Expecting pumpkins from karila vines

Twelve days ago, the world observed Inter-national Nurses Day on May 12. In some countries, governments, in collaboration with nurses’ councils and associations, held activities over the period of a week, dubbing it ‘Nurses Week’. In too many places, the day or week during which some officials gave grandiose speeches was nothing but a paltry attempt to recognise the contributions nurses have made/are making in global health care. Though it failed to hit the mark, that box was quickly ticked and closed for another year.

Here at home, it was reported that the Health Department of the Region Four Administration coordinated an event sponsored by ANSA McAL in which 15 awards were handed out to 6 health centres, seven nurses and two community health workers. Region Four must have hundreds of nurses employed at its three public hospitals and over two dozen health centres, clinics and posts. It is the most populous of the country’s 10 administrative regions. Yet only seven of its nurses were deemed outstanding enough to have qualified for awards; there were no runners-up.

Furthermore, a vague promise was made at the event by a regional official that the Regional Democratic Council, cognisant of the challenges nurses face, would be moving to improve their working conditions. No timeline was given as to when nurses might expect to see any improvements, where they would begin and what they would include. Perhaps that promise should be filed away under ‘fluff officials say on certain days’.

Earlier, that same week, however, Minister of Public Health Volda Lawrence, delivering an address at an event to mark the 90th anniversary of the Guyana Nurses Association (GNA), promised nurses that a 30-acre, state-of-the-art training facility for nurses would be built and added that a request had been made to the Ministry of the Presidency to have the Guyana Lands and Surveys Commission make the land available. This is good news, or at least it will be once that stretch of red tape has been conquered. After that, the issues that will arise over funding to build and furnish it and finding qualified staff to run it will no doubt resolve themselves. It sounded as though Minister Lawrence had only to wave her magic wand. On the scale of grandiose gestures, that was surely an 11.

Moreover, Minister Lawrence promised the nurses gathered that a month would be set aside during which all medical personnel in the public health system would have access to total medical checkups. She said she had noticed doctors and nurses working while “gravely ill”.

It is sad but true that many nurses and their families do not benefit from good medical care, somewhat like shoemakers’ children always being the worse shod. However, the minister may find that one month is unlikely to be sufficient if these medical checks are to be done correctly and equitably across the public health care system.

The sad fact is that nurses should also be benefiting from ongoing mental health care—basic counselling at the very least—to help them cope with the psychological and sometimes emotional toll that comes from dealing with sick and dying people on a daily basis. This is outside of the nurses who tend to psychiatric patients.

While nursing is a profession, nurses are people. They have lives just like the rest of us with similar challenges including, but not limited to: children, spouses, elderly parents to care for, long working hours for low pay, mortgages and bills. Yes, they are trained to care. But as far as local training is concerned, let us admit that it has been at best basic and at worse mediocre, at least in recent years.

Lest we forget, back in 2010, a World Bank study done on the nursing shortage in the English-speaking Caribbean highlighted a “sub-optimal quality of training” in Guyana and noted that nursing students were allowed to write their final exams three times.

The then government did not address the situation and in 2012, 80.5 percent of the nursing students who wrote the final exam failed. One must presume that they failed after their third attempt. If the former health ministers Dr Leslie Ramsammy and Dr Bheri Ramsaran were to be believed, back then either $600 million or $345 million was being spent annually on nurses training. With an 80.5 percent failure rate, it would be safe to say that the money was being wasted.

This went on for some time. Parliament heard in 2014: “Of the 255 students who entered the 3-year professional nursing programme in 2010 only 120 wrote the final exam and of those only 19 were successful. There was a total failure at the New Amsterdam School of Nursing, no one was successful. Stated more concisely, it can be said that less than 10% of the original intake completed the programme successfully.”

Student nurses and lecturers had long complained about overcrowding, which made teaching difficult. High intakes at the country’s three nursing schools started in 2005, but there was no commensurate hiring of lecturers. At one point there was reported to be eight full-time lecturers to 540 students, many of whom could not fit into the classrooms and stood outside in the corridor during teaching periods.

Suffice it to say that the treatment of nurses from training to employment does not gel with the claims by any administration to date that national health care is a priority. One cannot expect karila vines to produce pumpkins; yet somehow the concept of reaping what one sows and getting back what one puts in seems lost on those in authority. Perhaps Minister Lawrence should have contemplated these idioms before calling on nurses to improve the public image of their profession, at the GNA’s 90th anniversary. Her lament that the nursing profession was “falling into disarray…” and seemed to lack “discipline, dedication, integrity, ethics and professionalism” could surely also be directed at the politicians who contributed to such a situation. It will be interesting to see how quickly Ms Lawrence and her government moves to correct the errors that have clearly been made thus far.

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