GLOBAL HEALTH PROGRAM

Doctors In Nursing Science: Advance Nursing Practice

October 21-31, 2019

CHANG JUNG CHRISTIAN UNVERSITY

Tainan City, Taiwan

By:

LUCY ANTONETTE CALCETA-SALES RN MAN

DSN-STUDENT
From 21st to 31th of October,I visited Tainan, Taiwan for anadvance
Nursing Practice called Global Health Program for Doctors in
Nursing Science in Chang Jung Christian University with its objectives
namely; know the history and envirnoment in Taiwan, recognize
Taiwan’s medical syste, and challenges, know the health status and
medical needs of the Taiwanese people, recognize the impact and
needs of cross-cultural care, recognize the meanings and
applications of cross-cultural care and initiate the academic
research collaboration. The University was led by a president in the
name of Yung-Lung Lee and was estableshed on 1993. Its vision is
locally engaged, globally connected and a leading University with
social responsibility. Justice, responsibility, caring an excellent
christian University with Global vision which improves transnational
mobility initiating short term foreign cultural exchange
implementation plan.
 During the first day, the group were welcomed by a short ceremony in which
selected administrative officers were present to personally introduce their
university with pride. There was a short video clipping about different programs
offered by the university as well as the structures of the buildings inside the
campus and its land area.

We went to their library named as David Landsborough Memorial Library.

The mission of their library is to support the teachings, learnings and searching
needs of the students and professors of the school. The library collects more
than 400000 volumes and subscribe more than 1200 journals, 6000 theses and
dissertations, 300 databases, 23000 e-books, 80000 e-journals, 16 newspapers
and nearly 20000 auto-visual and non- book materials. There was like a fire
design placed at the center of the library which according to them it was the “
Nec tanem consumebature”, a common motto of reformed and Presbyterian
churches all over the world. The library also organizes user education programs,
lectures, tours, exhibitions that are designed to help readers make the best use
of the library.

We had a campus tour in which we have seen public sculptures like the
shepherd-honor the spirit of the shepherd and do not give any sheep. The story
of the washing of the feet in which according to our tour guide during graduation
ceremony, the university president with faculties will truly wash the feet for the
graduating students to use their humility as a model of love and service. The
three East wise men, the burning without destroying and the City doctor who is
the father of Taiwan sewer engineering and the ecological pool.
 A simulation ward has been set up for the Department of Nursing, a
comprehensive internship program has also been established in cooperation with
relevant entities. The department’s professional software and hardware have
given students the abundant resources and their faculty who made the students
possible to gain the wealth of knowledge in their studies. It was the first
university to own such facility in Taiwan.
 Nursing education in Taiwan was discussed whereby the goal is to educate
students to become a competent and accountable professional nurses that can
be relied on by the patients and their families. They offer Master Program in
Nursing in which their goal should be based on the competent of their eight core
values namely, critical thinking and reasoning, general clinical skills, basic
biomedical science, communication and teamwork capability, caring ethics
accountability and life-long learning. And to educate students to be master of
nursing skills, demonstrate professional autonomy and independent judgment
and become an advanced Practice Nurse. They also offer Nursing PhD Program
which is based on the nursing advanced professional ability and literacy of
master education. The PhDs should have the potential for professional and
leadership function. Lead the nursing profession to have a continuous growth.

Another lecturer presented her study entitled “ The Development Process

of the modern nursing profession in Taiwan” With the following findings,
Nursing ethics from Christian values, with God, nothing shall be impossible,
Gifts of Healing came from God, pay more attention to the souls of the patients,
everyone through you may come to know God better, a true nurse possess the gift
of the spirit of Jesus and Leading students in the development of Christian
characters. In conclusion, exploration of transmission of the core values were
native pioneer to the missionary nurses.

Chang Jung Christian University was established in the spirit of Christian

love that led Christ to lay down his life for the world. Its purpose is to
cultivate scholars of the highest caliber who will be guided by the ideals of
“devotion, diligence, honor, and service” to cherish our nation, contribute to
society, and serve humanity.

Chang Jung Christian University seeks to carry on the historical traditions

and rich cultural heritage of the Presbyterian Church in Taiwan. As it pursues its
goal of sustainable, holistic education, CJCU strives to continue the devotion
to God, the love of wisdom, and the commitment to education shown by the early
Presbyterian missionaries. It also seeks to create a campus culture that
upholds democratic freedoms; advances original thinking; promotes a global
worldview; imparts beauty to body, mind, and soul; and affirms the dignity and
value of life. The University values diversity and openness and seeks to cultivate
a lifelong love of learning, critical thinking, excellence in leadership,
innovation, and vision for the future. By striving to provide the finest education
possible in each of its five colleges, CJCU is responding to the divine call to
“pass the torch” to the next generation and to raise up individuals of exemplary
character who will excel in their fields and shine among their 21st century
contemporaries.

Nursing Vision – laying a solid foundation for a vibrant future. The

university turned a promising student into a good caregiver. CJCU believe
practice teaching in the Department of Nursing transform what happens in the
classroom into what happens inside and outside the medical field. Bachelor of
Science in Nursing (BSN) program at the Department of Nursing at CJCU
focuses on the combination of clinical practice and nursing expertise,
establishing immersive simulated ward exercises, providing international
nursing training opportunities for students, and encouraging dual degree
training. We also work with departments of the Health Management Institute
to provide long-term care professional awareness training that reflects today's
healthcare changes. These special reasons have led to the nursing department
of CJCU to bring to students and their families, including: Bachelor of
Innovation, Theory, Practice and Research. Expand international horizons and
provide overseas nursing learning opportunities. Teaching cooperation with
excellent medical institutions senior scholars and excellent teachers in the
industry.
Art was defined as feeling and emotions which are most important
wisdom. It is not reasonable if you think but it depends on scientific methods.
Using of imagination and mind makes life more successful. Create and innovate
to impart others and learn to love art. As a recommendation in order to love
art; need to use vision, go to museum always, enjoy it, use it on your own, use
it to patient to heal, be more observant in taking care of patients, use senses to
show your emotions and lastly, non- verbal communication.

The group experienced the use of caligraphy. Writing is not just a way of
presenting thoughts and ideas; your own handwriting can also become an
important design tool. Just how, though, do you conjure up expressions. This is
to show how to lend more expression to your own handwriting and to show you
both the theoretical and practical basics of calligraphy using calligraphy
markers.
 Tainan Confucius Temple was Taiwan’s first Confucian temple. It was
established during the Kingdom of Tungning, a government founded by Koxinga
between 1661 and 1683 as part of a loyalist movement to restore the Ming
Dynasty. For part of the Qing Dynasty, it served as a school for Taiwan’s
tóngshēng. The entry-level examinees who had passed the county or prefectural
examinations but were not yet enrolled in a state institute. The temple was also
known as the First Academy of Taiwan, and served as a vanguard for
Confucianism in Taiwan while gaining a reputation for cultivating intellectuals.
At the entrance to the temple stands a dismounting stele. The oldest and best-
preserved dismounting stele of the four remaining in Taiwan, it was placed at
the entrance on imperial orders in 1687, bestowing legitimacy upon the academy.
The presence of the stele also represents respect for Confucius.

The group started heading to Tainan Art Museum 2 (Building 2), is a

contemporary/fine art museum with a huge number of galleries. This could
actually be one of the largest art museums in Tainan because of their huge
amount of galleries. The first 2 floors which are currently open actually consist
of galleries that are listed alphabetically. I actually like this concept as it’s
easier and more intuitive to follow the alphabets as I was going through the
museum. Each gallery comes with a huge exhibition space t.hey also have a
really nice cafe area for you to snooze under the comfort of hot coffee and a
cozy ambiance while you seek refuge from the afternoon heat. I then checked out
the top floor which consists of a restaurant and a roof garden. The roof gives
you an amazing view of Tainan with several garden area to wander about.

Visiting historical sites lead us to deeper engagement with historical

events and give us an opportunity to develop a fuller appreciation for those
who lived before us. When taken seriously, theses experience can be invaluable.

Research proposals were presented together with the masterands and

facilitators who made some comments and suggestions in order to make our
study more comprehensive. Our study was about Transformational and
Transactional Leadership styles of Head Nurses and Job Satisfaction of Staff
Nurses: basis for a Leadership Program. We also had a chance to interact with
our partner masterand after the presentation because they were in charge of our
lunch, the name of my partner was Joy, she was 19 years of age and she was the
youngest of them all. We exchange a lot of things like, study, work, family,
ambition and a lot more. We even had a photo together. I had fun talking to
her.

The afternoon was also an informative and interactive discussion since the
topic was about Fundamental Patterns of Knowing in Nursing. Four
Fundamental Patterns of knowing were identified according to logical type of
meaning and designated as; Empiric’s, the science of nursing, esthetics, the art
of nursing, the component of personal knowledge in nursing and ethics, the
component of moral knowledge in nursing. A dimension was also presented
associated with each of the Patterns of knowing namely; Critical questions,
creative processes, formal expressions, authentication processes and integrated
expression in practice. In conclusion, we were given different scenarios and we
relate the Patterns of knowing.

We had our discussion at the café inside the campus. The topic was about
ethical issues of nursing care specifically on the series studies associated with
respect of patient’s autonomy. She shared to us her experience on her interest to
research which was focused on issues associated with health promotion, geriatric
symptom control and autonomy issues among elders and series of studies
associated with clinical bioethical issues. Qualitative and quantitative research
were used and from both patients and families perspective.

Located in the southern part of Taiwan, the city of Kaohsiung is the

island's largest industrial center. A thriving international metropolis at
the southern tip of Taiwan, Kaohsiung was the host city for the 2009 World
Games. Due to the regulating effects of the marine climate, Kaohsiung is
generally sunny and enjoys pleasant weather year-round. Known as
"Taiwan's Maritime Capital," the city has worked hard in recent years to
develop its tourism industry, including through beautification of the urban
landscape.

Kaohsiung is home to several popular visitor sites, including the Love

River, Shoushan (Mt. Shou), Xiziwan Bay, Lotus Pond, Qijin, and the Old
City of Zuoying. It also is an ethnic melting pot, joining Hokkien and
Hakka communities, the Pingpu, Tsou, Rukai, Bunun, and Paiwan
indigenous tribes, and a military community culture. Kaohsiung also offers
scenic mountains, ocean views, and rivers, as well as port, cultural, and
historic attractions. Visitors to the city can experience the beauty of nature
and savor fine cuisine, or head to the nearby Hakka village of Meinong to
experience traditional oil paper umbrella art. The Neimen Songjiang
Battle Array and the Fo Guang Shan Buddhist monastery in Dashu further
add to the ethnic richness of Kaohsiung. Taiwan's biggest mall and well -
known night markets complete the scene for a thoroughly satisfying trip.
We also visited the Domes Light which was located inside the train
terminal, we even climb a mountain to see the view of kaohsiung and we
had our dinner near the port with different seafood meal were prepared.

Chi Mei Hospital is a modern, fully equipped medical center with more
than 2488 beds capacity. They are the largest integrated health care system in
the Yunlin- Chiayi-Tainan area. They provide high quality health services to more
than 3 million patients in 50 years. Chi Mei Hospital aims to offer safe and
quality medical care, promote health and well-being of staff and the
community, and educate outstanding medical professionals. Their Core Values
are: Compassion, Accountability and Effectiveness. We had a short tour of their
facilities inside the hospital and we were amazed of the new advanced
technologies which were used by the nurses. We also went to the oncology
department and the hospice care unit with a short talk by the head nurses.
 Chi Mei hospital was the first in Taiwan and second in Asia to install the
TrueBeam® radiotherapy system equipped with HyperArc. This advanced
medical linear accelerator ensures precise and accurate radiation dose
distribution and delivers specifically targeted beams of radiation, offering
greater efficiency, accuracy and comfort for patients.

The Precision Medicine Laboratory was established in 2017, with advanced

genetic sequencing platforms and the next-generation genetic sequencer that
incorporate big data analytic tools to meet the rapid growth demands for new
drug development. It assists in the selection of precise treatment options and
in providing comprehensive testing services. The Lab has passed the biosafety
assessment in 2018 and is a biological safety level 3 laboratory.

Chi Mei hospital has been dedicated to delivering community health care
services including long-term care, home care, senior day care, community-
integrated services, and dementia community care.

The Chi Grace Hospice Ward emphasizes comfort and dignity by providing
quality end-of-life care, holistic approaches, and emotional support to patients
and their families. Commissioned by the Ministry of Health and Welfare in
2017, Chi Mei hospital pioneered medical institutions in southern Taiwan to
offer advance care planning and advanced directive services by undertaking a
pilot project to promote the Patient Autonomy Act.

Chi Mei Hospital is committed to patient centered care, takes a holistic

approach, makes patient safety our priority, and delivers proactive outreach
care. We strive to provide the communities and patients we serve with our
unmatched expertise and experience in holistic healthcare. This was a great
opportunity to develop a better understanding of the clinical role and safety
practice in workplace. I observed how the nursing staff performs their roles and
communicate with other staff and

Da Dong Night Market in Tainan City holds a dilapidated charm that

attracts a merry crowd of foodies and carnival enthusiasts amid the fluorescent
glow from the various food stalls, joint together with their various and distinct
aromas. We ploughed through the crowded market to bring a list of
recommendations on what to feast there. Stinky Tofu is a kind of fermented Tofu
that emanates a foul, pungent smell that is easily detectable when one steps
into the crowded bazaar. Some people love it, while others steer clear; The dish
is commonly deep-fried and served with pickled cabbage and spicy sauce.
Overcoming the smell is one thing, but the first bite is almost guaranteed to be
a messy one. But what comes after is a complex blend of flavors and textures:
crispy and chewy, paired with a hint of sweetness from the garlic sauce, sourness
from the pickled vegetables and a nice spicy kick from the chili. Located beside
the motorcycle parking lot, we spotted a queue at this stall that sells nothing
but sweet potato balls. Being the typical filipino that blindly allow the queues
to determine what we put into our stomachs, we joined shortly after, and we
weren’t disappointed. The crispy sweet potato balls contain a mellow sweetness
albeit a little starchy. This is perfect as a light snack before your true feasting
as you plough through the night market. There is a never-ending tapestry of food
longing to be discovered in the night markets in Taiwan. You may find yourself
revisiting an old place only to realize that it has disappeared, or you may find
yourself coming face to face with something entirely new.

Tainan Nursing Association and Nurses Association was established in

January of the 38th year of the Republic of China and was named "Tainan
 Nurses Association" when the case was filed. In view of the increasing
number of nursing practitioner licenses, in order to improve the quality of
nursing professions in order to improve the quality of nursing services and meet
the needs of the people, it was renamed "Tainan Nursing Association of Nurses"
in 1974, On June 14th, 2006, it was changed to "Tainan Nursing Association of
Nurses", and the number of members is nearly one hundred. The Association was
founded by Ms. Guo Baohuan and served as the first chairman. This was the
event were we parade our white uniforms and our caps to give importance in the
wearing of the nursing caps in the workplace. We also shared our Filipino
cultural dance that made all of them entertained. It was such a tiring but full
of learnings since we joined their booth activities.

The program, founded in 1995, is the first department of mass

communication in South Taiwan, featuring rich experiences and maintaining
steady growth. The only department of mass communication in South Taiwan
with a physical radio station; The program offers on-campus internship
opportunities and platforms for traditional and new media and print, as well
as electronic media, thereby facilitating education via knowledge-action
integration; Courses are designed with the idea of “learning while doing,” which
actively combines theory and practice; The department provides diverse
opportunities for off-campus internships in media, helping graduates
successfully enter the job market and opportunities are available for
international student exchange programs so their students can learn overseas,
with current partners in the United States, Canada, France, Austria, Czech, Korea,
Japan, and Hong Kong. International opportunities expand students’
international views and facilitate cultural learning experiences. During this
time, we were given the chance to be a news reporter and I voluntarily submit
myself to be the first one to report since it was my childhood dream.
 We went to observe a class of nursing students were they had their lecture-
demonstration. As per observation, we are still advance with how they do their
lectures since in our institution, we don’t use word documents in presenting our
topics to our students but rather power point presentation already. But what is
different with them is the way they make strategies in order for the students to
learn like visualizing their demonstration using a lot of cameras.
 Another topic was delivered to us which was all about Taiwan History
and Culture were we discussed about the peculiar International status of
Taiwan, the rise of Taiwanese national identity, the reconstruction and
configuration of Taiwan may it be Multiculturalism, Ocean Nation and
Japanese Colonial nostalgia and whether Taiwan is in the context of a new
Cold War between US and China.

Another site where we visited is the Jinhua Community. In its history,

Jinhwa Community locates in the southern part of Taiwan in South District,
Tainan City; it belongs to one of the 39 boroughs in the district and is with an
area of 0.28 km2. The community was an abandoned salt pan which was then
under development in the 1970s along with several urban developments. With
the congregated consensus of the later-moved-in residents and organizational
development of the community, the community had won multiple top
community competition awards held by Environmental Protection
Administration and Executive Yuan. The safe community programs of Jinhwa
Community include 8 safety issues: Home Safety, School Safety, Traffic Safety,
Public Place Safety, Leisure Activity Safety, Disaster Prevention and Care Service
for the Vulnerable, Elder Safety (added to the program in 2013) and Intentional
Injury Prevention. The programs gathered enthusiastic residents and support
from cross-sectional organizations to move forward with the action projects.
Although there was no dedicated budget from the government for these
programs, with the full cooperation of the related offices, action projects led
by Jinhwa Community were all carried out by responsible unit as the top
priorities. Interested by the news of the designation of International Safe
Community of Neihu in 2005, Jinhwa Community decided to develop into a safe
community as well, and began its safe community program in 2007. In 2010,
Jinhwa Community was designated as the 215th International Safe Community.

Aroma world is an herb garden located near the university where they
created their own aroma laboratory with the use of herbal plants that are most
common in Taiwan. We even taught on how to make our personalized candle
with a certain aromatherapy on it. All of us enjoyed it and at the same time we
learned from it.
 Taiwan Indigenous Peoples Cultural Park former name as Taiwan
Aboriginal Cultural Park is located near the Fugu Bay. It belongs to
Sentimen's Paiya Village of Pintung County, and this area is famous for its
beautiful natural scenery. In order to preserve the aboriginal culture and
artifacts, the government established this park in 1987, and was originally
named it as Machia Aboriginal Cultural Village. This is the biggest aboriginal
museum in Taiwan, which is over 82.65 hectares of land.

Taiwan Indigenous Peoples Cultural Park exhibits the lifestyle and

cultural heritage of the nine main aboriginal tribes in Taiwan. This park is
featured in a grand 360 degree multimedia room, a lifestyle exhibition, a wax
figure museum, and a handcraft room, which displays the aborigines’ bright
earth tone color handcrafts. Walking through the displays and exhibition
allows the visitors to learn about Taiwan indigenous people’s history and
culture. Inside the park, there are traditional tribal cabins, and from time to
time visitors can join the tribal cultural activities and participate their
ceremonies such as harvest festivals to further experiencing the vivid cultural
heritage of the aborigines.
 Kaohsiung Veterans Gegeral Hospital, Pingtung Branch (VHLC),is
located at Longtan Village in remote Neipu Township of Pingtung county,
buttressed by the picturesque Tawu Mountain to the east, and occupying an area
of over 11 hectares. The construction of the hospital dates back to July 1,1957,in
the makeshift name "LongChuan Veterans Tuberculosis Hosptial", which was
soon changed to "Taiwan LongChuan Veterans Hosptial"on September 1 at the
same year, and later officially designed " Executive Yuan Veterans Affairs
Commision LongChuan Veterans Hosptial "on November 1,1966. Finally under
the Veterans Affairs Commission¡¦s three-tiered integrated policy, it was
renamed Kaohsiung Veterans Gegeral Hospital Pingtung Branch in 2010.

For more than 50 years, the hospital has been developing and expending
in management, construction, and medical equipment and facilities, with range
and quality of services gaining recognition and praise of the public, owing to a
concerted effort made by all colleaques. As a public hospital, it is fully
dedicated to servicing people in town, with their welfare at heart, and committed
to enhancing the breadth and depth of community-based services, Through
assiduous plow and cultivation and constant diversification, the hospital is
aimed at providing warm, professional and high-quality medical care services,
safeguarding health, and achieving the vision of holistic medicine.

We went also in the Dementia Care Unit. This was a great opportunity to
develop a better understanding of the clinical role and safety practice in
workplace. I observed how the nursing staff performs their roles and
communicate with other staff and the residents in that aged care center. Effective
communication is essential to quality practices. Communication could be more
challenging when working with old people who had age related decline in
physical activities. I observed a care worker helped a patient walking. He
smiled to the patient and was gently holding the patient’s hand. Even when the
old patient could not walk normally. She has still very patient and gave her
verbal encouragement. This demonstrated good interpersonal skills including
respect for the patient and attentiveness. Safety practices is another important
issue we need to be aware of. Patients are able to take their personal belongings
and family photos. Residential aged-care facility is resident’s home.
 This study tour was a chance for self-reflection. It was full of insightful
and informative international experience. Almost everyday, we had a teaching
session delivered by faculty members of the institution. We had abundant
opportunities to hear many different voices and perspective during our study
tour. Experience their culture and of course taste various local dishes. Reflecting
our experiences through different perspectives was an intellectually demanding
task though it encouraged me to look back on myself in positive ways. This
educational tour offers an opportunity for a rich immersion experiences and a
tremendous way to facilitate learning.

Lastly, we visited the national museum which was really a great pleasure
because not only visiting it with no purpose but visiting it with pride and glory
because the historical paintings and artworks are inside the building that we
must know and understand the message of every artwork and appreciate the
kind of artwork. When I came in the museum it was really amazing and the fact
that most of its artworks are replica and sculpture that stayed original. The
building was huge and full of interesting things.
 This study tour explored my being a nurse educationalist as I underwent
the doctoral process. Learning takes place against a backdrop of endurance and
time constraints strives to juggle demands from the world of work and home
life with study requirements and creates a diary within a longer time span and
reevaluates the significance of the issues identified.
 AKNOWLEDGMENTS

I would like to express my heartfelt gratitude to the Almighty God for

making everything possible;

Dean Elizabeth Baua, for the full support to make this Global health
Practicum a realization;

St. Paul University Philippines and Chang Jung Christian University for
the acceptance of the said Practicum;

Dr. Ya-chuan Hsu for her timeless guidance to make each activity a
learning and enjoyable moments;

Dr. Lee-Jen Wu for our tireless tour and memorable moments;

To the Faculty, Staff and Students of CJCU Nursing Department for

their presence and time;

To our Speakers who gave their valuable Time and shared their
knowledge;

To All individuals we met in Tainan, Taiwan…Thank you for the

friendship

To our family for their financial and emotional support. And finally

To my Groupmates, I will always treasure our laughter, moments and

time together.

FROM THE BOTTOM OF MY HEART. THANK YOU VERY MUCH.