Center for International Education
December 2006

Raelene Shippee-Rice, Associate Professor of Nursing

Professor Shippee-Rice returned to Bulgaria after working for six months on a Fulbright grant, to conduct a seminar series on hospice care for nurses, physicians and social workers.


Raelene Shippee-Rice
Professor Shippee-Rice sharing breakfast withfriends in a mountain village near Gabrovo.

During the six months in Bulgaria sponsored by the Fulbright Commission, I conducted 14-week seminars on professional nursing practice and on care of patients with mental illness; taught a graduate social work course; completed a research project on Health care of older adults; conducted guest lectures at Schools of Nursing in Sofia and Plovdiv; met with families, colleagues and scholars; and read extensively to learn about Bulgarian ancient and modern history, culture, traditions, and current social and health care policies. In addition to the directors of healthcare agencies with whom I worked, I met with several other directors who were interested in the work I was doing in Bulgaria and who invited me to return to work with their organizations. The major purpose of the new work was to conduct a seminar series on hospice care for nurses, physicians and social workers involved in a clinic and social service agency interested in developing a hospice center for older adults.

I conducted seminars of approximately two hours each with two groups of nurses: one at a Diagnostic Clinic in Gabrovo on communicating with patients and a second at a Diagnostic Clinic in Sofia on the meaning of palliative care and hospice and communicating with patients. Approximately 20 nurses attended the seminar in Gabrovo with 50 attending the seminar in Sofia.

In Bulgaria, nurses are expected to carry out the 'doctor's orders' but are prevented by physicians from sharing any information about the purpose or expected outcome of the treatment or doing any patient teaching. Nurses also spend much of their time "completing the documents," their words for the work they do compiling and ensuring the completeness of the patients' medical records, ordering medications and supplies, and making future appointments for patients. Administrative assistants in the US typically do much of this written and scheduling work allowing the nurses to spend time helping patients manage their care and treatment. For the full report, visit