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Gillian is a Paediatric nurse in Ireland.  She travelled to Riyadh on a 3-month contract to work as a Staff Nurse in King Faisal Specialist Hospital and Research Center.

One of the most frequently asked questions from our nurses is what differences to expect when it comes to standards of care in Saudi Arabia.  Will it be worse?  Will my clinical skills be affected?

We asked Gillian for her perspective.

'I don't feel that the clinical standards in Saudi Arabia are bad.  Overall, if you pay attention, everything the nurses do here is the same.  There are policies and standards in place, just like home. However, there are differences.

The biggest difference is that everything is so IT-based.  Absolutely everything goes through the computer system.  This has good and bad sides.

On the positive side, the way that patients are assessed is very medicalised and thorough.  At home, I might go in and check vital signs in the morning and then be in and out of the room during the day doing different things.  In Saudi Arabia, the assessment is so structured - it's great because nothing can be missed.  It really does make you think about everything.

The downside to this system is that it's very time-focused.  All boxes need to be ticked by a certain time in the day... practically speaking this just isn't a realistic way to work.  Things that I would complete by the end of my shift have to be checked in the system as being done by 11am.  It's an unnecessary stress and leads to questions about why things haven't been done at the right time.  Whilst I like the system overall, the emphasis on ticking the right box at the right time doesn't work in practice. Also the same set assessment is mandatory on all patients,  but I don't think is relevant to each patient, every day.

Another major difference is that nurse-doctor / multidisciplinary team communication largely happens through this system, rather than face-to-face.  The working relationships are different and i guess theres a cultural elelment there as well. In Ireland, the doctor is right there whilst in Saudi Arabia, the doctor will do his/her rounds in the morning and then instructions come through the system.  Once you get used to it, it's fine and works well.  The system is easy to use, and full training is provided, however, it was the biggest challenge for me, and I relied on the senior staff to guide me with communicating any concerns I had with patient care.

There  is a Rapid Response Team.  I've understood from some of my American and Australian colleagues that this system in quite normal in their home hospitals.  If I am concerned about a patient, even just a little bit, I can alert the Rapid Response Team and within minutes there is a doctor, respiratory technician and a senior nurse preseny. They will assess the patient and decide if care needs to be escalated.  It's like a second set of eyes on your patient. 

When it comes to the job role, I was surprised at how many tasks are carried out by Health Care Assistants.  They have a more hands-on approach and they do a lot of the tasks that I would do myself in Ireland.  This took a little getting used to.

The main thing to be aware of if you want to come and work here is that you must be flexible.  Every country has a different system and you have to understand that different doesn't always mean better or worse.  Being open-minded is crucial to settling in and enjoying your time here.

Outside of work, it's been a great experience.  I have a family at home in Ireland so for me, personally, I'm not looking to stay longer but that could change in the future when the children are older.  The travel and social opportunities are great and the other Irish girls I came with have chosen to stay longer.

As a locum, I've had a few inconveniences.  It's not possible to have a bank account if you don't have an iqama (residence permit) and it's not easy to transfer money back home.  It's not ideal but it's not an unworkable situation either.  The financial benefit has been fantastic, so I can't complain too much!  Overall, things have gone very smoothly since I arrived here - starting from the first moment when I was met at the airport by a hospital representative.

Life here is more restrictive than in Ireland but no more restrictive than I expected.  I have to wear an abaya and I have a scarf with me to cover my hair when necessary, although this is not a requirement.  The main thing I miss is going for a walk - nobody walks here!  I suppose it gets very hot during the day but roads and paths aren't designed for it either! There are places you can go to walk so it's not totally out of the question but I do miss being able to simply leave home and go for a nice walk.

The social life can be great but you have to go out and get it.  Events need an invite so you need to know people - it won't come to you!  Just accept all invitations for the first few weeks - you'll meet friends and have plenty of invitations.  It's easy to get started socially but I imagine life here could be quite lonely if you don't make the effort. You can do everything from yoga to tennis and I've heard there's a GAA team here too.

Women driving is the new big thing here.  I haven't driven here and I don't know if I would want to but the hospital have been so encouraging towards women driving.  There is even a women-only parking area at the hospital already.  I haven't seen many women drivers yet but it's quite early days.  The atmosphere at this hospital really is very positive and supportive.

Travelling to Saudi Arabia has been a great experience.  If you're open-minded and looking to experience a different way of life and a different healthcare system, it's absolutely worth the move.  I was lucky enough to have the opportunity to try a short-term contract and if I didn't have my family at home, I would definitely consider staying here for longer.'


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