It was when a co-worker brought her ten-month-old baby to the office that something triggered inside Doris Butawan’s psyche. The sight of the baby–so similar in age to her own baby boy back in the Philippines–made Butawan, a Filipino nurse working abroad, sob uncontrollably for hours.
Butawan had been in London, England, for all of three months on that day 23 years ago, but it may as well have happened yesterday: the memory’s still fresh in her mind, the guilt of leaving her newborn baby, her three-year-old daughter and her husband in the Philippines still apparent.
As a nurse in the U.K., laying the groundwork for her family to pursue a better life, Butawan almost packed up her things that day and go back to her homeland.
“Faith is what got me through,” she said. Faith that she would be reunited with her family quickly, and faith that all her sacrifices will pay off one day.
Homesickness
On top of adjusting to a new country, new culture and a new work environment, Butawan battled with homesickness.
“I was missing my kids while trying to adapt,” she said of those early days. “If they see you’re not adapting, you won’t pass (the probationary period). I couldn’t go home, I couldn’t afford my plane ticket.”
Butawan counts herself lucky, as she was reunited with her family soon after, with her husband getting a nursing job as well.
Early Years as a Nurse
Butawan said that the immigration process as a nurse was easier back in 2000. Upon arrival to the U.K., she underwent two weeks of classroom training, a booklet to complete and was mentored by staff.
“Someone will watch me (do injections),” she said, of the process of being accredited as a nurse.
Starting as a general nurse, Butawan eventually developed back pain and injury, as she provided bedside care to patients. She then worked at a rheumatology clinic for 5 years, but was recruited by a consultant as a research nurse.
The short stint as an oncology research nurse led her to another path as a breast cancer care nurse, where she thrived being supported by a bigger team.
Compassionate Fatigue
As a breast cancer care nurse, Butawan said the job took an emotional toll on her.
“You’re there from the beginning (of the diagnosis) to the end of the treatment”, she explained. In one clinic, she said they had 5-10 breast cancer diagnosis a day.
Her work involved taking care of those who have just been diagnosed, those undergoing treatment, and those who are discharged. “I was the contact person.”
What really bothered her was breaking the news to 20-year-olds who have cancer.
“Naririnig ko pa rin yung iyak (I can still hear their cries),” she said. One of those patients was engaged to be married, but her fiancee left her after the diagnosis.
Another challenge is when she had to tell someone that they’re at the end of treatment options, that all options have beeen exhausted.
“That’s the hardest part,” Butawan said.
At first, she didn’t recognize she had compassionate fatigue. Butawan’s symptoms included not being able to tolerate noise, not having any energy left at the end of the workday, no energy for housework.
It wasn’t until after a speaker during one of their training days talked about compassionate fatigue that she realized she was suffering from it.
Language Barrier
“Although we speak English, I cannot understand their accents, especially those (who speak) with heavy accents,” Butawan said.
She recounted some instances where slang phrases and colloquialisms were misunderstood.
“An elderly patient said she wanted to ‘spend a penny’. I didn’t know that that meant she wanted to go to the bathroom.”
She didn’t think a “jumper” meant a sweater, and there was some confusion when she couldn’t find equipment such as a blood pressure machine (Philippine hospitals use a different kind), or when she made a makeshift splint, the way she was taught in the Philippines.
Butawan’s current job doesn’t deal as heavily on front-line care with breast cancer patients, and with part of her work in public engagement, she said she enjoys her work more.
Her willingness to learn, her resilience and her capacity to keep a positive attitude led her to achieve a successful career as a nurse in London.
