Dear Editor,
Recently, the media has been carrying debates and commentaries on several issues surrounding the education and training of aspirants in the critical field of nursing; major factors seem to include methodical aspects such as the formal academic attainment of students, the size of classes, teachers lacking the necessary clinical preparation, teaching aids, computers, etc, coupled with the usual ‘finger pointing’ to other persons, programmes and facilities so typical of our compatriots. It is interesting to note that one of the letters actually ended with the following alibis: “this is happening across the board … there [are] certainly some weaknesses in the education system…the students represent a microcosm of the society”
My interest in this matter has been heightened by the fact that I have just spent a week at a Canadian hospital where I was able to observe and discuss the factors that facilitated the exceptionally high quality of ‘service excellence’ among all categories of staff, with particular reference to the nursing and support staff (most of whom originate from the so-called third world like Guyana). This phenomenon in and of itself was not surprising to me, but in comparison with what obtains in Guyana (based on personal observation and anecdotal reports over the years by several individuals as well as the media), the contrast is considerable and calls for attention by the practitioners and authorities throughout Guyana’s medical services. While extrinsic factors such as working conditions, compensation issues, recruitment, education/training, etc, are all relevant, my experience convinces me that the intrinsic factors of individual staff attitude and behaviour are paramount.
I take this opportunity to emphasize (for credibility, not self-promotion which at this stage of my life is wholly unnecessary) the fact that my involvement in such matters is wide-ranging and long-lasting. For example, when I migrated to Canada in the 1970s, my first job was in the Human Resource Department of a world famous hospital in Ontario; my initial assignment was in job evaluation among the nursing and support staff with a view to ‘resolving’ perceived compensation disparities/ inequities among this group of employees. During the exercises, the phenomenon that struck me most was the fact that neither the individual staff nor their staff association, akin to a union, allowed whatever grievances they might have had with the employer to detract from their primary interest and attention to their patients. My experiences since then underscored the importance of employers and employees and their representatives recognizing that when it comes to customer-service/patient-service kinds of employment, the intrinsic, individual attitudes/behaviours of employees trump all other considerations. In this regard, the focus of people responsible for developing future nursing and other employees in related occupations must include as virtual prerequisites, the essential underlying attitudinal and behavioural components.
Training per se is not a panacea but its effectiveness is enhanced by focused, need-based and differentiated approaches. If not we risk incurring costly futility, like the farmer who indiscriminately throws fertilizers or chemicals on barren soil; if the ‘students’ are not receptive through no fault of their own or because their needs were improperly diagnosed, no pre-determined formula will produce beneficial results. Therefore, foci on syllabus, methodology, teaching aids, classroom size, etc, will not make any difference if the learning population is in discord with the objective and modality of the training population. In this regard, a unilateral focus on clinical nursing training tools to the virtual exclusion of empathy, attitude, behaviour of the students is counter-productive and wasteful; ask the average user of our medical services, the man-in-the-street, what he thinks of our medical services, what bothers him most. I believe the resounding response you will get is not lack of technical knowledge, but absence of humane considerations, arrogance and disrespect for the due rights of patients and their families.
What’s the point in having the technical/clinical knowledge when its application is frustrated by trained staff who are as different from the proverbial Florence Nightingale as chalk is to cheese!
Yours faithfully,
Nowrang Persaud
