You’re going where?

I've asked my colleague, Mary E. "Betty" Ulrich, RN, MSN, ANP-BC, FNP, to write a guest posting for today's blog entry. Betty, also a member of the Honor Society of Nursing, Sigma Theta Tau International, is a retired U.S. Army major who wasn’t through with public service and brought her considerable experience and expertise to the U.S. Foreign Service. — Judie

I don’t know how folks functioned in the U.S. Foreign Service before the advent of the personal computer. Every year, about a third to half of embassy staff members prepare to rotate to the next blue horizon. That goes for the medical crew, as well. We bid on a job list that is anxiously awaited every year and then get down to the business of learning geography all over again. Not every U.S. embassy has a health unit, so we are not in tune to every country, but we don’t do too badly.

I was working for the State Department about a year before it dawned on me that we don’t bid on country assignments but capitals. So, when you are looking at a list and it says, Yaoundé, you’d better look it up before you put it on your list. Many of you will know Berlin, Rome, Frankfurt and Beijing, but what about Lilongwe, Antananarivo, Ulaanbaatar, Chisinau, Quito or Cartagena? Okay, you may know Cartagena, if you are a Michael Douglas “Romancing the Stone” movie fan.

So, every year, the medical folks help those who are bidding on jobs—sometimes on the other side of the world—to assure that medical assets required by the bidder’s family are available at the new posting. Easier said than done! Over the years, a system of evaluating and writing down medical contacts and sources of excellent care has evolved into a massive worldwide I’ve-got-you-covered list. So Jamie, who has asthma and wants to go to an air-polluted environment, will need a very good pulmonologist who, by the way, speaks English well enough so that her mother, whose native tongue is French, will understand.

This whole topic evolved as a patient—and friend—walked into the office the other day and said her husband had gotten the job of his dreams in Lusaka.

“Great!” I said. “Hmmm,” I was thinking quietly, “where in the world? Okinawa? Japan? Southeast Asia?” No, my friends, none of the above. It’s the lovely country previously known as Zambia.

Now, what part of Africa is that in? Get out the maps, which a seasoned Foreign Service officer has bookmarked on the desktop. The usual thoughts race through the old gray cells: Malaria? Yellow fever? Diarrhea? Food sources? Typhoid? Etc, etc.

Well, this is going to take some education to pull off the medical-advice portion of a briefing for Lusaka. Like I said, I don’t know what medical providers did before the computer!

— Betty Ulrich, U.S. Foreign Service NP, medical rover, Washington, D.C. (for now)

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

A good thing

One of my favorite tasks as a Foreign Service medical officer is to mentor new-hire colleagues. This usually starts with an email from my director, asking if I am available to mentor a new employee, who is being posted to my region. I consider it an honor to be asked and a responsibility to be taken seriously. The purpose is to assist the practitioner in learning the Department of State administrative system, which, as you might imagine, is very different from a typical U.S. medical practice. Most of the mentoring occurs via e-mail or phone but may include a site visit as well.

My current mentee is posted to Kiev, Ukraine, and I recently made a site visit. My colleague is a young mother of two. Spousal employment can be a huge issue for many Foreign Service officers but this is a non-issue for my mentee, as her husband’s work can be done from home via the Internet. However, she is concerned about how overseas life might affect her children, since the lifestyle is so very different from growing up in the United States.

I brought my daughter overseas when she was 14, a terrible age to move a child from the known to the unknown, and we were fortunate it worked out so well. She had a personality that was open to exploration, and she was especially accepting of different cultures. Her first foreign school included a student body representing 34 countries. There is no doubt that it was a learning experience for her, far beyond the actual academic curriculum. Her senior year was spent boarding at a high school in Rome, and my concern that the year would not hold the wonderful memories usually attached to a senior year were unfounded. In fact, her dearest friends, eight years after graduation, are young women she formed a bond with in Rome and who have continued to be central relationships in her life.

I have tried to reassure my mentee that her children will most likely do just fine changing environments every two to three years. Not every Foreign Service child adapts and thrives, but the majority of them do. In fact, Foreign Service kids are some of the most adaptive and confident I’ve ever known. And, as my daughter will attest, the question, “Where are you from?” can make a Foreign Service kid the most interesting person in the room. That is usually a good thing.

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.