by Zach Read - firstname.lastname@example.org
Minh Nguyen’s second year of medical school at UNC consisted of the usual challenges students face: learning complicated physiological and medical concepts, applying that knowledge in a clinical setting, and finding ways to create much-needed downtime amidst a full, rigorous schedule.
At the same time, it contained an unusual challenge: responsibility for his younger brother, Tri, who came to the United States from Vietnam as an eighth-grade international student to live with him in Raleigh.
“I became like a dad,” says Minh, a wide smile forming on his face. “It was great.”
Minh had many parental responsibilities that year. Before commuting from Raleigh to Chapel Hill to get to classes and small groups by 8 a.m., he made sure Tri arrived at Neuse Christian Academy on time. He attended Tri’s soccer games and even taught Tri to cook for himself.
“One of the proudest moments I remember experiencing was a time I was busy with school and running home late from Chapel Hill,” Minh recalls. “Tri called to ask me what I wanted for dinner. I’d spent a lot of time teaching him how to cook because cooking is a hobby of mine, and he put together a great meal. By the end of his year with me, that became a common experience.”
Being a Mentor
When Minh first learned that Tri was coming to the United States for a year, he could have encouraged him to go to Houston, Texas, where their middle brother, Trac, their uncles and aunts and cousins, and their grandmother live. Instead, he insisted that Tri come to North Carolina.
“I wanted him to stay with me so that I could emphasize use of English,” he says. “We have so many family members in Houston that it would be easier for him to speak Vietnamese. By coming to North Carolina, the only person he could speak Vietnamese with was me. It forced him to focus on his English.”
In Minh, Tri had a valuable resource to tap when it came to navigating school in a new country. In 2004, Minh left Vietnam to spend his junior year of high school in Salem, Oregon. He reapplied for his student visa and did senior year in Watertown, New York, a small city located an hour north of Syracuse, near the Canadian border. His experiences as a high school student in the United States helped him develop his English and changed how he approached education.
“In Vietnam, when it came to studying English in school, we mainly focused on grammar and writing,” he says. “We didn’t have opportunities to converse as much. Living with American families was invaluable for me because I had to make conversation. Studying in American classrooms also taught me to become a more active learner – in Vietnam the learning is more passive.”
Minh emphasized those differences to Tri.
“I explained that if you want to find an answer, you need to look for it,” he says. “That’s the biggest difference between the educational systems. In Vietnam, they push information at you for you to absorb. Here, they give you an adequate amount of knowledge, but if you want more, if you want to be successful, you need to look for it – you don’t want other people to tell you the answer.”
Caring for Others
After finishing high school in Watertown, Minh lived with his family in Houston. In summer 2007, two of his uncles moved to the Triangle area of North Carolina to open a business. Minh went along with them.
In Raleigh, he enrolled at Wake Technical Community College. An interest in health care led him to take a few prerequisites for medical school in case he decided to study to become a doctor one day.
“Medical school is a big decision -- I didn’t want to rush into it,” he says. “For me, it made sense to take a few courses I could apply toward it so that I would save time later if I decided to go in that direction. During that year at Wake Tech, though, I realized I wanted to care for patients, but do so as a nurse. So, I transferred into the UNC School of Nursing.”
At UNC, in addition to his educational requirements, Minh found a way to provide service to people and communities in need in Vietnam. In 2010, as a senior nursing student, he received the inaugural Cronenwett Global Study Award, named after UNC School of Nursing Dean Emeritus Linda Cronenwett, whose passions included improving quality and safety in health care.
As part of his project, Minh spent a month at a hospital in rural, northern Vietnam working with the Project Vietnam Foundation, a nonprofit organization whose mission is to improve the health and health care of people living in underserved rural communities in Vietnam by providing volunteer health care services from physicians, nurses, students, and other health care professionals.
His project focused on educating health care personnel about the importance of hand hygiene in reducing infections at a 1,600 bed hospital.
“One of the big problems I found was that it was very overcrowded,” Minh remembers. “A room might have six or seven patients in it, and the family has nowhere to stay, so they sleep on the floor. I understood that I couldn’t help implement widespread change at the hospital, so my goal was to raise awareness about hand hygiene’s role in infection prevention – why to do it, when to do it, and how to do it.”
The Burn Intensive Care Unit Nurse
Minh graduated from the UNC School of Nursing in 2010. He received job offers in the Medical Intensive Care Unit at Moses H. Cone Memorial Hospital in Greensboro, the Cardiothoracic Intensive Care Unit at Wake Forest Baptist Medical Center in Winston-Salem, and the Burn Intensive Care Unit (BICU) in the North Carolina Jaycee Burn Center at UNC Medical Center in Chapel Hill.
He chose to work in the Burn Center because of professional challenges it presented. At first, he admits, he was anxious about the level of responsibility and the various demands associated with caring for patients in the BICU.
“They are very sick, and it is a very physically demanding place to work,” he says. “The patient requires total care. With all the fluid they are administered as part of their treatment, they become swollen and slippery and require frequent turning. It is one of the most physical jobs you can have as a nurse.”
Samuel Jones, MD, associate professor of surgery at the UNC School of Medicine and associate director of the Burn Center, agrees.
“It is physically, mentally, and intellectually taxing,” says Dr. Jones. “It requires a tremendous amount of commitment and dedication from nurses just to do their job, and we as a medical staff lean heavily on their expertise and insight and collaboration in helping us take care of these particularly ill adults and kids that we encounter on the unit.”
According to Bruce Cairns, MD, John Stackhouse Distinguished Professor of Surgery at the UNC School of Medicine and director of the Burn Center, intense multidisciplinary interaction is critical to properly caring for patients in the BICU. Surgeons, nutritionists, pharmacists, physical and occupational therapists, nurses and other health care professionals must collaborate effectively to ensure that appropriate and timely interventions are made that protect patients’ well-being.
“The BICU is an extraordinarily complex place,” says Dr. Cairns. “Nurses have to be able to recognize when there’s a change in the patient because if you allow that change to develop over time, even briefly, it could cause a serious deterioration that may make it very difficult to recover from. The person who represents that process is the experienced, knowledgeable, engaged ICU nurse because they are the ones who coordinate these various disciplines working together. We, as physicians, rely on that experienced nursing capability and judgment to allow us to address all of the elements and aspects of the very complex burn patient. It was in that context that we met and worked with Minh.”
A Place Where Miracles Happen
The world-renowned Burn Center takes the most complex burn cases that occur in North Carolina and the southeastern United States. Minh navigated the emotional toll of caring for such patients by remaining positive.
I think about the Burn Center as a place where a lot of miracles happen -- where patients have burns covering 80 to 90 percent of their body and where some are there for extended periods of time...but survive.” --Minh Nguyen
“One reason it’s so difficult to work in the BICU is that you have patients who don’t survive,” he says. “They may be there for months and not make it out. But I tend not to think about those cases. I think about the Burn Center as a place where a lot of miracles happen – where patients have burns covering 80 – 90 percent of their body and where some are there for extended periods of time, including more than a year, but survive.”
For Minh, focusing on the nurse’s role in creating positive patient outcomes throughout the recovery process was sustaining.
“As a nurse, it’s an incredible feeling when they walk out the door after being there for months,” he says. “You see them going through all states – from being critically ill to getting up for the first time to making the first step to walking out that door to coming back to do physical or occupational therapy. That was the rewarding aspect of nursing – after being there for them throughout their experience you get to be there for those moments.”
In addition to the medical professionals who comprise the BICU care teams, Minh credits his patients and the unique relationships nurses form with them with helping him be successful on the unit.
“We spend so much time with them that we develop personal connections,” he says. “We think that we’re the ones helping them but we quickly learn those personal relationships also end up helping us.”
He’s Lived It
As a nurse in the BICU, Minh gained understanding of the complex medical and physiological issues many patients face in ICU care.
“It was incredible,” he says. “You realize how amazing the human body is. I remember thinking, ‘Wow, it’s a perfect machine.’”
After three and a half years in the Burn Center, Minh’s interest in expanding his scope of care led him to pursue medical education at the UNC School of Medicine. Dr. Jones recalls when Minh first approached him about his interest attending medical school.
“I remember it vividly,” Dr. Jones says. “We told him that we would support him and foster and mentor that growth. When we had patients in common we would go more in depth about their physiology to see if that was something he was curious about because that passion and curiosity is a key characteristic that people in medicine value.”
Dr. Jones also saw that nothing scared Minh – and that he possessed many traits that would one day translate well to medical school and being a physician.
“He was very fearless, battle-hardened, and team-minded,” says Dr. Jones. “We appreciated all those traits about Minh, and for those reasons we thought he would do very well in medical school.”
Dr. Jones believes that Minh gained invaluable experience in collaborative health care while in the Burn Center – experiences that set him apart from students who enter medical school on a more traditional path and that reflect the current trajectory of health care in the United States.
“He understands that it’s not the physician on the mountaintop waving his hands producing better patient outcomes,” he says. “Being a physician today is a team-oriented career. It takes a village to achieve good patient outcomes. It’s hard for someone entering medical school to know that if they haven’t lived it. Minh has lived it before he even steps in the hospital to start his clinical rotations. You can’t prepare anyone for that – they would have to experience the clinical environment as Minh has.”
The Global and the Local
As a nursing student, working with rural, underserved populations in Vietnam held additional meaning for Minh. His parents both hail from areas similar to the one in which he applied his skills, and only moved to Saigon in the mid-1990s because opportunities for families in rural areas were scarce.
Minh’s global experiences shape his perspective today. After the Vietnam War, Minh’s grandfather served in a re-education camp, set up by the North Vietnamese, for men who worked for the South Vietnamese government.
“He was there for about a decade,” Minh says. “He suffered a lot from it but survived it. My grandma, meanwhile, who lives in Houston now, a tiny woman, raised eight children by herself during that time. Through those years she was strong enough to hold a family together. She was an iron woman, and I look up to her so much.”
Minh also admires both his parents for the opportunities they provided for him and his brothers and his family in Houston for carving out lives in the United States. Their example demonstrated for him an adaptability that he carries with him today.
Dr. Cairns recalls early conversations about Minh’s interest in medical school. He asked Minh to tell him about himself – he wanted to learn more about the context that was leading Minh to his decision to become a doctor.
“He shared with me his life story,” says Dr. Cairns, who has been working with Minh on a project that would enhance collaboration between first-year medical students and ICU nurses in an effort to develop interdisciplinary care early in students' medical education. “To me, it made everything crystal clear that Minh had to go to medical school because he has the personal experience, along with the capabilities he displayed in the Burn Center, that allow him to sympathize and empathize with all patient populations. When I think about the kinds of students we want to have at UNC, there was absolutely no question in my mind that every citizen of our state would be proud to have Minh Nguyen in our medical school.”
Two years ago, Dr. Cairns met Minh’s family at the White Coat Ceremony for first-year medical students – an event that marks students' transition into medical education.
“It gave me a fuller perspective on the global experience he brings to the table and how it can be valuable in North Carolina,” says Dr. Cairns. “Minh came to the U.S. and pieced together a career in a structured way without anything being handed to him. He adapted to the health care environment in North Carolina and its challenges, which include having one million underserved North Carolinians and a wide, diverse population. Minh never talks about his own perspective in getting to where he is, but it’s manifest in everything he does, so he’s able to use his own experiences and his understanding of North Carolina to help patients and colleagues, and be trusted by them.”