Abstract
A group of registered nurses in the graduate nursing program at Lubbock Christian University and their instructor traveled to Turkey in 2008 and, through personal contact and dialog, changed their perspectives about the country and its people.
As nursing educators we teach our students about cultural diversity and expect them to provide nursing care accordingly. The real test comes when they experience being in a foreign country and seeing its people in ordinary situations. In such settings, we often are unable to communicate because we don't know the language or understand the customs, religion, or beliefs.
We didn't go to Turkey to practice nursing. No, we went observe, to learn, and simply to be in the experience. However, there was nothing simple about any of it. It is not easy describing the emotions evoked by being immersed in an Islamic culture. It is even somewhat mystifying to experience our own internal changes of perspective. My own knowledge about Turkey, Muslims, and the Islamic faith was limited to what I had heard and read in the media. I purposely did not attempt to educate myself before our trip in 2007, because experience has often been my best teacher. I did carry with me some doubt and skepticism—even a bit of suspicion. Our guides Attila, Hadi, and Resul were three young Turkish men who were attending a university in our home town of Lubbock, Texas. “We want you to see another culture and another religion in practice.” This was Attila's simple explanation. It turned out to be this and so much more.
Our trip to Turkey was less about health care and more about people— learning about people but also, and more importantly, learning from them. There was a strong focus on dialog, which simply stated is communication in order to understand. It is being interested in other people and their culture, country, way of life, and certainly their beliefs. The irony of dialog is that it can supersede language. Dialog serves as the key to the door that lies between us as people and as countries. Clarity comes as we realize that emotions, responses, and feelings share common ground. We saw how similar we are—probably more similar than we are different.
An Awe-Inspiring Journey through Turkey
Our journey began in Istanbul, the only city in the world that spans two continents (Europe and Asia), divided by the Bosporus Strait. We traveled to Izmir, where we had lunch with our sponsors in an outdoor restaurant on the shore of the beautiful Aegean Sea. We communicated with smiles, touches, and hugs, as well as through the interpreters.
Our travels took us to Cappadocia where we climbed into ancient cone-shaped stone houses. We then went farther south to the land of Abraham at Urfa, about 10 miles from the Syrian border. We sat on tiny stools and had tea in a unique store where we bought lovely scarves.
Our 11-day experience in Turkey changed our lives forever. The beauty of the country, the kindness of the people, and the uniqueness of the culture contributed to a rich experience in this land of ancient history.
Graduate Nurses Respond to Their Experience in Turkey
Three of the graduate students who went on the 2008 trip responded to a survey about their knowledge and beliefs about the people, culture, and religion of Turkey before and after the trip, and how their own nursing practice would be influenced by the experience.
Describe Your Knowledge of Islam Before the Trip
I had very little knowledge of Muslims. I only knew what I heard in the media. We studied various beliefs in high school but I still knew very little about the Islamic faith.
I was worried about safety and being so close to Syria and Iraq. I guess I had stereotyped all Muslims as being filled with hate. I grew up Catholic and feel at a disadvantage in regards to knowledge about most religions.
Limited knowledge. I had negative attitude towards Muslims—not trusting. I thought Islam encouraged violence and hate towards other religions.
What Fears Did You Have Before Going to Turkey?
Could I communicate? Could I tolerate the food? Were the people rude? Would it be clean?
Mostly about safety. I really had no idea what to expect.
Fear for personal safety, fear of the unknown.
How Would You Describe the People in General?
The people are the most service-oriented, generous, helpful, clean, caring, committed to their faith, people I have ever known. I envy their lifestyle in that they seem to be less hurried and more relaxed, and take life as it comes. Our guides’ saying “Don't worry” is a way of life for them.
Very kind, service-oriented, and in general glad that we were there. It was amazing the difference in customer service compared to the United States. They are very customer-oriented and go out of their way to make you feel welcome. When we arrived back in Houston I was quickly reminded how much we in the U.S. disregard customer service.
Hospitable, friendly, service-oriented.
The irony of dialog is that it can supersede language; dialog serves as the key to the door that lies between us as people and as countries.
The trip made me realize that all cultures have their beliefs, and that I should respect the beliefs of the patient and work at helping the patient to be comfortable while in unfamiliar and sometimes threatening circumstances.
In Relation to Our Trip, What Does Dialog Mean to You?
I believe dialog is “putting yourself there.” We were able to interact in a way that allowed us the opportunity to view their world. We were exposed to schools, hospitals, businesses, and history, in a way that we were able to actually learn how the residents of the country viewed these things. We were given the opportunity to go inside and eat with an actual family. We discussed various things, from world politics to their daughters’ educational goals. It was really amazing to realize the world is a small place.
Interacting and blending into the culture. I will say, to truly be culturally diverse and engage in true dialogue, both sides have to agree to compromise. For example, I was willing to try most of the food but I do not eat lamb, so at times I struggled. But when I wanted to eat American food, it was looked down upon. The dialog must go both ways in order to be truly culturally diverse.
The dialog opened my mind, eased fears and concern, and fostered mutual respect.
How Does Dialog Make a Difference in Your Thinking and Perspective?
I actually learned how the people thought about culture, their nation, etc. I believe to get to know a person, or a group of people, dialog is a necessity.
For me, it is grounding. Sometimes I get caught up in the fact that I travel internationally a great deal and that I must know more than the next person but really there is no difference. I try to be culturally sensitive and in countries like England and France, that is enough. However, in a country like Turkey I am not sure I will ever truly understand or appreciate their culture of subservience of women. I really struggled with this and at times almost insulted the women by asking them to join us at the dinner table. I'm not sure I will ever understand why the women cannot pray with the men. The differences are so stark, it is not as easy to understand or try to blend in. Maybe tolerance is enough?
I am not as suspicious of other cultures as I once was. It is hard to hate someone or fear someone whom you have taken time to dialog with.
Address the Change in Perspective You Experienced Regarding Culture, Health Care, and People.
Their culture is based on their history and faith. I did not know much about either one. I realized that they have a deep faith, but that the western world is “moving in.” The women do not always wear scarves, the younger girls dress much like our girls, etc. I admire the sense of loyalty I saw in the culture. I wish we had history like that! Their health care technology is much like ours. The nurses get very little respect, and it is still considered a “woman's” career.
I always feel really shallow and ignorant after making international trips. I quickly realize that I do not know anything and that every day is a learning experience. I learned so much about cultural differences and people in general that it was definitely a learning experience for me. The health care system to me was a different story. We went to a private hospital where they wined and dined us and showed us a video that had all the latest and greatest technology, but there were no patients in that hospital. I found that odd. I would like to have gone to a public hospital or a clinic to see what real health care is about. The same is true for the education system. We only went to private schools and what we saw was amazing, but it cost the average student $10,000 a year to attend. I would like to have gone to the public schools to get a truer picture.
Stressed the importance of living by the “Golden Rule.”
Was There a “Tipping Point” That Changed Your View of Turkish People in General?
I'm not sure there was one. I believe that since I work with various cultures, my views are pretty open. I have learned not to judge according to ethnicity. I judge more on how people use (or don't use) gifts with which they have been blessed. I began seeing the service orientation of the Turkish people when we arrived. They do the polite things (carry women's bags, open doors, etc.) because it is the thing to do, not for money. When speaking with the various business leaders, I noted that they were all about peace, and wanting to get along with other nations. I'm not sure if this is nationwide, but it was definitely apparent in the leaders we met.
I think for me, it was having dinner with one of the host families. They were the kindest people and so gracious.
We were greeted at the airport one night by a group that gave us roses and took us to our hotel.
How Have Your Feelings Changed About Muslims Living in the United States?
The U.S. is such a melting pot. I believe all groups of people should be able to live in the U.S. We are all foreigners, and should treat each other with respect.
Knowing the difference between the majority of Muslims and the extremist is huge. It seems rather obvious but when the extremists are all you see in the U.S. media, it is easy to forget.
Increased tolerance and understanding eased fears.
How Will the Trip to Turkey Influence Your Nursing Practice?
It helped me understand the deep roots of the Turkish rituals. It made me realize that all cultures have their beliefs, and that I should respect the beliefs of the patient and work at helping the patient to be comfortable while in unfamiliar and sometimes threatening circumstances.
I appreciate living in a country where women and their professions (especially nursing) are respected. I have admiration for the women in Turkey who went into the nursing profession for the same reasons I did but who have to fight the system for respect. I think it is important to remember that “the grass is never greener” no matter what country you work in. Americans may say they respect nurses, but my students tell me that they feel like the field of nursing is nothing more than slave labor. Do we really respect our nurses?
This trip has made me more aware of my own personal biases and behaviors. It has made me more culturally sensitive.
I have admiration for the women in Turkey who went into the nursing profession for the same reasons I did but who have to fight the system for respect.
Being on location and dialoging allowed us to see beyond our reach and to get to the heart, which we found filled with goodness, love, and peace.
Conclusion
The experience of being in Turkey made lasting impressions. None of us view Turkey, and certainly not its people, in the same way. The exposure to our Turkish guides, sponsors, and people in general caused us to rethink our beliefs about Turkey. Being on location and dialoging allowed us to see beyond our reach and to get to the heart, which we found filled with goodness, love, and peace. Dialog between the United States and Turkey, even in small ways, does in fact increase understanding of the people, culture, and religion.
Traveling to Turkey provided the opportunity to observe its magnificence and historical structures. Our dialog with the people brought understanding and acceptance that is beyond measure. We are not the same—We have new perspectives and new ways of thinking.
Footnotes
Beverly Byers, EdD, RN, LMT, MTI, is associate professor and MSN coordinator in the Department of Nursing at Lubbock Christian University in Lubbock, Texas.
