How Nursing Students Are Changed by Their Experience in India
At the base of the mighty Himalayas sits the peaceful city of Rishikesh, India. The All India Institute of Medical Sciences (AIIMS) Rishikesh is situated along the banks of the great Ganges River. This large medical complex is a government-run trauma center that has partnered with BYU College of Nursing for the past six years, combining the expertise of local physicians with that of BYU faculty and students to conduct meaningful research and practice.
In 2018, this medical center was in urgent need of individuals with two very specific skill sets: high-altitude medicine and trauma room communication. It just so happened that Dr. Craig Nuttall (MS ’11) had recently completed postdoctoral education in high-altitude medicine, and his colleague Dr. Ryan Rasmussen (MS ’11) had focused his dissertation on trauma room communication. Their specialized skills paved the way for BYU College of Nursing to incorporate India into its Global and Population Health Nursing Clinical Practicum.
“It was this crazy moment of divine intervention,” Dr. Nuttall said. “It was meant to be.” Dr. Nuttall and Dr. Rasmussen moved forward to create a partnership between the college and the medical center, and many students over the past six years have had unique and impactful learning experiences at this hospital.
AIIMS Rishikesh is the main source of medical care for the more than three million Hindu pilgrims who set out on the Char Dham Yatra each summer. This Hindu pilgrimage is believed to open the gates to salvation and cleanse the pilgrim from sin, and each Shiva devotee must complete it once in their lives. The path goes through deep valleys and over high mountain passes, leading pilgrims to four holy sites located at the glaciers that feed the Ganges River.
While the pilgrimage is a holy experience, there are many physical dangers. The long path can take months to complete on foot, and each year thousands of pilgrims fall ill or are injured on the journey. AIIMS Rishikesh provides medical care to those in need so that they can worship safely.
BYU nursing students have the unique opportunity to be in Rishikesh each year at the opening of this pilgrimage. They get to worship with the pilgrims on the banks of the Ganges River and care for the injured or ill in the medical center. It is a sacred opportunity to support our Hindu brothers and sisters in their worship.
“These experiences have opened our students’ minds to the importance of religious freedom and how we can support that through healthcare access.” Dr. Nuttall said. “Our students often return home with a desire to be more dedicated to their own religion.”
Over the past two years, Dr. Nuttall and Kiley Bearden, a current BYU nursing graduate student, have been working with AIIMS to help train the first Helicopter Emergency Medical Services in India. This team of skilled nurses will provide much-needed emergency transportation from the Garhwal Himalayas to the medical center.
India faces health disparities and challenges. According to the CIA’s World Factbook (2023), India’s infant mortality rate ranked in the top 10 across all of Asia and in the top quartile globally. Assistant teaching professor Carly Peterson (BS ’99) led this year’s project, which aimed to improve education in newborn resuscitation. During the winter semester, students participated in the World Health Organization’s Essential Newborn Care Course. This experiential learning opportunity prepared them to provide this important education to community healthcare workers in Rishikesh.
The students’ overall experience is enhanced as they gain knowledge about and appreciation for the way healthcare is practiced in India. Megan Esplin related, “It was fascinating to learn how the nurses go door-to-door, establishing relationships of trust with community members in order to address specific needs.” And she plans to adopt this person-focused approach in her own nursing care: “By taking the time to understand the patient’s cultural beliefs, level of understanding, and comfort with healthcare, I can more effectively treat the people that I care for.”
India’s family-centered culture influenced nursing student Sydney Peterson’s perspective of healthcare. “In India, it is the family’s responsibility to bring food, provide medications, and perform sanitary changes,” she explains. “Many patients were ventilated and sedated, yet they still had a family member by their side ready to care for them. As a future nurse, I hope to provide culturally competent care by asking families how involved they want to be in their family member’s care.”
During their time in India, students also visited a spice market, took a rickshaw ride around Old Delhi, explored the Pink City of Jaipur, rode elephants, and saw the Taj Mahal.
When asked what he hoped students got out of the experience in India, Dr. Nuttall responded immediately, “I hope they come home changed. I hope they come home wanting to take better care of their patients.” Dr. Rasmussen had similar thoughts, “I want to give students a love and appreciation for a culture that isn’t their own, so that when they take care of someone that isn’t from our culture, they’ll have a little bit more empathy and care for them at a higher level than they would have otherwise.”
The mission of BYU College of Nursing is “To learn the Healer’s art and go forth to serve.” The Global and Population Health Nursing Clinical Practicum blends cultural and clinical elements, but what it provides is deeper than either of these elements could offer on their own. Those who practice the Healer’s art strive for a higher level of personalized care, a greater degree of empathy, and a loving approach to each patient they encounter. As BYU nursing students grow in their knowledge of nursing practice, they also seek to grow their spiritual capacity to connect with the patients under their care, rather than merely treating them.
Student Reflections:
Ellyn Snyder: I had a profoundly meaningful experience in the trauma ER. I quickly realized that the intensity of traumas in India were significantly higher than those in the US. Within my first hour at the ER, I assisted in the care of two brothers who had been attacked by a leopard while working on a mango farm. One boy had a severe head gash and the older brother had wounds on his hands and arms from desperately trying to save his younger brother from the leopard attack. Both brothers received appropriate wound care.
This experience was incredibly meaningful to me as it underscored how different regions become proficient in treating specific types of injuries. The doctors and nurses in India knew precisely how to handle this trauma and other similar cases, whereas a nurse in the US might not be as prepared for a leopard attack. This experience has prepared me to handle unusual cases in the future.
Madeline Sorhus: I loved my days in the ER trauma center. I was so impressed with how the healthcare workers in India were able to work so effectively with the little equipment they had. One patient came in who had been run over by a bus. His calf was severely degloved and he had multiple fractures. After the healthcare workers cleaned and bandaged the site, they had to procure a splint for his leg. They couldn’t find one, so they took a cardboard box and some poles that were in the room and created a simple splint. I was so impressed by how resourceful they were, and I realized how much I have wasted in the hospital. There have been many times when procedures have taken longer because we waited for specific equipment that could have been created from simple tools. In my future career I want to reduce waste and be more creative about how I use the tools available to me.