Jenni  works at KFSH&RC in Riyadh. She started in September 2011

Why I chose Saudi Arabia?

My original intention was to find a job in England (London) because one of my friends lives there. However, Professional Connections recommended Saudi Arabia to me, a country that I had never considered before. In hindsight, choosing Saudi was an excellent idea - I'm very happy to be at KFSH&RC in the capital city, Riyadh. After the spark that I got from Profco, I started to think that if I'm to go and work somewhere else for at least a year - with the motive of learning and experiencing something new and different - why not go all out and experience a completely different culture and climate. England (or anywhere in Europe for that matter) began to seem less exotic as, in the end, it would be culturally rather similar to what I'm used to. I have to admit that the warm climate, as well as the promise of a better salary, played a pivotal role in my decision to come here. But, early on (I've only been here little over two months) I learned that there are other perks as well; namely the fantastic opportunities to travel. So far I have only travelled to Jeddah, a large city in Western Saudi, on the coast of the Red Sea. I flew there with a couple of my Finnish colleagues from KFSH&RC for a weekend trip. It takes only about an hour and a half to fly there, and the tickets are very reasonable. After completing the three-month probation period at the hospital, you can travel abroad as well. You can also begin to use your vacation days. I've planned that after my three months come up, I'll go either to India or Thailand. The flight connections from here are superb. You can travel all around the world easily from here, and the distances are relatively short regardless what your destination is - Saudi is located in the centre of everything so to speak. Then of course there's also the neighbouring countries like e.g. Yemen, Oman, Qatar, Bahrain, Jordan, and UAE that you can get very cheap flights to. Because the flights are so short (approx. 1-2 h), it even allows you to make a mini-vacation out of your weekend off (without wasting the bulk of it on travelling).Working in Saudi is also lucrative in terms of the good salary which, most importantly, is tax-free. I get paid a little over 3 000EUR/month. (The salary depends on which ward area you work in and your nationality). Although money has probably been an incentive for most nurses that come here from abroad, it's by no means the only one. I have noticed that you can basically divide the group of nurses into two. One group has clearly come here to concentrate on the work and to save money. This is a very viable option if it's what you want to do. Many have a quota for what they want to get saved in a month. Sometimes they are saving for something specific, others send money home to their family. It is very easy to earn extra money by doing extra shifts if you want to. Saving here is easy as the living doesn't cost anything. The hospital pays for the housing which includes all the basic necessities (you pay for the phone and your own internet connections yourself). Food is also much cheaper here than back home. An important motive for the other group of nurses has probably more to do with gaining new experiences and seeing the world than merely saving money. And saying this, it is also extremely easy to spend money here - whether it be on travelling or on various purchases as the shopping opportunities are splendid. I learned from my Finnish colleagues that due to my work permit in Saudi Arabia, I could by e.g. a tax-free computer from Finland when I go back home for my holiday. Personally, I intend to get some money saved of course, but first and foremost I want to gain life experience during my stay here. I want to travel and see the world, and I'm willing to part with some of my salary to do so. My goal is to seize the incredible opportunity to visit many of the surrounding countries during my stay here. It is really easy and rather cheap to realise my wish to explore the Middle East from Saudi. I don't think I would fly to e.g. Oman from Finland, but now that it's right next door, I'm bound to go.

Butterflies in the belly - dealing with the only too natural apprehension on embarkment?

Anything new is always scary, and it is normal to have butterflies in one's belly before leaving to a new country (especially if one hasn't experienced it before) -and this was the case for me too. However, after the first week here, I remember thinking that I was so glad I decided to come. I had some problems with receiving my luggage, and this was a bit of a setback for my first impressions. But now it's just a faint memory, and I have no regrets about my decision to come! I believe coming to Saudi is a very educational experience as my language skills are developing all the time, and I get to work and live in a multicultural environment. I am positive that my time here will play a significant role in my personal growth. Saudi offers a chance to travel and experience the world, and thus to widen one' s perspective. So, even if you feel a little nervous and worry about "the unknown", I warmly recommend Saudi to other nurses that want to experience the same things as me. You can always think of it like this: If you really don't like it, it's not like you can't get out of here - so don't let minor butterflies deter you from coming!

The Application Process?

The application process wasn't very difficult in my opinion. There was a lot of paperwork to be sure, but in a way it prepared me for the paperwork characteristic to the local (Saudi) style. Of course it was relatively time consuming but as time passes these memories fade into the oblivion - it hasn't been something that I've remembered over here. I don't see the application process anyhow overpowering, and I would definitely go through it again in order to come here. Profco supports you very well with all the paperwork. I think that it was good preparation to the Saudi customs, since taking care of any official business here will require you to fill numerous forms. Furthermore, I learned that the application process, with all its study materials and various application forms, has come in handy for my work here, because it allowed me to prep up my English (especially specific medical terminology). The hospital uses a lot of American abbreviations, which even the native English speakers might struggle with if they haven't worked in a hospital in the US. We went through all these terms during the GNO (general nursing orientation) at the hospital. I takes some time to learn these, but you get used to them -don't worry.

Arrival?

As I already mentioned, I was naturally very nervous when I set off to Saudi. After all, I was going to country that is culturally very different from home. I didn't, however, experience any straight out panic, and my mind was set on going throughout the process.The arrival itself didn't go quite according to plan. I arrived in the middle of the night (around 2 am) and I was tired. When I reached my destination, I found out that my luggage hadn't been as fortunate as me. The hospital had arranged for an Arab man to be my meet-and-greet person at the airport. This tired looking man (unsurprising considering the hour) helped me solve the mystery of my disappeared luggage. Most likely due to my numerous connection flights, my bags had travelled to another destination. At that moment this inconvenience felt unbearable - I had all my stuff in those bags and I was extremely upset. However, one positive aspect about my arrival was that I found my ward manager-to-be in the car waiting for us outside the airport. She was extremely nice and empathetic and she understood my situation completely. Since I had almost nothing in my hand luggage, my ward manager suggested that we'll make a pit stop at her apartment before driving to mine. I was able to have a shower (which notably included the use of a towel since I wouldn't have had one myself) and she kindly gave me some clean clothes to change in. I actually got a crash course into the hospitality of the people here - they're extremely nice and helpful. My flat mate and the girls in my GNO loaned me a lot of clothes and make-up, and I bought some necessities like a toothbrush from the store. So in the end, it was relatively easy to patch the void created by my misplaced luggage (which I got back four days later). It's not like you couldn't get everything that you need from here, but of course you want some of your personal things too. My suggestion is that you pack as much as possible into your carry-on luggage, especially things that you think you need for the first few days. Even the Compound where I live has it's own store where you can get food, make-up, sun tan lotion etc. Then we also have a supermarket down the street within an easy walking distance (comp. with Tesco or Walmart).A further inconvenience on arrival was that due to the hassle with my luggage was that I ended up only getting about two hours sleep before I had to get up for the first day of orientation at the hospital. Being exhausted, I had a moment of despair when I thought I had made a huge mistake in coming here. These feelings blew over quickly though, and I'm happy to say I don't regret my choice in the least. The first weeks are rather hectic because you need to take care of all the practical matters (eg. photos and forms for your ID badge) and become acquainted with the new environment. It becomes a lot easier when you start your actual work routine. The cultural difference is of course quite drastic, but I didn't feel that it was too overwhelming -you get used to it very quickly!

Accommodation in Saudi?

I've been extremely pleased with my compound and its services. A compound is a private set of apartment buildings surrounded by a perimeter wall. There are security guards who monitor the comings and goings in and out the compound - no unauthorised person is allowed to enter the community. Even the taxis are stopped to check that it is a familiar driver and that the passengers are known to the guards. Within the confines of the compound as well as homes there are numerous other facilities available to residents (pool, shop, gym etc.). Due to the nature of life in Saudi Arabia there are many benefits in living on a compound. No men are allowed into our accommodation buildings - it's only us ladies here. Because of the cultural backdrop, this allows us more freedoms. Within the houses we can dress as we please. The houses form an enclosed courtyard with a swimming pool where we can be in bikinis and enjoy the sun. Our compound is located on the hospital grounds. The hospital is located in the middle and the housing is spread all around.I share my apartment with another nurse. She is from South-Africa and we became friends immediately. I have my own room, a walk-in closet and a bathroom. We share the kitchen and the living room. The kitchen has all the utilities; stove, microwave, fridge, water boiler, dishwasher etc. I don't have anything to complain about the flat - it's a neat basic appartment.Getting around It takes me about two minutes to walk to-and-fro from work, which is a definite bonus after a long day at work. Most of the foreign employees in KFSH& RC live on our compound, but some live a little further off as well. In this case, the hospital arranges the transportation to-and-fro from work. It is really easy getting around here. Women aren't allowed to drive in Saudi, but whether you want to go shopping, to visit your friends outside the compound, to a party or anywhere, you can just call a taxi. The hospital provides us this taxi service (Hala-taxis). It is very easy to use, it is reliable and it is rather cheap. It costs about 5-6 EUR for a 15-minute drive.  If you share the taxi with a couple of girls, it's really cheap. Getting a taxi is really easy as well. You just call the taxi service centre and they'll send you a car for you at the agreed time. After you get here, I'd advise you to find yourself your "own personal driver" amongst the Hala-taxi drivers. Even though the Hala-taxis are reliable and safe, I at least feel more secure having a driver that I know. My personal driver has a long history of driving Finnish nurses here. I got his phone number from the other Finnish nurses here. So when I need a ride, I'll just call directly to him. If he can't make it himself, he'll arrange for one of his friends to come in stead. The personal driver helps with practical matters as well - they'll know to tell you about the city; where to go and how things work. Some people like to use the Hala-taxis also for very short rides and would take one to the local supermarket as well - and you can do this without any problems. I tend to walk this distance myself. I might consider taking a taxi if I was planning to have a lot of purchases. In the beginning I had my doubts about walking outside the hospital area by myself - this was just because I didn't know how things are done here. But now, I don't see any problem with it. I wouldn't necessarily go wandering around by myself after dark, but if you go in the middle of the day it's absolutely alright. I'll go and run my errands both by myself and with the other girls. I don't feel unsafe when I go alone. The other evening I went shopping for Christmas presents alone (I also walked outside alone) and I had no problems whatsoever. Sometimes when you set off to go and get something specific, it's just easier to go by yourself. Then you don't have to compromise about which shops or services you visit. But a lot of the time I go and shop with the other girls - it's a way to spend time together, the taxi costs are split and of course many girls feel safer in a group.

Clothing?

The dress code differs quite a lot from back home. A woman is required to wear an abaya (black robe like dress) out in public, men are also expected to wear long trousers in public. You don't have to cover your hair, but you should always carry a head scarf with you. This is because a muttawa (religious police) might stop you (on the street or in a shopping centre for example) and ask you to cover your hair - a request that you have to comply with. The dress code is more lax on the compound and the hospital grounds. The basic requirement here is that you don't wear body hugging or revealing clothing and that your clothing should cover your knees and elbows. I've learned, however, that the abaya is an easy choice here too because you don't need to think about what you're wearing (you could be wearing only your underwear under it and people around you will be none the wiser). There's no dress code within the buildings and in the courtyard (for women only). So there you can enjoy the pool and sun bathe in your bikinis or dress however you like.

Spending your free time? Shopping?

You can find absolutely everything here. When you visit a shopping centre, you'll quickly develop needs to buy stuff that you didn't even know that existed before. The shopping centres, or shopping malls as they're known here, are enormous. They'll have numerous floors and some are skyscrapers. You can easily spend three or four hours in a mall and realise that you've only seen one small section of its countless stores and services. I have so far visited the Panorama Mall, the Sahara Mall, the Riyadh Mall and the Hayat Mall. I think there's around 30 malls around here. The Panorama Mall is only a walking distance away from my compound. It takes about 20 minutes to get there on foot. Even the American girls have been impressed by the size and selection of the malls here, and as their malls back home are also known to be grand, I think this describes well the sheer size of these complexes. You can find all sorts of shops, chains and brands here. Something that caught my eye was that American brand names are extremely visible. You can find any known label easily. Actually, you can find anything ranging from the most expensive products to a wide array of very cheap products. For example, you can find the basic H&M and ZARA everywhere, which I'm used to shopping at back home. You can also find a wide selection of sports clothes (e.g. Nike, Adidas, Puma, Quicksilver etc.). And there's an incredible selection of shoes! In addition to what you'll find at home, the local fashion is also well represented here. There's shops that offer everything from a to z when it comes to colourful and sparkly clothing - you can see diamonds and rhinestones in all shapes and sizes everywhere around you. In other words, Riyadh's shopping facilities have everything that you could possibly want. What is really different from back home is the amazing selection of evening gowns they have over here. You can find the most incredible evening gowns! I had never seen such beautiful dresses before I got here. And although you'll surely be able to find extremely expensive designer creations, a lot of the dresses are veryreasonable.

Social life?

There's a number of opportunities to wear an evening gown as well. There are a number of formal occasions arranged in the Diplomatic Quarters for expats, where women dress up in beautiful gowns and men in suits (black and white tie). I had never been to a ball before coming here, but here these formal occasions are rather common. So far I've only been to one of these social events called "The Red and White Ball". It was organised by the Canadian Embassy, and it included a formal dinner, music and an actual ball. The next formal social event I'm attending is at the Finnish Embassy on 6th of December. This is a ball organised for the Finnish Independence Day. You can choose to party, to shop, to travel, to do sports, go on excursion, or you can also come here just to work.

Sports

If you're into sports, you'll be glad to hear that there's a good selection of activities that are easily accessible. It is very easy to go to the gym here as almost all of the houses have their own one. I live on the fourth floor and when I feel like exercising, I'll just take the lift to the basement and find myself at the gym. My gym is rather small but it includes all the basic equipment. There's a bigger (and better) gym on the compound as well. The compound is extended all the time and as gyms are more and more popular, the newer buildings try to cater to these needs. The membership for my gym is extremely cheap - only 6EUR/month. The bigger gym will cost you a bit more (15EUR/month) but it's also cheap compared to the prices back home. The bigger gym has a mirror hall as well, where they organise exercise classes (e.g. yoga, aerobics etc.). You pay separately for the classes (20-40 EUR/month). You'll find recreational centres all around town. Sometimes I go to a big centre located in the Diplomatic Quarters with a Finnish friend. They have the same classes that I used to go to back at home (like Les Mills BodyPump or BodyAttack, yoga, spinning etc). The prices at this gym are, however, more expensive (a three month membership will cost you about 500EUR), but you can also get single tickets if you want to go there every now and then (a single ticket is valid for a whole day for 20EUR). During the weekends, the hospital's social club arranges desert "hash" walks. These are big social events, and they are organised in a different location every week. There will be a shorter and a longer route from which you can choose from. You can also choose whether you run or walk the hash. Men and women are mixed but as these events are intended for Westerners, the dress code is Western as well (e.g. I'll wear normal sports wear - a top and shorts).  After the walk, there's always some snacks on sale, so people will sit down to eat and mingle after the exercise. Transportation to and fro from the hash is organised by the hospital social club so it's really easy to go along.

Practical matters

Currency

The currency is Saudi riyals (SR). I changed money before leaving Finland, because I felt that the first days would probably be hectic enough without extra worries. The compound has a bank, so basically you could change money after arrival also. Cash money plays a bigger role here than back home. There are places, including the compound market, that accept cash only. So just to be on the safe side, I'd encourage you to have some riyals on you on arrival. I changed about 800EUR, but in hindsight probably half of this would have been enough. Banking works better than I expected over here. Soon after arrival you need to open a bank account, and your salary will be paid to this account. In Finland I was warned that I'll need a lot of time and patience when going to the bank in Saudi. And yes, it took a bit more time than what I'm accustomed to back home, but after some paper-pushing everything worked out really well. It is really easy to transfer money home from here. You'll need to visit the bank for the first transaction (and might thus take some time), but after that you can make the transfer from a regular ATM. Bank and credit cards: The VISA cards work here for both payment and cash withdrawal. However, if you have a combination bank/credit card - it will always be charged from your credit card here. Also, if you lift money from your home account (from the ATM), there's a 10 EUR fee per withdrawal - so it's not worth it. Although I have no experience about the VISA electron card, I wouldn't feel comfortable with that being my only card here (considering that all my combination card purchases have been automatically charged from the credit side). Also, if you're thinking about travelling, a credit card will be an asset in booking both flights and hotels. Because you get your local bank account soon after arrival, I haven't really used my home bank account much since. The local account includes a local bank card that you can use for both withdrawals andpurchases.

Mobile phone and operator:

Setting up a local number was very easy. I brought my own mobile with me, and soon after arrival I bought a prepaid package from a local operator called "Mobily"; they even gave me extra credit with the opening package. You'll find the closest Mobily shop down the road in the big hypermarket - it's easy to buy more credit when you go to the store anyway. The local phone calls are very cheap. I text back home, but for calls I use Skype.Laptop computer: I also brought my own laptop with me, and I think it's a good thing to have. It's easy to phone home on Skype and you can take care of a lot of things on the net. There are computers that you can use in the lobby of my apartment building (the lobby is a common sitting room as well). They also have printers if you need to print anything. I'm also considering buying a new laptop from here. You can get a QWERTY keyboard so no need to worry that they only have keys with Arabic script.

At the hospital:General Nursing Orientation (NGO):

All new nurses take part in the NGO which lasts about three weeks. It is a group orientation and you'll meet nurses from all over the world. I found the orientation to be very comprehensive and useful. We went through the hospital policies and procedures and got to know the hospital itself. The first few days include a lot of very practical information about starting your life in Saudi. The early days are hectic as your setting up your bank account, getting a photo for the ID card the hospital requires, just learning to get around etc. They teach you a lot (and you learn a lot) during the orientation. All the new nurses are put on the same starting line as they want the new nurses to be standardised to the new hospital. This is actually really nice, because it creates a feeling of unity amongst the new nurses. Our group was very tight right from the beginning (and still is). I have many close friends from my GNO group - actually, I was just sun bathing with one of them. In addition to hospital personnel lecturing about work related matters, there were also local Saudi people telling us about the culture and life in Saudi Arabia, which I found very interesting and useful.The Job:The hospital is very big. In Finland I worked in a relatively big and busy hospital and I knew what to expect. At the moment I'm working in a 41 bedded Ward 3A (urology, radiation therapy, gastro). One nurse is in charge of more or less the whole nursing care of three patients. In Finland I was used to having more patients, but working with a pair. Here you are working mostly alone with the three patients that you have - mostly you'll take care of bed bathing by yourself as well (very heavy patients are a different story). The patients have a person called the "sitter" with them in their room constantly. The sitter helps us with the moving and turning the patient. The sitter can be either a relative or friend or a hired person with no previous ties to the patient.One major difference between my work in Finland and here is that although the ward I'm working on is considered an acute ward, there'll often be non-acute patients here as well. Even the ER might have a patient stay a week or so. There are no homes for the elderly or hospices, which is one reason for some non-acute patients lingering around for many months in acute wards. Another reason is that sometimes the next of kin have denied transfer. Because of this feature, your job might differ a little from what you're used to at home - you might suddenly be doing bed bathing in an acute setting. So, unlike in Finland, the work encompasses also the basic care of a patient.However, some aspects of the nursing job have been divided into much smaller parts. In Finland the nurse will take care of a patient rather holistically, and although you'll do the entire basic care for a patient here, you'll find that every speciality will have specialised nurse for this. For example, if one of my patients has trouble with breathing and needs a respirator or clearing of the airways, I'd call the "respiratory therapist", who will come and give the patient the care needed. Or another example, if one of my patients has a wound, I can call the "wound care nurse" and they can come and take care of it (or I can consult them over the phone). We also have a "IV nurse" who I can call if I couldn't get a cannula inserted for example.The administration of medication is also organised very differently and it's very time consuming over here. We use the PYXIS (medical supply station) system, which is apparently also in use in America, but I hadn't heard of it at home. How it works is that all the ward's medication is in the PYXIS station. The station has a touch screen. You log onto the system with your own finger print and you'll be able to view the patient list. So for example, if I want to give a patient their morning medication, I'll sign on, choose the patient from the list, open their patient file, which will have the patient's medication. Then I just click on the needed medication and the station is put into motion - a drawer will pop out and the screen will say "please take the medicine from drawer 1, box 3" (the drawers and boxes open according the order you choose the medication). The screen will also tell you the dosage. The nursing care including the administered medicine will be recorded in the hospital's computer system AISIC.  The administration of medication is very time consuming. For example my own ward is relatively big and we have only two PYXIS stations. This means that the queues to the stations are rather long especially in the morning, when the nurses are getting their patients' morning medicine ready. Also, sometimes the stations might be out of some medicine as they haven't been filled up in time. So you might end up queuing twice, first to station 1 and then to station 2, and if both are out, you'll end up calling the hospital's pharmacy and ordering the medication, which in practice might mean that you'll get the medication to the patient only in the afternoon. Contacting the pharmacy for a given medicine requires you to first send a faxand then ring them on the phone. There are definite pros and cons with the PYXIS system. A definite con in my opinion is that it's very time consuming. Pros, on the other hand, include that it's definitely much more difficult to give the patient the wrong medication or the wrong dosage - in fact, it's almost impossible. Another pro is that the misuse of medicine etc. is also much more difficult. Another difference between administering medication here and back home is that all the medicine here will be ready mixed or diluted. For example in Finland the nurse will dilute the antibiotics (according to prescription) themself. Here, the doctor's prescription will go straight to the pharmacy, and the ready solution will come to the ward from the pharmacy. This of course will save you some time. As a whole, however, giving the patients their medication will take a significant amount of time. Also, we have a lot of "high alert drugs" here - much more than back home. Some medication that would be considered rather standard medicines back at home, have earned the high alert status here. To administer these medicines, you'll need a witness (another nurse) so that you can record it.

Learning Arabic?

I was rather surprised how beneficial it would be to know some Arabic. I thought that the interpretation service at the hospital would be more comprehensive than what it is. Each ward has an interpreter known as the "Patient Care Assistant" (who has other duties as well). Sometimes, when the interpreter isn't available, I have to rely on my helpful colleagues to interpret for me. We have a radiophone that we can use to call the interpreter's work desk as well. The interpreter shares an office with the Charge Nurse, who can also help with interpreting. Many nurses wish that the interpreter would be physically present more, rather than work through the phone because sometimes the patient asks more questions from you after the call ends. Of course sometimes they do come into the room with you, but I'd wish they'd do this more often. I've also been encouraged to learn Arabic after arrival - I didn't quite grasp the benefit of learning even the basics of the language before starting my job. Of course, how much you come to need the language varies from which unit or ward you're working in. Sometimes I get frustrated when I can't relate the simplest of things to the patient. The hospital facilitates the learning of Arabic - there are numerous courses you can attend if you want to. I have learned some of the most common phrases. I think a nurse coming here should be prepared to have a lot of patience with the language barrier. The hospital strives to maintain English as the working language (but sometimes you have to remind local doctors who are conversing with one another to remember to translate what they just said). The patients might get frustrated with the language barrier sometimes, and you have to remember not to take it personally. On admission to the hospital, the patient will have to sign a waiver that says something on the lines that "I understand that the clinical care staff in KFSH&RC does not necessarily speak Arabic". So basically the patients should be aware that you don't necessarily speak their language. The majority of patients, however, are extremely pleasant and cooperative. They are genuinely happy if you as much and try to utter a word or two in Arabic. In general they are very pleased with the care they receive. The culture is very different from what I'm used to. Many of the patients want to offer you something to drink or to eat as a thank you. Sometimes I get little presents from the patients, which is very different from the way back home. For example I had one patient whose wife gave me two Max Factor lipsticks as a thank you gift for taking care of her husband. So most of the patients are really warm and amiable, and overall I have much more positive experiences than negative ones.

Uniform?

The dress code at work is similar to Finland, or a bit livelier actually because you're allowed to wear colourful shirts. Back home we always had a full white costume. Here you get a white outfit from the hospital, but you can wear a shirt of your own with colours or patterns (Hello Kitty and Winnie the Pooh galore). The trousers should always be white. You need to bring your own shoes for work. They need to be light coloured but not necessarily white. You see people wearing e.g. light pink and beige shoes in addition to white. I like this aspect of work clothing, and considering the dress code in general, I found it quite surprising. The work atmosphere is great and I really like my colleagues. I received a warm welcome to my ward and felt appreciated straight away. I spend a lot of time with my colleagues on my free time as well. Actually, I have only good things to say about my colleagues. I think a multicultural working environment is a richness and that you can learn a lot from it. I haven't personally encountered any clashes, but I've heard that sometimes these occur due to cultural differences. There aren't any Finns on my ward, but I know a lot of them well from the compound.

Contact me through Profco nurses@profco.com