Travel and working abroad have a way of stretching us. As our awareness of a wider world and other traditions expands, so does our capacity for compassion and love. As nurses and nurse practitioners (NPs), when we experience working in a new and different environment—perhaps with fewer resources than what we are accustomed to—we learn “up close and personal” how others live and provide health care, however meager it may be. We adapt our practices to fit within the culture and the resources available to us. Our nursing framework of ideal practices has to be put aside and replaced with the need to do what we can with what we have.
Recently, while serving as editor for Kaplan Publishing’s anthology, Nurses Beyond Borders: True Stories of Heroism and Healing around the World, I was privileged to read hundreds of stories written by nurses who have served in the arena of international health care. And, while I could only choose 25 of their wonderful stories to be included in the book, I recognized that each of them was undeniably a very special person who reached out eagerly—though not necessarily without fear—for new, rich experiences. One contributor’s commitment to nursing and passion for global health struck a particular chord with me. This “angel of mercy” has not only served numerous times abroad herself, but she also helped found the nonprofit organization One Nurse At A Time (ONAAT), which has a mission to assist other nurses and NPs in enhancing our profession as they, too, look for opportunities to serve locally, nationally, and internationally.
The Vision is Born
Sue Averill, RN, MBA, considers herself a “humanitarian snowbird.” While she works half the year in the emergency department (ED) of a large metropolitan hospital, she spends the other 6 months volunteering abroad. Her travels read like an atlas: Mexico, Liberia, Sumatra, Guatemala, Ecuador, Venezuela, Pakistan, Bangladesh, Jordan, Cambia, Cambodia, Darfur, Uganda, Kenya, Ethiopia, South Sudan, and most recently, the Philippines. Sue noted that the key for her had come during a surgical trip to Pakistan. “By comparison with girls and women there, I have lived a charmed life.” She explained that since she was born in a time and place that fosters independence, education, and freedom for women, she believes that it is her responsibility to give of herself because of the many gifts she has received through no merit of her own.
Sue has always shared her nursing volunteer experiences with friends, who passed them on to others. When she returned from each trip, friends, acquaintances, and even perfect strangers would ask, “How can I do what you're doing?" Sue would always find time to chat and guide them along their path.
One of these individuals was Staci Kelley, with whom Sue had worked in the ED for years. Although Staci was inspired by Sue’s stories and photos of medical missions, she delayed volunteering until 2005, when she seized the opportunity to travel to Haiti as a member of a church-sponsored medical mission team. “I knew my trip to Haiti would be life changing,” Staci explained, “but I wasn’t prepared for exactly how it would affect me.” Staci found her heart going out to the mothers of young children who fought each day merely to survive. Families would line up hours before the beginning of clinic and wait patiently for the opportunity for their children to have a medical exam. Staci was also touched by the mother who walked over 35 miles with her 8-year-old son so he could be examined by their eye team. He qualified for cataract removal surgery, and 2 days later he was able to see again. She learned that her skills as a nurse can be that avenue through which these mothers receive the care they and their families so desperately need. “I now know what extreme poverty looks like,” Stacy continued, “and I saw what happened when there was little to no health care provided. Most importantly, I learned the value of my skills and knowledge. This experience ignited a fire in me to further pursue volunteer work.”
Birth of a Nonprofit Corporation Over the years, Sue and Staci had often discussed the lack of centralized information available to nurses wanting to travel. In order to solve this problem, they joined forces to found ONAAT in 2007. “However,” Sue explained, “it took us several months to define and refine our ideas and message and focus on the core of our mission and vision statements.” The goal of ONAAT is to make it easier for nurses to use their skills to help people around the world, to lower the entry barriers, and to increase public awareness of the role and contribution nurses make in the humanitarian world. “I truly believe we can change the world,” Sue said.
Since they had no money, they looked for pro bono opportunities and did the work themselves. Through WAASCO, an organization that links nonprofit organizations with volunteer lawyers, they were connected to Gonzaga Law School. They worked with law students to create ONAAT’s bylaws, articles of incorporation, various policies, and IRS approval as a 501(c)(3), which enabled them to accept tax-deductible donations and issue receipts for them. Sue credits Gonzaga School of Law for the bulk of the paperwork that needed to be filed. “We also had lots of direction from accountant Sharon Vik here in Seattle who works with many nonprofits and gave us a lot of direction,” Sue explained. “Another friend who is the director of a volunteer clowning organization gave us ideas about start-up, philosophy, and other matters to help us formulate and define our start-up.”
The Central Database and Communication
Over years of trying to expand her own volunteer experiences, Sue had become acutely aware that there was no central database/website to inform nurses about volunteer opportunities. The information available via the Internet was scattered, available only in bits and pieces. There were websites for doctors, but not for nurses. And there was no place to ask questions: What should I do? Where should I go? How do I find volunteer opportunities? How do I go about planning? As a result, it became a priority to create a central database as part of the ONAAT website; this database would be updated annually to assure it remained current and correct. Eventually, after hundreds of hours of research, ONAAT’s database was complete. “In 2009 our website went live and so did we,” said Staci.
Networking
Although the majority of Americans have some understanding of what nurses do in the United States—working in clinics, hospitals, nursing homes, and the community—most of them have no idea what nurses and NPs do when they volunteer abroad. International volunteering involves a wide breadth of work: teaching, diagnosing and treating, and functioning as hospital administrators and logisticians. They, like medical MacGyvers, must wear many hats and stretch far beyond their scope of practice at home. ONAAT wants the public to recognize the great value that even one single nurse or NP brings to a mission, to a people in need.
Networking is a huge part of ONAAT’s organization. It is a vital way to encouraging nurses to get involved in humanitarian and volunteer nursing. Representatives of ONAAT speak at public forums, maintain an active presence on Internet social networks, write articles, and submit stories to anthologies like Nurses Beyond Borders, among other activities. While finding ways to reach out and educate the public, they look for more opportunities and encourage scholarship recipients to follow their lead.
Scholarships for Volunteers
Doing volunteer work, by definition, doesn't pay. Many, if not most, international organizations ask nurses to pay their own transportation, room and board, and sometimes a team fee. In order to volunteer, the nurse or NP must also use vacation time or unpaid time off from work. Volunteers often can do one mission, but most can't afford to go frequently. Because Sue and Staci wanted to overcome that barrier so that more nurses and NPs could share their skills and expertise in the world, they created an ONAAT scholarship program that offers $1000 to qualified applicants. (The simple scholarship application is available for download from the ONAAT website www.onenurseatatime.org.)
“It's a matter of balancing donation income and requests, but so far, we're on target for one scholarship per quarter,” Sue said. “If we get more donations, we'll give out more scholarships.” Donations are greatly appreciated and can be made as an easy “PayPal” transaction from the ONAAT website or mailed to: One Nurse At A Time, c/o Sue Averill, President, 7747 38th Ave NE, Seattle, WA 98115.
We Are One World
Of course, volunteering isn’t limited to faraway places. “One of the things I learned about volunteering,” Staci said, “is that there is just as much need in my own community as out in the world.” As a mother of small children, Staci is no longer able to travel abroad for long periods of time to volunteer. Instead, she has discovered a way to immerse herself in helping with the healthcare needs of her own community. Discussing her approach to volunteering has often served as a springboard for conversations with colleagues who are also unable to travel but still want to help.
By Nancy Leigh Harless
One Nurse at a Time
ONAAT is a nonprofit organization created by nurses and supported by nurses and nurse practitioners who are passionate about giving back to their local and global communities through volunteer and humanitarian medical pursuits. ONAAT is dedicated to helping other nurses and nurse practitioners enhance their profession as they look for opportunities to serve locally, nationally, and internationally. Together—one nurse at a time—we can change the world. Please visit our website: www.onenurseatatime.org
Click here for more information on ONE NURSE AT A TIME.
Reprinted with permission, NP World News, Nov/Dec 2010, www.webNPonline.com, NP Communications, LLC
(Images provided by Nancy Leigh Harless. Image 1: Volunteer Kim Garcia, NP in Sartun, Guatemala. Image 2: Sue Averill holding a premie born to a mother infected with Hepatitis E requiring emergent blood transfusion in Darfur. Image 3: Staci Kelly starting an IV on a Haitian woman before surgery.)