Jessica Ransome

I am an undergraduate adult nursing student studying at Bournemouth University. I have now completed my second year. 

I always wanted to experience the overseas option for placement since I heard about it in my first year. I was skeptical about whether I would pursue it or not due to covid restrictions, confidence and finances.

Work the World was highly recommended by my university and after reading through the website and other students' stories I knew it was for me.

Once I landed in Iloilo, the Work the World team were waiting for me. They took me to the house and prepared a meal that came with delicious mango, something The Philippines is famous for! 

That evening I met my roommates, two lovely girls practicing physiotherapy.

The Work the World house in Iloilo is a large house with a courtyard and annexe. It had a huge kitchen and dining area where they’d serve us buffet-style breakfast and dinner. 

The living area had sofas to lounge on and a TV for movie nights and karaoke on a Thursday! 

On my first official day, the team took me and all the other new arrivals to our placement hospital where we were introduced during the flag ceremony which celebrates the achievements of others!

We then went on a city tour, which was amazing. We learned to ride local buses and three-wheeled motorbike taxis called tricycles. We had some amazing food and we all got to know each other.

I was in Iloilo for four weeks in total. My first two weeks were based at a university hospital in internal medicine. This ward was separated into three sections; infectious, non-infectious and chemotherapy. 

In my final two weeks, I moved to a government-run medical centre where I spent two weeks in the emergency department. This department was not separated but it involved both pediatric and adult cases. I spent most of my time in the trauma wing and outside in triage. This benefited my learning by seeing how the local admission process compared with the UK process. 

Starting at a university hospital, I was introduced to the chief nursing team and the internal medicine nursing team. As it was a teaching hospital they were used to students. I was assigned a supervisor each day and I followed them on their rounds and assigned tasks. 

One of the biggest differences between nurses in the UK and in The Philippines was that the latter didn’t get involved in personal care or feeding patients. These tasks were left to the families of the patients, who were with them 24/7. 

I mostly worked in the non-infectious area and the chemotherapy unit, where I saw many interesting cases such as; leukemia, multiple uncontrolled diabetes cases (types 1 and 2), tracheotomies and abdominal obstructions to name a few.

I also saw some things that were similar to the way we do things in the UK such as paper charting. The orders and tasks were written by clinicians, and the rounding style is almost the same as in the UK. The Filipino nurses were surprised that their style was so similar to the UK’s.

During my time in the emergency department, I involved myself in as much as I could regarding adult and pediatric cases. I spent most of my time in trauma and triage in the non-infectious area. Patients were split out based on their covid status — I was allowed to see the area where infectious patients were placed, but I chose to spend my time in the non-infectious area. I spent some time in critical care where I saw intubations and discussed patients’ conditions and their ongoing care with the attendant.

Most of my shifts were mornings, Monday to Friday. But I was able to do nights and afternoons whilst in the ER, which I found very beneficial as I got to see the differences in staffing and patients.

At first, being in the medical environment was a shock. It was different from my expectations because even though I was informed of the differences by Work the World and by my colleagues from The Philippines, it’s hard to imagine something you’ve never seen. 

Over time I felt more comfortable in the environment and learned how involved the families of patients are.

I felt I was able to talk about my experience with my fellow students, which helped me process some of the more confronting cases I saw in the emergency department.

My first week ended with a trip to Boracay with ten of my housemates. Boracay is a paradise island north of Iloilo. Words can’t express how amazing it was! 

I have gained so much more knowledge culturally, environmentally, clinically and academically whilst in the Philippines.

It has taught me a different way of life, and the key differences between the UK and The Philippines when it comes to healthcare. 

I feel so much more confident after my elective placement. I proved to myself how much knowledge I already had, which helped grow my passion for healthcare.

My passion has always been elderly care, and on this placement, I was able to show this passion by discussing conditions with elderly patients and what their next steps were. Learning how the older population is looked after in The Philippines was fascinating too. It turned out that families look after them, and nursing homes are extremely rare.

These open discussions allowed me to build a rapport with my colleagues — both students and medical staff — on the wards. I still feel very passionate that ward nursing is for me. Especially in the department of elderly care. Spending time on placement in Iloilo also sparked a new interest in educating, which I hope I can put into action once I have students of my own.

I was worried about the language barrier but found it very easy to talk to people, as English was spoken by most people. I did make the effort to use the few phrases I learned in the language classes held in the Work the World house. I think local people appreciated this. 

Reflecting back on my time in The Phillippines, I really do feel like I have improved as a person. I feel academically ready for next year, and clinically I feel more confident in myself. I’m ready for the next challenge. 

I think being pushed out of my comfort zone even though it was scary was an amazing experience and was definitely needed. Regarding my employability after this placement, I believe I have gained once-in-a-lifetime experience that I can demonstrate to my future employers.

If I was asked the question, ‘Would you recommend this to other students?’ I would say, “Absolutely!”

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