The "New Look" in Vietnamese Nursing

Abstract

BEFORE the second World War, the present republic of Vietnam was one of three countries which comprised the rich French colony of Indo-China. On a map of southeast Asia this colony appeared as a sort of inverted question mark at the base of China with the rounded side jutting out into the South China Sea. Its area was one third larger than that of France, and it was inhabited by about 23 million people, three quarters of whom were Vietnamese. Today, the countries of Cambodia and Laos, on the inner side of the question mark, have their separate governments, and the eastern border, which is Vietnam, has been cut in two at the 17th parallel. North of this division is Communist controlled territory; south of it is the Republic of Free Vietnam. It was in the midst of Vietnam's 9-year struggle for independence, and resistance against Communist domination that the United States began to provide economic and technical assistance to this vital rice bowl of the East, and a unit for health and sanitation was included in this aid program. Among the many health problems with which the Vietnamese government requested assistance was the urgent necessity for the preparation of health workers in every category to meet the needs of the population and the fighting forces. In response to this request, the United States sent a team of health specialists including doctors, nurses, laboratory technicians, sanitary engineers, a hospital administrator, and health educators to furnish the technical guidance and the supplies that were needed to inaugurate or improve training programs in the related health fields. The first American nurses who came to work in this country faced two questions: Who to work with? Where to start? Nursing of the sick was considered a degrading function to be carried out by untrained laborers or the patient's servants or relatives. The Army demanded every able-bodied man, and the class of young women who would enter nursing had, at best, only grammar school education. It had been the practice to give girls of this type a year to 18 months of apprenticeship training, with lectures by one or more of the few Vietnamese doctors. After this they were considered qualified to dress wounds, give injections, and to substitute for physicians throughout the villages and provinces where there were few, if any, doctors. They were not expected to give nursing service as we know it; that kind of service was completely unknown. The American nurses felt, therefore, that a demonstration of nursing care might illustrate to the health authorities the kind of service that well-prepared nurses would be able to offer this country. Accordingly, in February 1952, two American nurses carried out seven 2-hour demonstrations, in four North Vietnamese cities, of basic bedside care, including the bed bath, oral hygiene, taking temperature, pulse and respiration, care of the patient's back, bed making, giving medications, giving treatments, and serving a diet. These demonstrations were attended by government and health officials, physicians, nurses, and other hospital personnel. Demonstrations were also given in operating room nursing, operating room administration, and the preparation of sterile supplies. In August 1952 one of the American nurses assisted as scrub nurse for two thoracoplasty operations performed by an American surgeon as a demonstration for the Vietnamese nurses and doctors. The consultant nurse also demonstrated the care of these patients before and after the operation. All of these nursing demonstrations were received with much interest and enthusiasm and the government requested further assistance in educating young men and women for nursing service. The original plan was to enlarge the three existing training centers and to incorporate them into one school with headquarters at Saigon and branches at Hanoi in North Vietnam and at Hue in Central Vietnam. American nurses were stationed at each of these cities, where they gradually began to introduce new ideas and to sell modern nursing, first of all to the nurses and doctors, and later on, they hoped, to the entire population. Various techniques were employed to promote the idea of nursing as a professional service. Permanent demonstration units were set up at the training hospital at each city and in outlying areas. These were wards