Alumna journeys to China

Talk with Deb Kramlich '09

by Peggy Roberts

Deb Kramlich '09Deb Kramlich '09 of Raymond, Maine, recently earned her Master of Science in Nursing and is a clinical staff nurse and unit-based educator in the pediatric intensive care unit at Maine Medical Center in Portland. Last fall, she traveled to the Children's Hospital Medical Center of Fudan University in Shanghai, China, with a 10-member Maine Medical team led by pediatric heart surgeon Dr. Reed Quinn.

How did you happen to go to China?

Dr. Quinn has helped the Shanghai hospital establish a pediatric open heart surgical program. A team goes over every few years and he asked for volunteers. We went to support his program and help the nurses learn to care for these children. Dr. Quinn likes to show them he depends on his whole team when doing heart surgery, which is different from how they do things there.

What are the biggest differences in China's medical approach?

The male physician is dominant. While nurses are well educated, they're not allowed to use it. When Dr. Quinn encouraged the doctors to think of the nurses as equal partners in the care of the children, the nurses just beamed. The doctors reacted with polite restraint and I think a little dismay, but they would never disagree openly.

It was not just the hierarchy between physicians and nurses but between males and females. There were no female surgeons, although they did have a female pediatric cardiologist. I asked if there were male nurses, and they sort of scratched their heads and said "maybe we have one who works in the emergency room."

As children are recuperating, is family allowed in?

Traditionally, families left their children before surgery and didn't see them again until they were out of intensive care. But, because of the head nurse's thesis on family-centered care, families may now visit their children in the ICU for 20 minutes a day - absolutely groundbreaking in China. I tell you, I cried a lot when I was over there. Once a child is transferred to the general ward, it's an about-face. With only two nurses caring for 32 children, families must learn how to keep chest tubes clear, care for the wound and look for infection.

What are their pain management methods?

There really aren't any. They give sedation and some medication when children have breathing tubes in; once they're removed the children aren't given anything, not even Tylenol. When I questioned the surgeon; he smiled and said, "They're just babies." With so few nurses, he said, if the baby cries, the nurse knows it's alive. They do use sedatives for their convenience, but it's not for the child's comfort.

What affected you most about the experience?

We're all very similar. We may practice differently and have different beliefs, but we'd all do anything for our children.

What did you think of Shanghai?

An amazing city with glaring opposites - abject poverty right next to opulence.

Has this changed the way you carry out your job?

Yes. It's made me appreciate what we have, but has also made me much more aware of our excesses. Americans expect an awful lot. I just think about how little they have over there and how grateful they are for what they do have.