Many have suggested that nurses are the backbone of any given health facility. I find that line cliche and exhaustively tiring. It lacks the zest that the users intend and it falls just a punctuation mark of sarcasm. Being a nurse morphed from being a call; thanks to Catholic nuns of eons ago, into being a profession; thanks to the modern theorists of the nursing profession.
When the world is grappling with the demon that is Covid-19, nurses can not afford to panic. They can’t afford a second to sit back and wonder what their next move should be. Like ambushed soldiers in the battlefield, they have to figure it out while donning the armour of service to all mankind.
With trepidation nurses from across the globe have decried lack of proper personal protective equipment. Many might say I am biased towards nurses and God knows I am. A nurse spends the most hours in contact with patients exhibiting signs and symptoms of Coronavirus. Nurses are also the first people to interact with these patients. The level of exposure therefore, is undoubtedly greater amongst nurses of all levels.
This is especially so in my country Kenya and other third world countries where we do not necessarily have carers to work alongside us.
Equip the Nurses
Indeed nurses took the Florence Nightingale path and swore to do no harm. This is not a prerogative for committing suicide. Suicide is used loosely here to refer to working in precarious situations with the necessary personal protective equipment. Nurses need to he trained on the use of the same as well. There is a well packaged load of Covid-19 in and around Nurse’s workplacwa.
It ia futile to clap for us and call us amazing heroes of healthcare if you won’t provide PPEs. That is an empty song whose void tunes assault the listeners. Nurses must be equipped. Without this vital move, we can be sure that other efforts against Covid-19 will be self-defeating.
An exposed nurse will easily transmit the disease to many patients within the hospital and carry some of the virus with her to her household. Then waves upon waves of new infections will continue to be witnessed. We must break the chain of transmission by ensuring the right gear is with the right folks.
Unions and associations of nurses keep pushing governments to ensure that gloves, gowns, face shields and proper masks are provided. This is not the time to play superiority games. It is a time to save the nurse as they save humanity from possible annihilation.
Train The Nurse
I must applaud the Training of Trainers ( TOTS) rolled out by the Kenyan Ministry of Health. However the timing is wrong. What we lack as a country is disaster preparedness. When the first case was reported in other parts of the world, this was a golden opportunity for nurses to be trained on what to do in the event Covid-19 hits Kenya.
Case definitions and identification cycles should have been distributed to all the six levels of healthcare in Kenya by now. What we are currently doing is playing catch up while we already have one death from Coronavirus.
We have very few critical care nurses in Kenya. Majority of the ones that work in such set ups especially in private hospitals are not properly trained to execute the roles of a critical care nurse. This is a time where we need rapid response initiatives. I implore the government through the capable Ministry of Health to not only focus on prevention training but also management.
Nurses need refresher courses on use of the available ventilators and maintenance of negative pressure rooms ( if we have any!)
When doctors are busy shuffling between one critically Ill patient to the other, it is the nurse who is left to man an entire shift at any particular point. We need to make sure that we have a standardised way of response. This is possible through retraining.
We must eliminate gaps and make sure that what a Covid-19 patient is getting in terms of management at Kenyatta National Hospital in the ICU is replicated in Kilifi County ICU. That gives us a standard operating system which even allows for proper consultation and follow up.
We can not hide our heads in the sand and assume that everyone working in the ICU is good to go. Just because we can incubate and extubate does not mean we are qualified as critical care nurses.
I know it is a desperate time which calls for desperate measures. Part of that is immediately training nurses in all departments on use of ventilators, monitors and a thousand other equipment in an ICU set up. We may have started late but last I checked, Kenya is a running country and we sure as the blue sky above can catch up.
Protect The Nurse
With nostalgia I remember the last strike nurses held. It was in 2017 and politically heated. Nurses kept asking for a review of Risk allowance. I will always recall the headline that screamed that Nurses were dancing on the graves of patients. For some reason I took a picture of that headline and sometimes I refer to it when I want to remind myself how bad editing can damage a profession.
It is immoral to award some healthcare workers a risk allowance of Kes 20,000 and casually throw Kes3,850 to nurses. This is sacrilegious. An insult. A strategy made by the devil’s advocates. Nurses take shifts as most other healthcare providers take calls. Nurses do not even enjoy the huge medical cover benefits accorded other cadres. It is therefore sick to call nurses heroes while throwing them under the bus with the greatest risk of crushing.
Protect nurses as they continue protecting us. If not for them, then for their children who they keep exposing to Covid-19 after every exhausting shift. Other counties resorted to contracting nurses on short term contracts. This is a time to give the nurses a permanent and pensionable slot with all benefits awarded other healthcare professionals.
Even as the government rolls out plans to employ more nurses to beat Covid-19, it behooves all counties to ensure no nurse is on a temporary contract. We will need the additional workforce even post Covid-19. That calls for the government to ensure that the new nurses to be employed won’t be given shoddy contracts but pulled into the payroll under permanent and pensionable terms.
We can go back to hating the nurses we are presently calling godsend later. We can resort to disrespecting them and calling them expensive derogatory terms after this crisis. As for now, all efforts must be geared towards protecting this vulnerable group.
As you were!