Reflections and Ruminations

On My First Year in Saudi Arabia

28 MARCH 2014,

Interesting, fascinating, breathtaking and exciting… all perfectly apt adjectives to describe my first year in Saudi Arabia.

From the moment I stepped off the plane and made my way to the baggage collection area at King Khaled Airport in Riyadh, I knew my life would change in a profound and meaningful way. I had slipped on an abaya in the plane’s washroom but was still set apart from the Muslim women who were mostly fully veiled. The sight of another human completely covered in black cloth was slightly shocking and unsettling; little did I know that although my understanding of the religious beliefs that dictated this practice would change little, my acceptance of it would happen rapidly.

In short order, with suitcases claimed and stowed in the hospital van, I found myself sitting with four other arrivals and chatting with Emma, a lovely nurse coincidentally from my Canadian hometown who had volunteered to meet us at the airport. As it was 2 am, my new roommate was fast asleep when I arrived at my complex and I quickly organized my bed in anticipation of the scheduled 8 am start of the hospital orientation to my new workplace at King Faisal Specialist Hospital and Research Centre.

In all honesty, the next three weeks were a bit of a blur. Bizarrely, in the mammoth-sized Heathrow airport, the only other Canadian nurse who was hired at the same time as me, overheard me telling another traveler that I was on my way to Riyadh, and in the time it took to eat a soggy sandwich at a café while we waited for our connection, we became fast friends. Each morning, Joyce and I would meet outside of our respective apartments; make our way through the tunnel under Takhassousie Street and into the hospital and each day we marveled at the fact that although it was a chilly +6 at 7:30 am, by the time mid-day reached +20, there was a 40-degree differential between here and the cold Canadian climate we had left behind.

Flying all the way from Canada meant that my jet lag was deep and long lasting. Thank goodness for the many gourmet coffee bars scattered throughout the hospital as, fueled with large lattes, we made our way to the post-graduate centre for the myriad lectures, classes and introductory presentations sponsored by various hospital departments. I.D numbers issued, uniforms measured and tailored, bank accounts opened; with all necessities arranged, we prepared to start our individual work experiences in the departments we were hired for.

I had worked for seven years in the same endoscopy unit in Canada. Five years previous, we had moved into a brand-new, state-of-the-art department with an incredible floor plan. Everything from charts to equipment was sparkly and new. During my hiring process for this job at KFSHRC, I had been informed that the current endo department would soon be moving to a wonderful new facility housed in the North Tower. However, I started my new work experience in a small, crowded and far-from-new area located on the third floor along with other outpatient departments. Strange how quickly it began to feel like my small, crowded and far-from-new home. Lucky us; we have since made the transition to our brilliant new facility, which rivals the Canadian one I left behind.

It was a lot to assimilate. Not only was I in a new country with foreign language, culture and religious ideology, I was in a new workplace where even the most innocuous pieces of nursing equipment were packaged differently than what I was used to. My eyes darted along the supply shelves looking for 4x4's and I.V. tubing. Equipment I had used every working day and could therefore describe with my eyes closed, was packaged differently here.

My ears experienced the same confusion. I was the only person in a staff of 25 people, for whom English was a first language and although it is the working language of the hospital, every single person I worked with had an accent. A wonderful potpourri of Malaysian, Filipino, Indian, and Middle Eastern people made up my new family. My head nurse was from the Netherlands and there was a Finnish nurse who had started just before me. I was the lone representative from North America.

Even answering the telephone was extremely challenging. My brain knew the person on the other end was speaking English, but quite often, I honestly understood not one single word. Doctors identified themselves by their first names and there are some names here that are extraordinarily popular. "Dr. Khaled" was one of twenty or so in this hospital, but he truly thought I would be able to identify him, perhaps by his voice. But that was if I could even understand what his name was. Many times I was confused as to whether an Arabic name belonged to a male or female and as well, it was not uncommon to have two patients sharing three of their four names. I very quickly learned to identify my patients only by their medical record number whenever referring to them in a clinical sense. Charting followed the same guidelines. Paramount is my hospital ID number; far more than signing my last name to my entry.

The cultural implications of my new job are truly interesting. In Canada, all nurses are expected to provide care for any patient regardless of their gender or the treatment required. Here, aside from basic procedures, male nurses look after men and female nurses care for females. In fact, my male colleagues are not to be alone in a room with a female patient unless another female is present. In the recovery area, the curtains closing off the cubicles are kept tightly closed if a female patient is inside and parting a lady from her hijab, even for a procedure, can be daunting! On the flip side, all of my patients are curious about where I am from, and are invariably happy when I respond that I am Canadian. Many have visited my homeland and have fond memories they enjoy sharing with me. I am frequently surprised by how many have at least a rudimentary understanding of English. Somehow, between my attempts at Arabic, theirs at English and with the generous support of my Arabic co-workers, I am able to care for my patients in a safe and informative way.

You can understand how every aspect of my physical, emotional and spiritual being was stimulated and challenged. I pride myself on being an open-minded, non-judgmental individual and I choose to explore new opportunities when they present themselves to me. Here at King Faisal hospital, there is no end to the potential for expanding one’s professional scope. Cutting-edge procedures are performed almost routinely and my nursing colleagues are adept in a most enviable way. I had felt quite confident in my nursing skill-set when I arrived, and have since developed an abiding respect for the nurses I work with here, from both a technical and efficiency perspective.

I too, bring something important to my department. Generally speaking, in Canada I enjoyed a wonderfully synergistic relationship with the doctors I worked with. This in turn, created an atmosphere of mutual reliance and respect. However, some of my peers here do not understand that they deserve to be spoken to respectfully and professionally in all situations. Sadly, this has developed into a lack of confidence and a sense of inadequacy in some of the nursing staff. By modeling assertive professional behavior and advocating for my colleagues in the forums provided by our Unit and Divisional councils, a new sense of individual strength and pride in our department is blossoming throughout the staff on a daily basis. Each person is realizing that they are an important and valued member of our endoscopy team and that through empowerment and the development of autonomy in their nursing practice, their contribution becomes essential.

Currently, the entire hospital is bustling with the anticipation of the JCIA adjudicators set to arrive in the next few weeks. Each and every microcosm of the hospital is being scrutinized, analyzed and beautified. From paint to policies, no layer is exempt from examination. Concurrent to JCIA re-certification, King Faisal hospital is seeking to be recognized as a one of only ten ‘Magnet’ hospitals located outside of the United States. This accreditation would formally position this forward-thinking facility as an exciting, dynamic provider of quality health care. What a stimulating time to be associated with this institution!

Almost every day I am asked about my first year’s experience in this hospital and in Saudi Arabia. Upon reflection, I have realized how humbling it is to be a stranger in a foreign land where every aspect of my life is new and challenging. I am also, however, filled with a fresh awareness in my ability to adapt, accept and appreciate this adventure I am on. To this end, I have comprised a list of tried and true tips, which have served me so well that I am behooved to share them in the hope of enhancing the experience of all newcomers.

Dawn’s Tips for Surviving and Thriving in Saudi Arabia

Tip #10
Avail yourself of every opportunity to meet people. This may be in the workplace, at the cafeteria or in your complex. Introduce yourself and ask what they do for fun when they are not working.

Tip #9
Look at the Social Club events calendar and attend as many functions and outings as you are able. These are a wonderful way to not only explore the city and region, but you will meet many others doing the same thing. Don’t be nervous about attending a function by yourself; sometimes that is the best way to meet people.

Tip #8
Catch the shopping busses to Dhirra and Bhatta in the evening or on Thursday mornings. Again, not only will you be able to do some shopping in these fascinating markets for food, clothing and household items, you will meet plenty of other people doing the same thing.

Tip #7
Attend the Arabic language classes offered by the hospital. Even knowing a few words can make a world of difference with your patients and their visitors and to the young shop attendants selling lipstick at Debenham’s.

Tip #6
Don't be afraid of the heat. 50 degrees here is comparable to 35 in North America. Remember, it is easier to tolerate a "dry" heat than a humid one! If you repeat this often enough, it will become true!

Tip #5
Utilize the many gymnasiums and swimming pools located around the hospital grounds. It is easy to adopt a sedentary lifestyle when your work and home are in the same location.

Tip #4
Get involved in your department’s activities. Being part of a project is a good way to get to know your co-workers, and is great for your portfolio and annual evaluation.

Tip #3
Use the contact information given to you during the orientation. There are many fun activities you can participate in: language and exercise classes, self-defense training and special interest groups who offer photography and art lessons etc. Expand your existing skills or acquire new ones; there is no end to the exciting things to do in your spare time.

Tip #2
I strongly encourage everyone to try to go walking in the desert at least once. Again, you will be given details during orientation. This is a terrific outing. You will meet many people, see some stunning landscapes in the deserts surrounding Riyadh, and enjoy a wonderful physical activity. Truly one of the most enjoyable things you can do while you are here.

Tip #1
Understand that for most of you, EVERYTHING will be very different than it was for you at home. Resist the temptation to compare and complain. Remember that you are here by choice and that “different” does not necessarily mean “wrong”. Embrace your time at King Faisal hospital as an opportunity to participate in unique professional experiences provided by a fast-paced, exciting and challenging environment. Remember that you really will reap what you sow; the positive energy you commit to your work life will spill over into your after-hours life as well. Lastly, feel the inherent joy in being a vital part of this vibrant, multi-cultural setting, revel in the music made by the languages of the people who surround you and release your fears; each of us before you, has worn the same shoes and paced the same sandy path you are on.

Marhaba!