A Nurse First

Mission: Heal

• Sigma Nursing • Season 6 • Episode 2

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Regina Yuen took a leap of faith when she accepted her first mission with Doctors Without Borders, stepping into the unknown in South Sudan. Faced with a new culture, limited resources, and the challenges of humanitarian nursing, she quickly learned the power of adaptability and teamwork. Her experience reshaped her perspective on global healthcare and solidified her passion for making a difference in the world’s most vulnerable communities. 

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I began my journey in Detroit, Michigan in a level one trauma center and so came in as a new grad to the emergency department. There was a lot to learn, but I was very, very fortunate to have a lot of great colleagues and a lot of great educators on my side. I was about three years in and we had gone through the first and second stages of COVID and I had said, okay, I think I need a little break from emergency medicine. I was actually quite burnt out. I was really interested instead about public health because from the emergency department, we see a lot of the failures within the public systems. And so with people that are unhoused, suffering from addictions, with food insecurity, and these were things that made me very, very passionate about public health because I Welcome to A Nurse First. This is Regina Yin, Soon I made my way through the Canadian Arctic and Yellowknife, Northwest Territories of Canada, to work in public health. And there I was for six months in the cold of the Canadian Arctic, and unfortunately we see a lot of tuberculosis, double the rates in the Canadian North as opposed to the Canadian South. And so this was working within the indigenous populations, which were very passionate about And so after that, I was really interested in, of course, also with emergency preparedness. And so that led me to do some travel nursing between the Canadian Red Cross and in British Columbia and in California. That was also during COVID, where we had supervised a COVID swabbing clinic at an international border between Canada and the U.S. And I was also very interested in seeing different aspects of health systems, given that both Canada and the U.S. have decentralized systems. I was able to go to British Columbia and go to California as well to see how different places functioned. And I think at the end of it, it all really comes down to where you live geographically with the social determinants of health and how people are accessing health care. This is something I realized that really pushed me to do my master's in public health so that I can learn more about the macro, learn about the overall system, and finally with also in the concentration with humanitarian health so that I could focus on accessibility to healthcare in remote or conflict settings. I became interested in Doctors Without Borders when I was attending university. I completed my Master's of Public Health at Johns Hopkins University just one year ago, and so there are these amazing student conferences where there's a lot of professionals from different career pathways within nursing. They had talked about their experiences in the field, and I had never thought about a career outside of my national border, let alone somewhere so remote or somewhere that had such challenging perspectives. And so that really, really piqued my interest. After that, I looked on the website. I reached out to what they had called an informational interview, where we just reach out on LinkedIn and I just talk to anybody that I can think of that was within the organization. And they provided me a little bit of the context of what it was like working in this sector. Doctors Without Borders is different from other organizations, and this is what I was really drawn to them, is that they're an independent organization. which means that 95% of their funding comes from independent donors as opposed to governments or typically within aid organizations. They are able to respond, they're able to do their needs assessments and respond to emergencies immediately. They have their principles that they stick to, the medical ethics, independence, impartiality, and neutrality, which means that they don't discriminate regardless of age, sex, sexuality, and they provide aid to people that need it regardless. That leads the way for them to provide the aid that they want, to provide the aid that's needed, and for populations that may not always be accessible. And Applying for a position with Doctors Without Borders was both a leap of faith and the culmination of Regina's drive to connect nursing and public health in a meaningful way. The prospect of living and working in South Sudan was both thrilling and daunting, yet Regina knew this was exactly the kind of challenge she had been preparing for all When I first learned that I got the job, I was ecstatic. At that point, I had graduated from my master's, and I was feeling a little bit lost, to be frank, because my master's was in public health, and it seemed really monumental at that time to bridge the gap between nursing and public health, despite everybody, you know, a lot of my professors and a lot of the professionals I had met saying, your work is so important, and it's so pertinent to public health. But it seemed really difficult at the time when I was applying for jobs. And so this was the dream. This was something that I wanted for a very, very long time. And so when they told me I had got the job, I was just thinking that, OK, no matter what happens, my dream has been actualized. And whether it's a good or bad experience, I know that my hard work has paid off, one. And two, I'm going to be doing something I'm very passionate about, which is ensuring accessibility to healthcare for people that need it most. So my first mission with Doctors Without Borders in South Sudan, I was acting as a nursing activity manager. So typically within that role, it's more about capacity building and health system strengthening, which means that there are nurses everywhere around the world, and so of course we don't need to be importing foreign nurses to other countries to help, but it's more so providing skill sets, providing knowledge, and ensuring that the nurses have the resources to do what they need to do to provide quality patient care. This project has actually been around for a long time. And so, of course, there are projects where there are very, very quick, emergent things happening because they're an emergency, and whereas projects that are what we call considered a regular project. In this instance, it was a regular project, they had been established, and hitting the ground running was that I was getting a handover from my predecessor. Mentally, I would say that because I was lucky to have met some friends that had worked there, I was lucky to have spoken also to a nurse that was in the field in the same project, and they provided, I think, a lot of contact. Unfortunately, regardless of how prepared you think you might be or how the advice that people give you, until you see it for yourself, you never truly understand. And so I think I came in with the expectation or I prepared myself by thinking that, OK, no matter what happens, no matter what gets thrown at me, I'm just going to come from a perspective of, OK, I'm going to learn. I'm going to listen to my colleagues that have more experience than me. And I'm going to take it one day at a time. And we're going to solve it as a team. When you first arrive, there's a lot of information coming at you. And, you know, it can be quite overwhelming at first because you're learning about a new country, a new culture, and a new health system. And most importantly, of course, you have to learn about the community that you're helping. And so, of course, this is something that you have to keep in mind to ensure that people feel safe, that you establish trust within the community. And so I really, really paid attention to those reports so that, of course, to help bridge that gap, to ensure the positive relationships within that aspect. And you meeting your team for the first time, and depending on the project that you go to, it can be a really small team, it could be a really big team. In my perspective, in my experience, it was a big team. And so, of course, meeting everybody, getting everybody's stories, which is something that I really, really enjoy when I'm first meeting people and understanding where they're coming from, their livelihood, their life story, and their journey. I spent a total of six months in South Sudan and the majority of the time, of course, I was managing nurses in that I was providing education, looking for any gaps, asking their input on, you know, is there any training that you think would be advisable and working alongside the nurse supervisor. A day in the life during my mission would be, of course, getting up, having breakfast, getting dressed, and typically the temperatures there were very, very warm. It was from 43 to 45 degrees Celsius. And so, of course, we'd have to wear something that was relatively light so that we didn't overheat. And, of course, getting ready, ensuring that I have all of my materials. have lots of water packed, and then off we went. So, depending on which hospital you worked in, you have scheduled car movements, or you can walk. After that, we would check in, do rounds of the wards that I was overseeing, check in with the nurse supervisor, check in with the nurses, and kind of start going through the process. And then, of course, ensuring asking the nurses what they needed for the day so that they could succeed. and making sure that we have some of the administrative processes down, ensuring we have the resources that we need, and just checking over some charts to ensure that the treatments, the medications that we had were around. The status of nurses in South Sudan, I would say that it's difficult because the health system is still fractured. There's a lot of factors at play, including less resources than what you're used to. The day-to-day was ensuring that our infection control practices were good, trying to think of new ideas, trying to improve maybe infrastructures that would make things a little bit, or make maybe tasks a little bit faster for the nurses, to try to find ways to innovate and to think of how can we best promote this, how can we best promote best practice. Essentially, we want to work ourselves out of a job so that once things stabilizes, we can leave the country, we can leave the project with a clear conscience in our mind saying that, okay, you know, now they're going to be able to take over and provide help. Every now and then I think, When people heard about my work, they said, oh, you're going there, you're going to be helping all of these poor children, people that don't have food, that are experiencing food insecurity, and you're going to be going there and helping them and providing aid. But it's not necessarily true. It's just as much of a privilege for me to be there, to be working. And it's definitely a collaboration. 90% of the staff are national staff. We don't need to be importing foreign nurses and doctors to be working there on the front line, right? This is more so for you to be providing knowledge, and it's a collaborative effort because I'm learning as well, and the national staff are teaching me just as much about what to do in the field. I was really grateful that my team, again, was very experienced. With an MS casualty incident, there's a lot of things happening with a lot of people. And so, of course, these are situations that you have to collaborate, that you have to think fast, and that you have to be really, really calm for because people are relying on you during a difficult situation. We were able to work through the situations together to ensure that people were safe or even just within the situation that it was the best outcome possible. Adapting to a context where anything might happen at any time, of course, is part of the job and that's what makes the job so exciting as well. But it's also something that you have to be ready for 24-7. If somebody comes knocking on your room at 11 o'clock, at 3 o'clock, 4 o'clock, saying something happened, then you have to be ready to just get ready quick, think quickly, and respond. When somebody comes in, they're very, very sick and they're critical. You're used to having everything under the sun and doing everything under the sun. And so when you don't have these resources and you're doing the basics, which is really just starting an IV cannula and running some IV fluids, and it's shocking the amount of times that people recovered from just these services. I think when I think back on my experience and I think about the patients that I have seen, The caregivers that they have that were so resilient and at the bedside and providing such important care that was based in community. What did this experience teach you about yourself? During this mission, what I learned about myself was other people's resilience and my own resilience. I think that going in, of course, there are certain criteria that you need to meet and certain questions that they force you to ask yourself to ensure that you're ready for the mission. And until you get there, you think, OK, well, I've been through this experience. I've been through that experience. I'm hoping that it provided enough experience for me to now go and provide care in a more difficult context. But you never really know until you get there. And so I would say until you arrive, you don't know how you're going to be facing situations head on. And in that, when I saw the project, when I saw what was going on and learning about the history, I was so amazed by the resilience of the population and just frankly, you know, how sick people can get and how quickly they can recover despite the illness. And so within myself, when I was dealing with very difficult situations in the field, Every now and then I do have some imposter syndrome and say, well, I've never been through this before. How am I supposed to tackle it? And then we do. We rise to the occasion because in the field, that's what it calls for. When I was young, I had a lot of thoughts about, OK, well, only if you studied this, only if you had this very specific type of experience, then that's only that's what you can achieve. And it's not true. And nowadays, there's so many experiences, especially with globalization, that it can take you so far. And especially within the nursing career, when I was in school, I really only knew about bedside. And now I know that there's nurses that can work internationally, i.e. that nurses can work within telehealth within communities. And so I think it's so important to not hold ourselves back and use that viewpoint of, hey, I can do this. I've mastered this at work, and now I can tackle the next thing. And those skills that I've used, Thank you for listening to A Nurse First from Sigma. If you loved this episode, do us a favor and subscribe, rate, and leave us a review. It is very much appreciated. For more information about A Nurse First and Sigma, visit