who has wide view.
Thank you.