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End of Shift: ‘Aha!’ Moments


Some of the most exciting and worthwhile things in life are not planned, and this is certainly true of my involvement in the creation of the Vietnam Nurse Project. The VNP is a privately funded education and practice partnership I helped establish between the University of San Francisco School of Nursing and the Bach Mai Nursing School in Hanoi, Vietnam.

The VNP began in 2005 when I vacationed in Vietnam and unexpectedly met Thuc Le Ba, MD, PhD, vice rector of BMNS. Thuc provided me with a tour of the hospital and nursing school, and the rest, as they say, is history.

Within the first 10 minutes of the tour, it became obvious to me that hospital and nursing school resources fell far short of need. During the tour, I was reminded of a question that the president of USF, Rev. Stephen A. Privett, frequently poses: “OK, you see what the needs are, what are you going to do about it?”

After the tour and a discussion with Thuc and his faculty, it became clear there were great needs in the hospital; however, as a retired nursing professor, the nursing school was where I could make a real difference. I identified two critical needs at the school. First, the curriculum was not based on contemporary international standards. Also, the teaching approach needed to move to a more student-centric model.

I agreed to return the next day to present a lecture on the contemporary role of the nurse in the U.S.

After returning to my hotel, reality began to set in, and there were moments when I felt overwhelmed by the needs. But I recalled one of my mantras: “Feeling overwhelmed is not the same as being overwhelmed.”

During this journey, which has spanned six years and 15 trips to Vietnam, there have been certain instances when I recognized the project was making a difference. The first major “aha!” moment came during my third visit, after working with Thuc on the curriculum. Thuc had just returned from making a presentation to the Ministry of Education and Training, and the Ministry of Health where he presented some of the changes he wished to make to the curriculum. Thuc proposed to introduce the concepts of evidence-based practice, research, nursing theory, and the nurse’s role in providing safe and effective care. Thuc’s request was approved.

The next major “aha!” occurred when I was invited to make presentations to the MOET and MOH International Cooperation Department and the U.S. Ambassador’s conference on higher education in Vietnam. Both presentations were well received, and both ministries gave their support.

Perhaps one of the most important “aha!” moments came when I had the opportunity to observe faculty in the classroom. During several visits, we presented workshops on designing student-centric education and learning. The faculty began — in small steps — to include more interaction with their students. They involved the students in activities such as role play and small group learning projects.

Traditionally, Vietnamese faculty do not engage the students during instruction. This has been acknowledged by MOET as one of the major impediments to learning at all levels of education in the country.

The most recent “aha!” came on my 15th visit in November 2010. I was accompanied by two nurses from USF/SON and seven volunteers. We were invited to make a presentation to several nursing schools on how nursing curricula are developed, maintained and evaluated. The audience included officials from MOET and MOH. The ministries were beginning to understand that if they wanted their healthcare system to be more effective, nurses must be allowed to do more. To accomplish this, some of the boundaries of nursing education and practice would need to be breached. Just as in the U.S., issues of gender, scope of practice, education and expanding roles for nurses has not, and will not, be easy.

I never imagined I would be leading an international nursing project; however, when the opportunity presented itself, I took the chance. Although there have been frustrating issues to resolve, I would do the whole thing over again.

The project has since expanded to include three more schools in Vietnam. For more information, visit

Gregory Crow, RN, EdD, is director, Vietnam Nurse Project, University of San Francisco, School of Nursing.


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