Nursing students get a taste of refugees’ plight

The refugees moved through a range of emotions – confusion as they were bombarded with information on HIV, dismay at hearing just how little food they would get, shock when they saw pictures of the unsanitary conditions they would have to live in. But they only had to play the role for two hours.

The “refugees” were students at the Washington State University Intercollegiate College of Nursing. They participated in a simulation Friday of the challenges real refugees face as they transition into their new lives. It is the first time for students at the college to participate in the simulation, which was developed by World Relief Seattle, as a way of increasing cultural awareness.

Associate Professor Carol Allen and Assistant Professor Janet Katz said students need to visualize the experiences of refugees because global health issues affect everyone, especially as people move across borders. Also, it is very likely that students will work with refugees in their careers.

“We give them skills. Even if they don’t know much about a group, they know what to ask, what to look for,” Allen said.

Katz added that nurses need to understand refugees’ ideas on health issues may differ. “The concept of health is culturally based,” she said.

Cultural competency has become a required part of the curriculum at the college. Students must take a class specifically to help them explore other cultures, and many other nursing classes have incorporated culture and diversity into their subject matter, Allen said.

Culture is broadly defined to encompass not just ethnicity, but other elements such as sexuality, gender orientation and disabilities, Katz said.

At the simulation, students were divided into families from Afghanistan, Iraq, Myanmar, Somalia, Sudan and the Ukraine. They had to play different characters, dress up for the part, and learn facts about their countries. Role play included interviews at an HIV clinic, a health center and a United Nations post where refugees had to prove their cases were legitimate to gain entry into another country; at times they had to deal with aggressive and impatient “officials.”

“The people who are administering may not necessarily be caring, concerned, culturally competent people,” Allen said.

As the students struggled to express themselves, many realized the limitations faced by refugees especially when there is a language barrier.

“It was nerve-wracking,” said Eldaah Constantine, who played the role of the father for the Iraqi family. She said the exercise shows the importance of health workers to have respect and tolerance for different people.

Sharon Miller, a student ambassador who helped to organize the simulation, said refugees are often vulnerable and some of the processes they undergo can be dehumanizing. Nurses who work with them need to find ways to communicate and set them at ease.

Miller said students not only need to educate themselves about other cultures, but also need to be aware of their own.

“If we don’t know our own culture, our prejudices, our biases, we cannot deal with them,” she said, adding that at the same time it’s important to treat patients as individuals. “We have to realize there is no one pattern for culture.”