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“My first international work was in 2004 when I spent six months in Georgetown, Guyana, at St. Joseph Mercy Hospital. It was a challenging time, yet it provided me the opportunity to inspire the nursing students to gain an understanding of how important nursing is to patients, family and country. I was able to bring to the country its first:
“Although traveling miles in a boat to provide health care to remote villages was personally fulfilling, my greatest accomplishment was to help the students recognize that they are important people.
“My second international work was in Rwanda, Africa. I spent 2014 in Kibungo, where Duke University had partnered with Human Resources for Health. I was charged with completing a needs assessment and creating a change project to help nurses. The two main issues from the needs assessment were: 1) in 2014, the nurses did not do physical assessments on their patients and 2) many nurses did not see themselves as important people in the health care delivery process.
“I proceeded to design a history and physical (H&P) course. This five-day course began with a pretest, and the course itself offered hands-on experiences followed by 30 days of practice. Testing included practical and written exams. Upon graduation, each nurse received a certificate and a stethoscope, which were donated by my cardiology patients in Wyoming. A total of 42 nurses completed the process. This course continues today through the non-communicable disease (NCD) specialty nursing education.
“Olivier Hagimakubana was a nurse assigned to me. He had a three-year nursing certificate, and he exceled in the H&P course with insatiable curiosity in cardiopulmonary assessments. Working together, the Kibungo hospital sent Hagimakubana to NCD speciality training. Upon his return, he opened the first nurse-driven NCD clinic in southeastern Rwanda. Hagimakubana now trains nurses throughout the country. In 2020, he will graduate with his bachelor’s degree, and he remains one of the top cardiac echosonographers in Rwanda.
“To address the issue of nurses feeling unimportant in the scope of health care delivery, I developed a new leadership training process called LEAP: leadership, engagement, accountability and professionalism. This course was presented twice in 2014. After I left Rwanda, one of the nurses who completed this early LEAP program, Christian Ntakirutimana, asked me to continue this project. I chose a nurse educator (Ntakirutimana), a staff nurse (Hagimakubana), a pharmacist and an engineering student to be the team to help guide and build the program in Rwanda.
“LEAP was completed in January 2018 and presented at the University of Rwanda School of Nursing to 52 participants. The Rwandan LEAP team continues to present the course. I have gone on to begin a leadership business called LEAP Leadership LLC with the intent to help nurses become inspired and curious about leadership — from the bedside to boardroom — while finding the courage to make changes personally and within the workplace.
“My international experiences were far more a gift to me than I gave to others. I gained an understanding about Rwandan nurses concerning their training, equipment, support structures, traditional processes, sociopolitical environment and typical organizational structures that impact health care. I gained lifelong friendships that impact me today. We have laughed and cried together, we have celebrated births and deaths, and we have grown as colleagues and family. Most importantly, together, we are helping others become their best.”
An international trip is about relationships
It will first start with you, your thoughts, your dreams
It will be formed and strengthened by those who share your dreams
Sharing your vision with another to create a dream
Your new international friends will become your family
But your strength comes from within
It is a time of Change
A time of emotional struggle as you say goodbye to so much
It is a change in water and food and how you lived
But change is a time to embrace a new adventure
To find new friends, family and colleagues
A time to find courage
A time to be innovated
A time of integrity
A time to share your knowledge and wisdom
A time to grow yourself
And you will find that you are strong
A time to strive towards your new vision
Your adventure is about your courage and vision
It is about using your hidden talents
It is about helping others find their talents
It is about helping others find their voice
It is about overcoming barriers and making bridges
It is about innovations
It is about frustrations that become successes
It is about others sharing with you
And it all starts with you
Dream your Impossible Dream
And become who you are meant to be through your international adventure.
— Maria Kidner, DNP, FNP-BC, APRN, FAANP